Nokea
The nurse is interviewing a client taking prescribed methimazole for hyperthyroidism. Which assessment finding requires notification to the physician?
- A. body mass index (BMI) 23
- B. sore throat
- C. pulse (P) 84
- D. skin rash
Correct Answer: B
Rationale: Sore throat may indicate agranulocytosis, a rare but serious methimazole side effect, requiring immediate physician notification. BMI 23, pulse 84, and skin rash are less urgent unless severe.
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The nurse is caring for a client eight hours postoperative following a total thyroidectomy. Which of the following assessment findings indicate that the client is developing a complication?
- A. Moderate amount of dried sanguineous drainage on the dressing
- B. Oral temperature of 99.2°F (37.3°C)
- C. Apical pulse of 56
- D. The client reports a sore throat when speaking
Correct Answer: A
Rationale: Excessive drainage post-thyroidectomy may indicate hemorrhage, a serious complication. A slightly elevated temperature, mild bradycardia, and sore throat are expected or less concerning in the immediate postoperative period.
The nurse is caring for a client who developed a thyroid storm. The nurse should obtain a prescription for
- A. enalapril
- B. regular insulin
- C. levothyroxine
- D. dexamethasone
Correct Answer: D
Rationale: Thyroid storm requires blocking excess thyroid hormone effects. Dexamethasone reduces hormone release and inflammation. Enalapril is for hypertension, insulin for glucose, and levothyroxine worsens the condition.
The nurse is teaching a client who has Graves' disease about self-management. Which of the following should the nurse include in the teaching plan?
- A. Stool softeners can be taken daily to prevent constipation.
- B. Thyroid replacement should be taken first thing in the morning.
- C. Report any significant weight gain while taking the antithyroid medication.
- D. Maintain the prescribed fluid restriction to prevent fluid overload.
Correct Answer: C
Rationale: In Graves' disease, antithyroid meds control hyperthyroidism; significant weight gain may signal overtreatment, needing reporting. Stool softeners, thyroid replacement, and fluid restriction are for hypothyroidism or other conditions.
The nurse is caring for a client newly diagnosed with Cushing's disease. Which of the following client statements requires follow-up?
- A. I will need to eat more potassium-rich foods.
- B. I will need more steroids during periods of stress.
- C. I will be at a higher risk for an infection.
- D. I should do weight-bearing exercises.
Correct Answer: A
Rationale: Cushing's causes hyperkalemia, so more potassium-rich foods are harmful and need follow-up. Extra steroids for stress, infection risk, and weight-bearing exercises are appropriate.
The nurse is caring for a client who presents with hyperglycemia. Which of the following findings are expected?
- A. Blurred vision
- B. Increased urinary output
- C. Cool and clammy skin
- D. Tachycardia
- E. Orthostatic hypotension
Correct Answer: A, B, D
Rationale: Hyperglycemia causes blurred vision (osmotic lens changes), increased urination (osmotic diuresis), and tachycardia (dehydration response). Cool, clammy skin is typical of hypoglycemia, and orthostatic hypotension is less specific.