Nokea
The nurse is reviewing the laboratory results of a client with hypothyroidism. An expected finding is:
- A. Decreased thyroxine (T4) and increased thyroid-stimulating hormone (TSH) levels
- B. Decreased TSH and increased T4 levels
- C. Decreased creatine phosphokinase levels
- D. Absence of antithyroid antibodies
Correct Answer: A
Rationale: Hypothyroidism is characterized by decreased thyroxine (T4) and increased TSH as the pituitary attempts to stimulate the thyroid. Other options are inconsistent with hypothyroidism.
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The nurse is caring for a client with a history of chronic obstructive pulmonary disease who is prescribed salmeterol (Serevent). The nurse should instruct the client to:
- A. Use the inhaler as needed for shortness of breath.
- B. Rinse the mouth after using the inhaler.
- C. Shake the inhaler before use.
- D. Use the inhaler twice daily.
Correct Answer: D
Rationale: Salmeterol is a long-acting bronchodilator used twice daily for maintenance therapy in COPD.
When you are monitoring your client who is now started on an intravenous antibiotic for an infection, you notice that the client is exhibiting signs of anaphylaxis. What is your first priority intervention?
- A. Stop the intravenous flow
- B. Slow down the intravenous flow
- C. Notify the doctor
- D. Begin CPR
Correct Answer: A
Rationale: Stopping the IV flow is the first priority to halt the administration of the allergen causing anaphylaxis, followed by other emergency interventions.
A client with a history of type 2 diabetes mellitus is prescribed glipizide (Glucotrol). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild nausea.
- B. Hypoglycemia.
- C. Weight gain.
- D. Fatigue.
Correct Answer: B
Rationale: Hypoglycemia is a serious side effect of glipizide, requiring immediate reporting to prevent complications.
A newborn diagnosed with respiratory distress syndrome (RDS) is prescribed surfactant replacement therapy. The nurse evaluates the infant 1 hour after the therapy and determines that the infant's condition has improved somewhat. Which finding indicates improvement?
- A. An audible respiratory grunt
- B. Slight increase in the respiratory rate
- C. Arterial blood pH increases to ≥ 7.35
- D. Fine inspiratory crackles heard over both lungs
Correct Answer: C
Rationale: RDS causes hypoperfusion with hypoxemia that results in tissue hypoxia and metabolic acidosis. If the arterial blood pH increases to ≥ 7.35, the metabolic acidosis is resolving and the newborn's condition is improving. Within a few hours, respiratory distress becomes more obvious in RDS. The respiratory rate continues to increase (to 80 to 120 breaths/min), so a gradual increase in rate does not mean that the condition is improving. Also, an audible respiratory grunt and fine inspiratory crackles heard over both lungs are not signs the condition is improving.
A client with a history of heart failure is prescribed carvedilol (Coreg). The nurse should instruct the client to:
- A. Monitor blood pressure regularly.
- B. Take the medication with meals.
- C. Avoid potassium-rich foods.
- D. Stop the medication if dizziness occurs.
Correct Answer: A
Rationale: Carvedilol can cause hypotension, requiring regular blood pressure monitoring.