The nurse is teaching the client who lacks parathyroid hormone (PTH) about foods to consume. Which items should be included on a list of appropriate foods for the client?
- A. Dark green vegetables, soybeans, and tofu
- B. Spinach, strawberries, and yogurt
- C. Whole grain bread, milk, and liver
- D. Rhubarb, yellow vegetables, and fish
Correct Answer: A
Rationale: High-calcium foods like dark green vegetables, soybeans, and tofu are appropriate for hypoparathyroidism to address chronic hypocalcemia.
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Which signs/symptoms indicate the client with hypothyroidism is not taking enough thyroid hormone?
- A. Complaints of weight loss and fine tremors.
- B. Complaints of excessive thirst and urination.
- C. Complaints of constipation and being cold.
- D. Complaints of delayed wound healing and belching.
Correct Answer: C
Rationale: Constipation and cold intolerance indicate persistent hypothyroidism due to inadequate thyroid hormone. Weight loss/tremors, thirst, and healing/belching are unrelated.
What is the nursing priority when administering care to a client with severe hyperthyroidism?
- A. Assess for recent emotional trauma.
- B. Provide a calm, nonstimulating environment.
- C. Provide diversionary activity.
- D. Encourage range-of-motion exercises.
Correct Answer: B
Rationale: A calm, nonstimulating environment reduces hyperactivity and stress in hyperthyroidism, which exacerbates symptoms.
The client is three (3) days postoperative unilateral adrenalectomy. Which discharge instructions should the nurse teach?
- A. Discuss the need for lifelong steroid replacement.
- B. Instruct the client on administration of vasopressin.
- C. Teach the client to care for the suprapubic Foley catheter.
- D. Tell the client to notify the HCP if the incision is inflamed.
Correct Answer: D
Rationale: Notifying the HCP for incision inflammation prevents infection post-adrenalectomy. Lifelong steroids are for bilateral procedures, vasopressin is for DI, and Foley catheters are not standard.
Which documentation finding provides the best indication that the client has successfully avoided an adrenal (addisonian) crisis after surgery?
- A. The client's pedal edema has lessened.
- B. Capillary blood glucose level is within normal limits.
- C. Vital signs are within preoperative ranges.
Correct Answer: C
Rationale: Stable vital signs indicate the absence of adrenal crisis, characterized by hypotension and shock.
A client is diagnosed as having insulin-dependent diabetes mellitus (IDDM). She received regular insulin at 7:30 A.M. When is she most apt to develop a hypoglycemic reaction?
- A. Mid-morning
- B. Mid-afternoon
- C. Early evening
- D. During the night
Correct Answer: A
Rationale: Regular insulin peaks 2-4 hours after administration, making mid-morning (9:30-11:30 A.M.) the most likely time for hypoglycemia.
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