Nokea
The physician diagnoses Graves' disease for a 28-year-old woman seen in the clinic. The nurse would expect the client to exhibit which of the following symptoms?
- A. Lethargy in the early morning.
- B. Sensitivity to cold.
- C. Weight loss of 10 lb in 3 weeks.
- D. Reduced deep tendon reflexes.
Correct Answer: C
Rationale: increased metabolic rate causes weight loss even with increased appetite
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A 70 year-old woman is evaluated in the emergency department for a wrist fracture of unknown causes. During the process of taking client history, which of these items should the nurse identify as related to the client's greatest risk factors for osteoporosis?
- A. History of menopause at age 50
- B. Taking high doses of steroids for arthritis for many years
- C. Maintaining an inactive lifestyle for the past 10 years
- D. Drinking 2 glasses of red wine each day for the past 30 years
Correct Answer: B
Rationale: Taking high doses of steroids for arthritis for many years. The use of steroids, especially at high doses over time, increases the risk for osteoporosis. The other options also predispose to osteoporosis, as do low bone mass, poor calcium absorption and moderate to high alcohol ingestion. Long-term steroid treatment is the most significant risk factor, however.
Based on principles of teaching and learning, what is the best initial approach to pre-op teaching for a client scheduled for coronary artery bypass?
- A. Touring the coronary intensive unit
- B. Mailing a video tape to the home
- C. Assessing the client's learning style
- D. Administering a written pre-test
Correct Answer: C
Rationale: Assessing the client's learning style. Tailoring teaching to the client's learning preferences enhances understanding.
An older adult is admitted with severe pneumonia. Which of the following measures should the nurse include in the plan of care immediately after admission? Select all that apply.
- A. Encourage the client to drink 2 L of fluid daily.
- B. Administer antipyretics as ordered.
- C. Administer antibiotics as ordered.
- D. Administer mucolytics as ordered.
- E. Ambulate three times a day.
- F. Eat three large meals a day.
Correct Answer: A,B,C,D
Rationale: Fluids hydrate and thin secretions, antipyretics control fever, antibiotics treat infection, and mucolytics aid mucus clearance in pneumonia. Ambulation and large meals may be inappropriate initially due to fatigue.
The nurse is caring for a client with an electrical burn. Which structures have the greatest risk for soft tissue injury?
- A. Fat, tendons, and bones
- B. Skin and hair
- C. Nerves, muscle, and blood vessels
- D. Skin, fat, and muscle
Correct Answer: A
Rationale: Fat, tendon, and bone have the most resistance. The higher the resistance, the greater the heat generated by the current, thereby increasing the risk for soft tissue injury. Answer B has intermediate resistance, so it is incorrect. Answer C is incorrect because it has very low resistance. Answer D has low to intermediate resistance, so it is incorrect.
The nurse is caring for a client with a history of cirrhosis who is receiving lactulose (Chronulac) 30 mL PO tid. Which of the following findings should the nurse report immediately?
- A. Ammonia level of 40 mcg/dL.
- B. Potassium 3.5 mEq/L.
- C. Diarrhea with 4 stools per day.
- D. Sodium 140 mEq/L.
Correct Answer: C
Rationale: Diarrhea with 4 stools per day suggests lactulose overdose, risking dehydration. Options A, B, and D are normal.