Nokea
The physician has prescribed Synthroid (levothyroxine) for a client with myxedema. Which statement indicates that the client understands the nurse's teaching regarding the medication?
- A. I will take the medication each morning after breakfast.
- B. I will check my heart rate before taking the medication.
- C. I will report visual disturbances to my doctor.
- D. I will stop the medication if I develop gastric upset.
Correct Answer: C
Rationale: Reporting visual disturbances is important, as levothyroxine can rarely cause visual changes, indicating a need for medical evaluation. It should be taken before breakfast, not stopped for gastric upset.
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Which of the following findings would necessitate discontinuing an IV potassium infusion in an adult with ketoacidosis?
- A. Urine output 22 mL/hr for 2 hours
- B. Serum potassium level of 3.7
- C. Small T wave of ECG
- D. Serum glucose level of 180
Correct Answer: A
Rationale: Adequate renal flow of 30 mL/hr is a necessity with potassium infusions because potassium is excreted renally. Because potassium level will decrease during correction of diabetic ketoacidosis, potassium will be infused even if plasma levels of potassium are normal. A small T wave is normal and desired on the electrocardiogram. A tall, peaked T-wave could indicate overinfusion of potassium and hyperkalemia. Glucose levels of <200 are desirable.
The client at 35 weeks gestation is admitted with a diagnosis of vasa previa. The nurse should monitor for which complication?
- A. Fetal bleeding
- B. Maternal hemorrhage
- C. Preterm labor
- D. Fetal macrosomia
Correct Answer: A
Rationale: Vasa previa involves fetal blood vessels crossing the cervical os risking rupture and fetal bleeding during labor or membrane rupture. Maternal hemorrhage preterm labor and macrosomia are less directly related.
The nurse is caring for an adolescent with a five-year history of bulimia. A common clinical finding in the client with bulimia is:
- A. Extreme weight loss
- B. Dental caries
- C. Hair loss
- D. Decreased temperature
Correct Answer: B
Rationale: Frequent vomiting in bulimia exposes teeth to stomach acid, leading to dental caries (tooth decay), a common clinical finding.
A 12-year-old girl has been diagnosed with insulin-dependent diabetes mellitus. Which of these principles would best guide her nutritional management?
- A. Concentrated sweets are taken during increased activity.
- B. Food restriction is imposed to reduce weight.
- C. Caloric distribution should be calculated to fit activity patterns.
- D. Fat requirements are increased owing to the possibility of ketoacidosis.
Correct Answer: C
Rationale: Concentrated sweets are eliminated from diet planning. Complex carbohydrates may be taken at the time of increased activity. Food restriction is not used for diabetic control of growing children. Caloric restriction may be imposed for weight control if necessary. Total caloric intake and proportions of basic nutrients should be consistent from day to day. Distribution of these calories should fit the activity pattern. Extra food is needed for increased activity. A balance of food, exercise, and insulin should be maintained. Because of the increased risk of atherosclerosis, the fat percentage of the total caloric intake is reduced.
The nurse is caring for a client who has diabetes insipidus. The nurse would describe this client's urine output pattern as:
- A. Anuria
- B. Oliguria
- C. Dysuria
- D. Polyuria
Correct Answer: D
Rationale: Polyuria is a primary symptom of diabetes insipidus. These clients have decreased or absent vasopressin secretion, which causes water loss in the urine and sodium increases.