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What is the most common cause of hyperaldosteronism?
- A. Excessive sodium intake
- B. A pituitary adenoma
- C. Deficient potassium intake
- D. An adrenal adenoma
Correct Answer: D
Rationale: An adrenal adenoma is the most common cause of primary hyperaldosteronism. Hyperaldosteronism is typically caused by an adrenal adenoma, a benign tumor in the adrenal gland that leads to excessive aldosterone production. Excessive sodium intake (Choice A) does not directly cause hyperaldosteronism. Pituitary adenoma (Choice B) is associated with conditions like Cushing's disease, not hyperaldosteronism. Deficient potassium intake (Choice C) can lead to hypokalemia but is not a common cause of hyperaldosteronism.
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The healthcare provider is assessing a client with hypothyroidism. Which of the following clinical findings would the healthcare provider expect?
- A. Tachycardia
- B. Weight loss
- C. Cold intolerance
- D. Diaphoresis
Correct Answer: C
Rationale: Cold intolerance is a classic symptom of hypothyroidism. In hypothyroidism, the body's metabolic rate is decreased, leading to a reduced ability to regulate body temperature. As a result, individuals with hypothyroidism often feel cold, especially in their extremities. Tachycardia (A) is more commonly associated with hyperthyroidism due to the increased metabolic rate. Weight loss (B) is also a typical finding in hyperthyroidism, as the body burns calories at a faster rate. Diaphoresis (D), excessive sweating, is not a typical symptom of hypothyroidism.
A nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is at risk for excess fluid volume?
- A. The client taking diuretics
- B. The client with renal failure
- C. The client with an ileostomy
- D. The client who requires gastrointestinal suctioning
Correct Answer: B
Rationale: The correct answer is B. Clients with renal failure are unable to excrete fluids effectively, leading to an increased risk of fluid volume excess. Option A, the client taking diuretics, would be at risk for fluid volume deficit due to increased urine output caused by the diuretics. Option C, the client with an ileostomy, is at risk for fluid volume deficit due to increased output from the ileostomy. Option D, the client who requires gastrointestinal suctioning, may be at risk for dehydration, but not specifically excess fluid volume.
A client with Cushing's syndrome is being monitored for complications. Which of the following findings should the nurse report to the healthcare provider immediately?
- A. Hypertension
- B. Hyperglycemia
- C. Low-grade fever
- D. Weight gain
Correct Answer: C
Rationale: The correct answer is C: Low-grade fever. A low-grade fever may indicate an infection, which is a serious concern in clients with Cushing's syndrome due to their immunosuppressed state. Hypertension and hyperglycemia are common manifestations of Cushing's syndrome and may not require immediate reporting unless severe or uncontrolled. Weight gain is also a common symptom in clients with Cushing's syndrome and may not warrant immediate reporting unless it is sudden and significant.
A client with DM is being taught about the importance of monitoring blood glucose levels. The nurse should instruct the client to monitor blood glucose:
- A. Before meals and at bedtime.
- B. Only after meals.
- C. Only in the morning.
- D. Only when feeling unwell.
Correct Answer: A
Rationale: The correct answer is to monitor blood glucose levels before meals and at bedtime. This timing allows for a comprehensive understanding of how the body responds to food intake and to assess fasting glucose levels. Monitoring blood glucose only after meals (Choice B) may miss important pre-meal fluctuations. Checking glucose levels only in the morning (Choice C) overlooks the impact of meals throughout the day. Monitoring blood glucose only when feeling unwell (Choice D) is reactive and does not provide consistent data for managing diabetes effectively. Therefore, monitoring blood glucose before meals and at bedtime helps in maintaining good glucose control and preventing complications.
Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?
- A. Tetany
- B. Hemorrhage
- C. Thyroid storm
- D. Laryngeal nerve damage
Correct Answer: A
Rationale: The correct answer is 'Tetany.' Tetany is characterized by muscle twitching, tingling, and numbness, which are indicative of hypocalcemia. After a thyroidectomy, accidental removal or damage to the parathyroid glands can lead to decreased calcium levels, resulting in tetany. Choice B, 'Hemorrhage,' is incorrect as it typically presents with symptoms such as sudden swelling, increased pain, or drop in blood pressure. Choice C, 'Thyroid storm,' is incorrect as it involves a sudden exacerbation of hyperthyroidism, leading to symptoms like fever, tachycardia, and confusion. Choice D, 'Laryngeal nerve damage,' is incorrect as it would manifest with voice changes, difficulty swallowing, or respiratory distress, not the symptoms described in the scenario.