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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.
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The client admitted to rule out pancreatic islet tumors complains of feeling weak, shaky, and sweaty. Which priority intervention should be implemented by the nurse?
- A. Start an IV with D5W.
- B. Notify the health-care provider.
- C. Perform a bedside glucose check.
- D. Give the client some orange juice.
Correct Answer: C
Rationale: Weakness, shakiness, and sweating suggest hypoglycemia from an insulinoma; a glucose check confirms this, guiding treatment. IV D5W, HCP notification, and juice follow confirmation.
The nurse is caring for the client with Addisonian crisis. Which clinical change should indicate to the nurse that the therapy is effective?
- A. Increase of 25 mm Hg in the client's blood pressure
- B. Decrease of 25 mm Hg in the systolic blood pressure
- C. Increase in serum potassium from 3.4 to 5.8 mEq/dL
- D. Decrease in serum sodium from 146 to 136 mEq/L
Correct Answer: A
Rationale: An increase in BP indicates effective therapy by correcting hypotension from sodium and water depletion.
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.
Which assessment technique is most appropriate when checking for laryngeal nerve damage in a client who has had a thyroidectomy?
- A. Turning the client's head from side to side
- B. Occurifying the client's swallowing
- C. Looking for tracheal deviation
- D. Asking the client to say 'Ah'
Correct Answer: D
Rationale: Asking the client to say 'Ah' assesses vocal cord function, which can be affected by laryngeal nerve damage.
A clinic nurse is teaching the client newly diagnosed with hypothyroidism. Which instructions should the nurse provide about taking levothyroxine sodium? Select all that apply.
- A. Take the medication 1 hour before or 2 hours after breakfast.
- B. Call the clinic if the pulse before taking the medication is greater than 100 beats per minute.
- C. Report adverse drug effects, including weight gain, cold intolerance, and alopecia.
- D. Take this drug as prescribed; it replaces thyroid hormone thatå‚¾å‘ diminished or absent.
- E. Have frequent laboratory monitoring to be sure your levels of T3 and T4 decrease.
Correct Answer: A,B,D
Rationale: Taking levothyroxine on an empty stomach ensures absorption, notifying the clinic for tachycardia prevents overdose, and taking it as prescribed replaces deficient hormone.