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Which laboratory data make the nurse suspect the client with primary hyperparathyroidism is experiencing a complication?
- A. A serum creatinine level of 2.8 mg/dL.
- B. A calcium level of 9.2 mg/dL.
- C. A serum triglyceride level of 130 mg/dL.
- D. A sodium level of 135 mEq/L.
Correct Answer: A
Rationale: Elevated creatinine (2.8 mg/dL) suggests kidney damage, a complication of hyperparathyroidism’s hypercalcemia. Normal calcium, triglycerides, and sodium are unremarkable.
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The client with an acute exacerbation of chronic pancreatitis has a nasogastric (N/G) tube. Which interventions should the nurse implement? Select all that apply.
- A. Monitor the client's bowel sounds.
- B. Monitor the client's food intake.
- C. Assess the client's intravenous site.
- D. Provide oral and nasal care.
- E. Monitor the client's blood glucose.
Correct Answer: A,C,D,E
Rationale: Monitoring bowel sounds, IV site, oral/nasal care, and glucose manage NG tube complications and pancreatitis-related risks (e.g., hyperglycemia). Food intake is irrelevant with NPO status.
The nurse identifies the client problem 'risk for imbalanced body temperature' for the client diagnosed with hypothyroidism. Which intervention should be included in the plan of care?
- A. Discourage the use of an electric blanket.
- B. Assess the client's temperature every two (2) hours.
- C. Keep the room temperature cool.
- D. Space activities to promote rest.
Correct Answer: A
Rationale: Hypothyroidism causes cold intolerance; discouraging electric blankets prevents burns due to reduced sensation. Frequent temperature checks, cool rooms, and rest are less relevant.
The nurse manager of a medical-surgical unit is asked to determine if the unit should adopt a new care delivery system. Which behavior is an example of an autocratic style of leadership?
- A. Call a meeting and educate the staff on the new delivery system being used.
- B. Organize a committee to investigate the various types of delivery systems.
- C. Wait until another unit has implemented the new system and see if it works out.
- D. Discuss with the nursing staff if a new delivery system should be adopted.
Correct Answer: A
Rationale: An autocratic leader unilaterally decides and informs staff, as in educating them on a chosen system. Committees, waiting, and staff discussions are democratic or laissez-faire.
Postoperatively, the nurse should consult the physician before encouraging the client who has undergone a subtotal thyroidectomy to perform which activity?
- A. Forced coughing
- B. Decompelling
- C. Ambulating
- D. Dangling legs
Correct Answer: A
Rationale: Forced coughing can increase pressure in the neck, risking bleeding or wound disruption post-thyroidectomy.
The nurse is collecting information about the client who underwent a transsphenoidal removal of a pituitary tumor. Which findings should indicate to the nurse that the client is experiencing DI? Select all that apply.
- A. Serum osmolality 310 mOsm/kg
- B. Weight increased 2 kg in 24 hours
- C. Experiencing an extreme thirst
- D. Urine output 4200 mL in 24 hours
- E. BP averaging 164/92 mm Hg or higher
Correct Answer: A,C,D
Rationale: Elevated serum osmolality, extreme thirst, and high urine output indicate DI due to fluid loss and ADH deficiency.