Nokea
Which of the following instructions should be included in the discharge teaching plan for a client after thyroidectomy for Grave's disease?
- A. keep an accurate record of intake and output.
- B. use nasal desmopressin acetate (DDAVP).
- C. be sure to get regular follow-up care.
- D. Be sure to exercise to improve cardiovascular fitness.
Correct Answer: C
Rationale: Regular follow-up care is crucial after a thyroidectomy for Grave's disease to monitor the patient's thyroid hormone levels, assess for signs of complications such as hypothyroidism or hypoparathyroidism, and ensure appropriate management of any related conditions. Routine follow-up visits with healthcare providers allow for ongoing assessment and adjustment of medications, as well as addressing any concerns the patient may have post-surgery. By emphasizing the importance of regular follow-up care, the healthcare team can provide necessary support and guidance to the patient throughout their recovery process.
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You are evaluating a 2-year-old boy with multiple bruises. Physical examination is unremarkable apart from multiple bruising areas. Lab investigations including coagulation profile are normal. Of the following, bruises that are LEAST likely suggestive of physical abuse is
- A. bruises over the neck
- B. looped extension cord marks on the body
- C. bruises over bony prominences
- D. bruising of the torso
Correct Answer: C
Rationale: Bruises over bony prominences are common in toddlers due to falls and rough play, whereas bruises in unusual locations like the neck or torso are more suspicious for abuse.
A client becomes upset when the physician diagnoses diabetes mellitus as the cause of current signs and symptoms. The client tells the nurse, "This must be a mistake. No one in my family has ever had diabetes." Based on this statement, the nurse suspects the client is using which coping mechanism?
- A. Denial
- B. Anger
- C. Withdrawal
- D. Resolution
Correct Answer: A
Rationale: The client's response of stating that diabetes cannot be possible because it is not prevalent in the family indicates that the client is using the coping mechanism of denial. Denial is a common defense mechanism where individuals refuse to accept reality or facts that are too uncomfortable for them to acknowledge. In this situation, the client is denying the diagnosis of diabetes as a way to cope with the distressing news, hoping that it may not be true because it has not affected their family members in the past. Recognizing this coping mechanism is important for the nurse to provide support and education to help the client come to terms with the diagnosis and start managing the condition effectively.
A client has been taking a decongestant for allergic rhinitis. During a follow-up visit, which of the following suggests that the decongestant has been effective?
- A. Increased salivation
- B. Reduced sneezing
- C. Increased tearing
- D. Headache
Correct Answer: B
Rationale: A decongestant is a medication often used to relieve nasal congestion and reduce allergy symptoms such as sneezing. If a client with allergic rhinitis has experienced reduced sneezing during a follow-up visit after taking a decongestant, it suggests that the medication has been effective in helping to alleviate their symptoms. Increased salivation, increased tearing, and headache are not typical indicators of the effectiveness of a decongestant for allergic rhinitis.
An infant with tetralogy of Fallot becomes cyanotic and dyspneic after a crying episode. To relieve the cyanosis and dyspnea, the nurse should place the infant in the:
- A. Orthopneic position
- B. Knee-chest position
- C. Lateral Sims' position
- D. Semi-Fowler's position
Correct Answer: A
Rationale: The orthopneic position is the best position to relieve cyanosis and dyspnea in an infant with tetralogy of Fallot. This position involves sitting up and leaning forward, which helps improve lung expansion and oxygenation. Placing the infant in the orthopneic position will reduce the workload on the heart, improve oxygenation, and relieve symptoms of cyanosis and dyspnea associated with tetralogy of Fallot. It allows for better expansion of the lungs and improves ventilation-perfusion matching, thereby enhancing oxygen exchange and alleviating the cyanotic spell.
After a Whippie procedure for cancer of the pancreas, a client is to receive the following intravenous (IV) fluids over 24 hours; 1000 ml D5W; 0.5 liter normal saline; 1500 ml D5NS. In addition, an antibiotic piggyback in 50 ml D5W is ordered every 8 hours. The nurse calculates that the clients IV fluid intake Tor 24 hours will be:
- A. 3150ml
- B. 3650 ml
- C. 3200 ml
- D. 3750ml
Correct Answer: C
Rationale: To calculate the total IV fluid intake for 24 hours, we will add up the volume of each type of fluid ordered.