Nokea
. Which of the following laboratory test results would suggest to the nurse that a client has a corticotrophin- secreting pituitary adenoma?
- A. High corticotropin and low cortisol levels
- B. high corticotropin and high cortisol levels
- C. Low corticotropin and high cortisol levels
- D. Low corticotropin and low cortisol levels
Correct Answer: B
Rationale: A corticotrophin-secreting pituitary adenoma, also known as Cushing's disease, results in an overproduction of adrenocorticotropic hormone (corticotropin). This excess corticotropin stimulates the adrenal glands to produce increased levels of cortisol. Therefore, a client with a corticotrophin-secreting pituitary adenoma would typically exhibit high levels of both corticotropin and cortisol. Option B is the correct choice, as it indicates elevated levels of both hormones, suggesting the presence of a corticotrophin-secreting pituitary adenoma.
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When monitoring for hypernatremia, the nurse should assess the client for:
- A. Dry skin
- B. Tachycardia
- C. Confusion
- D. Pale coloring
Correct Answer: C
Rationale: Hypernatremia is a condition characterized by high levels of sodium in the blood. When monitoring for hypernatremia, the nurse should assess the client for signs of neurologic impairment, such as confusion. This is because hypernatremia can lead to changes in mental status due to the hyperosmolarity of the blood affecting brain function. Assessing for confusion is crucial in identifying and managing hypernatremia promptly to prevent further complications. Dry skin, tachycardia, and pale coloring are not specific manifestations of hypernatremia and are less likely to be directly related to this electrolyte imbalance.
Mr. RR is to have a brain scanning. Nursing intervention in preparation for this test includes:
- A. Discontinuing any anticonvulsant therapy
- B. Obtaining consent for the treatment
- C. Explaining to Mr. RR that although his head will be supported in place for a period of time, the test will not be painful.
- D. Informing Mr. RR that nausea and headache are frequent following this test
Correct Answer: C
Rationale: The nursing intervention in preparation for a brain scanning test such as an MRI or CT scan should include explaining to the patient (Mr. RR in this case) that although his head will be supported in place for a period of time during the test, the procedure itself will not be painful. Providing this explanation helps to alleviate any anxiety or fear Mr. RR may have about the test and ensures that he feels comfortable and well-informed before the procedure. This communication is key to promoting a positive patient experience and ensuring cooperation during the test. It also helps in managing patient expectations and reducing any potential stress or discomfort during the scanning process.
Nurse Nancy is assessing a child with pyloric stenosis; she is likely to note which of the following?
- A. "Currant jelly" stools
- B. Regurgitation
- C. Steatorrhea
- D. Projectile vomiting
Correct Answer: D
Rationale: Pyloric stenosis is a condition in infants where there is a tightening of the muscle at the outlet of the stomach, causing obstruction of food passage into the small intestine. One of the hallmark symptoms of pyloric stenosis is projectile vomiting, in which the vomit is forceful and shoots out a significant distance. This distinguishes it from regular regurgitation or spitting up, which are more common in infants for other reasons. Nurse Nancy would likely note this symptom while assessing a child with pyloric stenosis.
A female child, age 2, is brought to the emergency department after ingesting an unknown number of aspirin tablets about 30 minutes earlier. On entering the examination room, the child is crying and clinging to the mother. Which data should the nurse obtain first?
- A. Heart rate, respiratory rate, and bloodpressure
- B. Recent exposure to communicable diseases
- C. Number of immunizations received
- D. Height and weight
Correct Answer: A
Rationale: In this situation, the priority data the nurse should obtain first is the vital signs including heart rate, respiratory rate, and blood pressure of the child. This information will help assess the child's current physiological status and potential effects of ingesting the aspirin. Aspirin overdose in children can lead to serious complications such as metabolic acidosis, respiratory distress, and cardiovascular instability. Monitoring the vital signs will provide crucial information to guide appropriate interventions and determine the severity of the child's condition. Height and weight (option D) are important for routine assessments but not the priority in this urgent situation. Recent exposure to communicable diseases (option B) and number of immunizations received (option C) are not relevant to the immediate management of the child's aspirin ingestion.
A client is admitted to an acute care facility with a tentative diagnosis of hypoparathyroidism. The nurse should monitor the client closely for the related problem of:
- A. Severe hypotension
- B. Profound neuromuscular irritability
- C. Excessive thirst
- D. Acute gastritis
Correct Answer: B
Rationale: Hypoparathyroidism is a condition characterized by decreased levels of parathyroid hormone, which can lead to low levels of calcium in the blood (hypocalcemia). Profound neuromuscular irritability is a significant complication of hypocalcemia and is a key concern for clients with hypoparathyroidism. Symptoms can include muscle cramps, tetany, seizures, and decreased cardiac contractility. Monitoring for neuromuscular irritability and promptly addressing low calcium levels are essential in the care of clients with hypoparathyroidism.