Nokea
Which of the following should be included in the discharge teaching of a client with a unilateral adrenalectomy?
- A. The client's need to pay close attention to skin care
- B. The client's need to restrict dietary intake of sodium and protein
- C. The client's need to recognize signs of hypoglycemia
- D. The client's need for daily steroid medication
Correct Answer: D
Rationale: Unilateral adrenalectomy may impair cortisol production, requiring lifelong steroid replacement. Skin care, dietary restrictions, and hypoglycemia are not primary concerns.
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The nurse is caring for a client following removal of the thyroid. Immediately post-op the nurse should:
- A. Maintain the client in a semi-Fowler's position with her head and neck supported by pillows.
- B. Encourage the client to turn her head side to side to promote drainage of oral secretions.
- C. Maintain the client in a supine position with sandbags placed on either side of her head and neck.
- D. Encourage the client to cough and deep breathe every 2 hours with her neck in a flexed position.
Correct Answer: A
Rationale: Semi-Fowler's position reduces swelling and supports the surgical site post-thyroidectomy. Turning the head or flexing the neck risks wound dehiscence. Supine with sandbags is unnecessary and uncomfortable.
A client has returned to the floor from thyroidectomy surgery.
After a client has returned to the floor from thyroidectomy surgery, it is MOST important for the nurse to take which of the following actions?
- A. Monitor vital signs every four hours.
- B. Observe for frequent swallowing.
- C. Monitor for signs of respiratory distress every hour.
- D. Position the client in the supine position.
Correct Answer: C
Rationale: Strategy: Answers are a mix of assessments and implementations. Does this situation require assessment? Yes. Determine what assessment is being made in each answer choice. (1) assessment is not specific to this surgery (2) assessment, method used to monitor for postoperative hemorrhage in a tonsillectomy client (3) correct-assessment, after surgery, swelling can occur, which causes respiratory distress (4) implementation, head of the bed should be elevated
A 6-year-old child is seen in the physician's office. His mother tells you that for the last few weeks, the child has been urinating frequently, drinking and eating a lot. The nurse determines that the urine specific gravity is 1.004. The child is afebrile. What tests does the nurse expect to be ordered for this client at this time?
- A. CBC with differential
- B. Urine and finger stick glucose tests
- C. Intravenous pyelogram.
- D. Urine for culture and sensitivity
Correct Answer: B
Rationale: Polyuria, polydipsia, polyphagia, and low urine specific gravity (1.004) suggest diabetes mellitus; urine and finger stick glucose tests confirm hyperglycemia. CBC, IVP, or culture are less relevant.
An adult who has myasthenia gravis is about to be discharged. Neostigmine is prescribed for her. What should the nurse include when teaching the client about this drug? Tell the client to take the drug:
- A. one-half hour before meals.
- B. between meals.
- C. immediately following meals.
- D. upon arising and at bedtime.
Correct Answer: A
Rationale: Taking neostigmine 30 minutes before meals maximizes muscle strength for chewing and swallowing, critical for myasthenia gravis patients, unlike other timing.
A client with chronic obstructive pulmonary disease (COPD) and a history of coronary artery disease is receiving aminophylline, 25 mg/hour. Which one of the following findings by the nurse would require immediate intervention?
- A. Decreased blood pressure and respirations
- B. Flushing and headache
- C. Restlessness and palpitations
- D. Increased heart rate and blood pressure
Correct Answer: C
Rationale: Restlessness and palpitations. Side effects of Aminophylline include restlessness and palpitations.