Nokea
Which psychosocial problem should be included in the plan of care for a female client diagnosed with Cushing's syndrome?
- A. Altered glucose metabolism.
- B. Body image disturbance.
- C. Risk for suicide.
- D. Impaired wound healing.
Correct Answer: B
Rationale: Body image disturbance addresses Cushing’s physical changes (e.g., moon face, hirsutism), a key psychosocial issue. Glucose, suicide, and healing are physiological.
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The client taking thyroid replacement hormone is hospitalized, and a thyroid replacement hormone is not prescribed. A week after being hospitalized, the nurse assesses that the client is becoming increasingly lethargic and has a decreased blood pressure, respiratory rate, temperature, and pulse. Which actions should be taken by the nurse? Place each nursing action in the order of priority.
- A. Warm the client
- B. Administer intravenous fluids
- C. Assist in ventilatory support
- D. Administer thyroxine as prescribed
Correct Answer: C,B,A,D
Rationale: Ventilatory support addresses decreased respiratory rate, IV fluids treat hypotension, warming prevents metabolic demand increase, and thyroxine corrects hypothyroidism.
In addition to amenorrhea, which other signs of myxedema is the nurse likely to observe in this client? Select all that apply.
- A. Hoarse, raspy voice
- B. Oily skin with large pores
- C. Thin trunk and extremities
- D. Exireme restlessness
- E. Low body temperature
- F. Decreased blood pressure
Correct Answer: A,E,F
Rationale: Myxedema (hypothyroidism) causes a hoarse voice, low body temperature, and decreased blood pressure due to slowed metabolism.
If a regular diet is ordered, which between-meal snack should the nurse offer to help regulate the client's blood glucose level?
- A. A small carton of milk
- B. A small apple
- C. A handful of raisins
- D. A slice of bread
Correct Answer: A
Rationale: A small carton of milk provides a balance of carbohydrates and protein to stabilize blood glucose in hypoglycemia.
When the client practices self-administration of the insulin, which action is correct?
- A. Piercing the skin at a 30-degree angle
- B. Using a syringe calibrated in minims
- C. Using a 29-gauge needle on the syringe
- D. Rotating abdominal sites for each injection
Correct Answer: D
Rationale: Rotating abdominal sites prevents lipodystrophy and ensures consistent insulin absorption.
The nurse is providing an in-service on thyroid disorders. One of the attendees asks the nurse, 'Why don't the people in the United States get goiters as often?' Which statement by the nurse is the best response?
- A. It is because of the screening techniques used in the United States.
- B. It is a genetic predisposition rare in North Americans.
- C. The medications available in the United States decrease goiters.
- D. Iodized salt helps prevent the development of goiters in the United States.
Correct Answer: D
Rationale: Iodized salt provides dietary iodine, preventing iodine deficiency goiters common elsewhere. Screening, genetics, and medications are not primary reasons.