Nokea
Which risk factor should the nurse expect to find in the client diagnosed with pancreatic cancer?
- A. Chewing tobacco.
- B. Low-fat diet.
- C. Chronic alcoholism.
- D. Exposure to industrial chemicals.
Correct Answer: C
Rationale: Chronic alcoholism is a well-established risk factor for pancreatic cancer, often linked to chronic pancreatitis, which predisposes to malignancy. Chewing tobacco is more associated with oral cancers, a low-fat diet is not a risk factor, and while industrial chemical exposure is a possible risk, it is less specific than alcoholism.
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Which finding would be the greatest cause for concern to the nurse during the early postoperative period following a thyroidectomy?
- A. Temperature of 100°F
- B. A sore throat
- C. Carpal spasm when the blood pressure is taken
- D. Complaints of pain in the area of the surgical incision
Correct Answer: C
Rationale: Carpal spasm (Trousseau’s sign) indicates hypocalcemia, a serious complication post-thyroidectomy due to parathyroid gland injury.
The nurse is caring for the client with elevated growth hormone (GH) levels. Which problem should the nurse exclude from the plan of care?
- A. Fluid volume deficit due to polyuria
- B. Insomnia due to soft tissue swelling
- C. Impaired communication due to speech difficulties
- D. Altered body image due to undersized hands, feet, and jaw
Correct Answer: D
Rationale: GH excess causes overgrowth of bones and soft tissues, not undersizing, so altered body image due to undersized features is excluded.
The nurse is teaching the client diagnosed with hyperthyroidism. Which information should be taught to the client? Select all that apply.
- A. Notify the HCP if a three (3)-pound weight loss occurs in two (2) days.
- B. Discuss ways to cope with the emotional lability.
- C. Notify the HCP if taking over-the-counter medication.
- D. Carry a medical identification card or bracelet.
- E. Teach how to take thyroid medications correctly.
Correct Answer: B,C,D
Rationale: Coping with emotional lability, reporting OTC meds, and carrying ID address hyperthyroidism’s effects and safety. Rapid weight loss is expected, and thyroid meds are for hypothyroidism.
Which assessment technique is most appropriate when checking for laryngeal nerve damage in a client who has had a thyroidectomy?
- A. Turning the client's head from side to side
- B. Occurifying the client's swallowing
- C. Looking for tracheal deviation
- D. Asking the client to say 'Ah'
Correct Answer: D
Rationale: Asking the client to say 'Ah' assesses vocal cord function, which can be affected by laryngeal nerve damage.
The nurse administers 15 units of glargine insulin at 2100 hours to the client when the client's fingerstick blood glucose reading is 110 mg/dL. At 2300, an NA reports that an evening snack was not given because the client was sleeping. Which instruction by the nurse is most appropriate?
- A. You will need to wake the client to check the blood glucose and then give a snack. All diabetics get a snack at bedtime.'
- B. It is not necessary for this client to have a snack; glargine insulin is absorbed over 24 hours and doesn't have a peak.'
- C. The next time the client wakes up, check a blood glucose level and then give a 15-gram carbohydrate snack.'
- D. I will notify the HCP; a snack at this time will affect the next blood glucose level and dose of glargine insulin.'
Correct Answer: B
Rationale: The onset of glargine is 1 hour; it has no peak action, and it lasts for 24 hours. Because it has no peak action, a bedtime snack is unnecessary.