Nokea
Which signs/symptoms indicate the client with hypothyroidism is not taking enough thyroid hormone?
- A. Complaints of weight loss and fine tremors.
- B. Complaints of excessive thirst and urination.
- C. Complaints of constipation and being cold.
- D. Complaints of delayed wound healing and belching.
Correct Answer: C
Rationale: Constipation and cold intolerance indicate persistent hypothyroidism due to inadequate thyroid hormone. Weight loss/tremors, thirst, and healing/belching are unrelated.
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What should be included in the nursing care plan for a client with diabetes insipidus?
- A. Blood pressure every hour
- B. Strict intake and output
- C. Urine for ketone bodies
- D. Glucose monitoring four times a day
Correct Answer: B
Rationale: Diabetes insipidus causes excessive urine output due to low antidiuretic hormone, requiring strict intake and output monitoring to assess fluid balance.
The client is three (3) days postoperative unilateral adrenalectomy. Which discharge instructions should the nurse teach?
- A. Discuss the need for lifelong steroid replacement.
- B. Instruct the client on administration of vasopressin.
- C. Teach the client to care for the suprapubic Foley catheter.
- D. Tell the client to notify the HCP if the incision is inflamed.
Correct Answer: D
Rationale: Notifying the HCP for incision inflammation prevents infection post-adrenalectomy. Lifelong steroids are for bilateral procedures, vasopressin is for DI, and Foley catheters are not standard.
The nurse is caring for the client with SIADH. Which interventions should the nurse plan to implement? Select all that apply.
- A. Obtain the weight near the same time each morning.
- B. Place the client on a fluid-restricted diet as prescribed.
- C. Prepare to give a 500-mL NaCl intravenous fluid bolus.
- D. Administer furosemide intravenously as prescribed.
- E. Monitor for hyperactive reflexes and heightened alertness.
Correct Answer: A,B,D
Rationale: Daily weights monitor fluid retention, fluid restriction treats hyponatremia, and furosemide addresses fluid overload in SIADH.
An 18-year-old female client, 5'4 tall, weighing 113 kg, comes to the clinic for a nonhealing wound on her lower leg, which she has had for two (2) weeks. Which disease process should the nurse suspect the client has developed?
- A. Type 1 diabetes.
- B. Type 2 diabetes.
- C. Gestational diabetes.
- D. Acanthosis nigricans.
Correct Answer: B
Rationale: Obesity (BMI ~44) and a nonhealing wound suggest type 2 diabetes, associated with insulin resistance. Type 1 is less likely, gestational diabetes requires pregnancy, and acanthosis nigricans is a symptom, not a disease.
Which documentation finding provides the best indication that the client has successfully avoided an adrenal (addisonian) crisis after surgery?
- A. The client's pedal edema has lessened.
- B. Capillary blood glucose level is within normal limits.
- C. Vital signs are within preoperative ranges.
Correct Answer: C
Rationale: Stable vital signs indicate the absence of adrenal crisis, characterized by hypotension and shock.