Nokea
Which statement made by the client makes the nurse suspect the client is experiencing hyperthyroidism?
- A. I just don't seem to have any appetite anymore.
- B. I have a bowel movement about every three (3) to four (4) days.
- C. My skin is really becoming dry and coarse.
- D. I have noticed all my collars are getting tighter.
Correct Answer: D
Rationale: Tight collars suggest goiter, a hyperthyroidism symptom. Anorexia, constipation, and dry skin are hypothyroid-related.
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An elderly client with Type 2 diabetes mellitus develops an ingrown toenail. What is the best action for the nurse to take?
- A. Put cotton under the nail and clip the nail straight across
- B. Elevate the foot immediately
- C. Apply warm, moist soaks
- D. Notify the physician
Correct Answer: D
Rationale: An ingrown toenail in a diabetic client risks infection and poor healing, requiring physician evaluation rather than self-treatment.
The nurse is planning a program for clients at a health fair regarding the prevention and early detection of cancer of the pancreas. Which self-care activity should the nurse discuss as an example of a primary nursing intervention?
- A. Monitor for elevated blood glucose at random intervals.
- B. Inspect the skin and sclera of the eyes for a yellow tint.
- C. Limit meat in the diet and eat a diet low in fat.
- D. Instruct the client with hyperglycemia about insulin injections.
Correct Answer: C
Rationale: A low-fat diet reduces pancreatic stress, a primary prevention strategy. Glucose monitoring, jaundice inspection, and insulin teaching are secondary or tertiary.
Which statement provides the best evidence that the client understands the prescribed drug therapy?
- A. I must take this drug after meals.
- B. I'll need to take this drug life-long.
- C. I can skip a dose if I'm nauseated.
Correct Answer: B
Rationale: Levothyroxine for myxedema typically requires lifelong therapy to maintain thyroid hormone levels.
The client with an acute exacerbation of chronic pancreatitis has a nasogastric (N/G) tube. Which interventions should the nurse implement? Select all that apply.
- A. Monitor the client's bowel sounds.
- B. Monitor the client's food intake.
- C. Assess the client's intravenous site.
- D. Provide oral and nasal care.
- E. Monitor the client's blood glucose.
Correct Answer: A,C,D,E
Rationale: Monitoring bowel sounds, IV site, oral/nasal care, and glucose manage NG tube complications and pancreatitis-related risks (e.g., hyperglycemia). Food intake is irrelevant with NPO status.
The client diagnosed with type 1 diabetes is receiving Humalog, a rapid-acting insulin, by sliding scale. The order reads blood glucose level: <150, zero (0) units; 151 to 200, three (3) units; 201 to 250, six (6) units; >251, contact health-care provider. The unlicensed assistive personnel (UAP) reports to the nurse the client's glucometer reading is 189. How much insulin should the nurse administer to the client?
Correct Answer: 3 units
Rationale: Per the sliding scale, a glucose of 189 (151–200 range) requires 3 units of Humalog.