Cell Reg (Cirrhosis and Thyroid)

in preparing a teaching plan for a client with hyperthyroidism, the nurse anticipates which diet will be prescribed? 1. high-calorie diet 2. low-sodium diet 3. high-roughage diet 4. mechanical-soft diet

1

the nurse is caring for a client with cirrhosis of the liver. the nurse anticipates a prescription for neomycin enemas based on which abnormal laboratory test? 1. ammonia level 2. culture and sensitivity 3. white blood cell count 4. alanine aminotransferase (ALT) level

1

which information would the nurse provide to a client with hyperthyroidism receiving methimazole? 1. initial improvement will take several weeks 2. few side effects are associated with this medication 3. this medication may be taken at any time during the day 4. large loading doses are used initially to normalize thyroid function

1

a client with hepatic cirrhosis begins to exhibit slurred speech, confusion, drowsiness, and a flapping tremor. based upon this assessment, which prescribed diet would the nurse anticipate? 1. no protein 2. moderate protein 3. high protein 4. strict protein restriction

2

a client with hyperthyroidism has been treated with radioactive iodine to destroy overactive thyroid gland cells. to reduce radiation exposure, which would the nurse consider when providing care? 1. wearing a lead-shield apron at all times 2. limiting time with and increasing distance from the client 3. wearing a radiation meter to measure exposure 4. remaining at least 6 feet away from the client at all times

2

which condition is it most important for the nurse to assess for in a client admitted to the hospital for acute gastritis and ascites secondary to alcohol use and cirrhosis? 1. nausea 2. blood in the stool 3. foot interlaces 4. hourly urinary output

2

which clinical finding would the nurse expect when caring for a client with hyperthyroidism? select all that apply 1. lethargy 2. tachycardia 3. weight gain 4. constipation 5. exophthalmos

2, 5

a client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. a diagnosis of septic cirrhosis is made. with is a nursing priority? 1. institute fall prevention and safety measures 2. evaluate coping skills 3. measure abdominal girth daily 4. test stool specimens for blood

1

a client with acute gastritis secondary to alcoholism and cirrhosis reports frequent nausea, pain that increases after meals, and black, tarry stools. the client has also recently joined AA. the nurse would give priority to which client history item? 1. black, tarry stools 2. frequent nausea 3. joining AA 4. pain that increases after meals

1

a client with cirrhosis of the liver and ascites is scheduled to have a paracentesis. which intervention would the nurse do to prepare the client for the procedure? 1. instruct the client to void 2. tell the client not to eat for 4 hours 3. give the client an analgesic 4. have the client turn to the lateral position

1

an infant with congenital hypothyroidism receives levothyroxine for 3 months. which finding would indicate to the nurse that the medication is effective? 1. the infant is alert and interactive 2. the skin is cool to the touch 3. the baby's fine tremor has ceased 4. the baby's thyroid stimulating hormone level has increased

1

which medication will the nurse expect the health care provider to prescribe to a client who had a thyroidectomy and is pale with spasms of the hand when taking the blood pressure? 1. calcium 2. magnesium 3 bicarbonate 4. potassium chloride

1

ac client with hyperthyroidism asks the nurse about the tests that will be ordered. which diagnostic tests would the nurse include in a discussion with this client? 1. thyroxine (T4) and x-ray films 2. thyroid-stimulating hormone (TSH) assay and triiodothyronine (T3) 3. thyroglobulin level and Po2 4. protein-bound iodine and sequential multichannel auto analyzer (SMA)

2

one week after beginning antithyroid medication for the treatment of hyperthyroidism, a client reports diarrhea, abdominal pain, and a fever. the client is admitted with a diagnosis of thyrotoxic crisis. which intervention is appropriate to implement for this client? 1. limit fluid intake 2. reduce body temperature and heart rate 3. observe for an exaggerated response to sedatives 4. treat the associated hyperglycemia and ketoacidosis

2

postoperatively, a client who had a thyroidectomy reports tingling and numbness of the fingers and toes. and the nurse observes muscle twitching. which complication would the nurse suspect the client is experiencing? 1. hypokalemia 2. hypocalcemia 3. thyrotoxic crisis 4. hypovolemic shock

2

the nurse is taking care of a client with cirrhosis of the liver and ascites. which lunch is an appropriate choice for a client with this disorder? 1. ham sandwich with cheese, whole milk, and potato chips 2. penne pasta, spinach, banana, and decaffeinated iced tea 3. baked lasagna with sausage, salad, and milkshake 4. hamburger, French fries, and cola

2

which equipment would the nurse include when setting up emergency equipment at the bedside of a client in the immediate postoperative period after a thyroidectomy? 1. crash cart with bed board 2. tracheostomy set and oxygen 3. ampule of sodium bicarbonate 4. airway and nonrebreather mask

2

which information will the nurse teach a client about thyroid cancer who is scheduled for thyroidectomy? 1. the dietary intake of carbohydrates must be restricted 2. thyroxine replacement therapy will be required indefinitely 3. chemotherapy will be used in conjunction with the surgery 4. a tracheostomy is required for clients having this procedure

2

which instructions would be included when teaching a client with hyperthyroidism who just had a radioactive iodine to ablate thyroid tissue? 1. remain in the house 2. avoid holding an infant 3. save urine in a lead-lined container 4. refrain from using a bathroom used by others

2

which laboratory test change leads the nurse to determine that the lactulose administered to a client with cirrhosis of the liver is effective? 1. decreased amylase 2. decreased ammonia 3. increased potassium 4. increased hemoglobin

2

which mechanism of action explains how propylthiouracil (PTU) helps in the management of hyperthyroidism? 1. it binds previously formed thyroid hormones 2. is decreases production of thyroid hormones 3. vascularity of the thyroid gland is decreased 4. the need for thyroid iodine supplements is reduced

2

which statement would the nurse consider when administering opioids to a client with myxedema who has undergone abdominal surgery? 1. tolerance to the medication develops readily 2. one-third to one-half the usual dose should be prescribed 3. opioids may interfere with the secretion of thyroid hormones 4. sedation will have a paradoxical effect, causing hyperactivity

2

which statement would the nurse include in the plan of care of a client with hyperthyroidism prescribed propylthiouracil and potassium iodide? 1. administer propylthiouracil and potassium iodide on an empty stomach 2. assess the client for signs of infection and bleeding every shift 3. stop the medications 2 weeks before thyroid surgery 4. discontinue the medications if the heart rate is maintained within the expected range of 48 hours

2

which instruction would be included in a discharge plan for a client hospitalized with severe cirrhosis of the liver? 1. the need for a high-protein diet to avoid malnourishment 2. the use of a sedative for relaxation to decrease personal stress 3. the need to increase daily intake of oral fluids 4. the need to report personality changes to the primary HCP

4

which intervention would be included in the plan of care for a client diagnosed with hyperthyroidism? 1. monitor for hypoglycemia 2. protect visitors and staff from radiation exposure 3. provide foods to increase appetite 4. arrange for sufficient rest periods

4

which mediation is indicated for decreasing the size and vascularity of the thyroid gland before thyroidectomy? 1. vasopressin 2. levothyroxine 3. propylthiouracil 4. potassium iodide

4

which reason will the nurse explain is the purpose for neomycin being prescribed to a client with cirrhosis? 1. prevents an infection 2. limits abdominal distention 3. minimizes intestinal edema 4. reduces the blood ammonia level

4

which interventions would the nurse include in the plan of care during the first 4 hours after a thyroidectomy? select all that apply 1. ensure that the cline lies flat 2. monitor vital signs every hour 3. monitor for stir or dyspnea 4. monitor for the signs and symptoms of early tetany 5. assess the sides and back of the client's neck for evidence of bleeding

3, 5

a 10 yo child is diagnosed with lymphocytic thyroiditis (Hashimoto disease) and develops a goiter. which education would the nurse provide to the parents and child about this condition? 1. the goiter is chronic 2. treatment is difficult 3. it is an inherited disorder 4. the child may need thyroid replacement

4

a client with severe cirrhosis is hospitalized. the nurse discovers fetter hepaticus when the nurse performs which part of the client's assessment? 1. assessment of the client;s urine 2. assessment of the client's stool 3. assessment of the client's hands 4. assessment of the client's breath

4

after assessing a client with a 25 year history of excessive alcohol use, which finding would the nurse consider consistent with the client's history? 1. an elevated temperature 2. signs of liver infection 3. a low blood ammonia level 4. a small liver with a rough surface

4

for which clinical indicator associated with a complication of portal hypertension would the nurse assess in the client? 1. liver abscess 2. intestinal obstruction 3. perforation of the duodenum 4. hemorrhage from esophageal varices

4

on the third postoperative day after a subtotal thyroidectomy for a tumor, a client complains of a "funny, jittery feeling." with intervention is appropriate for the nurse to take? 1. explain that this reaction is expected and not a concern 2. take the vital signs and place the client in a high-fowler position 3. request stat serum calcium and phosphorus levels and chart the results 4. test for Chvostek and Trousseau signs and notify the primary HCP of the complaints

4

the assessment of a newly admitted client reveals malnourishment, nausea, distention, and a firm abdomen with ascites. the client has tachycardia and is hypotensive. which physiological change occurred theat resulted in the client's development of ascites? 1. an increase in vitamins to maintain cell coenzyme function 2. an increase in ion to maintain adequate hemoglobin synthesis 3. a decrease in sodium to maintain its concentration tissue fluid 4 4. a decrease in plasma protein to maintain a

4

the nurse provides education for a client with cirrhosis of the liver who has a prolonged prothrombin time and a low platelet count. a regular diet is prescribed. which instruction would the nurse include in the teaching? 1. avoid foods high in phytonadione 2. check the pulse several times a day 3. drink a glass of milk when taking aspirin 4. report sings of bleeding no matter how slight

4

the serum ammonia level of a client with hepatic cirrhosis and ascites is elevated. which is an important nursing intervention? 1. weigh the client daily 2. restrict the client's oral fluid intake 3. measure the client's urine specific gravity 4. observe the client for increasing confusion

4

which additional supplement will be needed by a client with chronic liver disease who reports, "my gums have been bleeding spontaneously." and has small hemorrhagic lesions on the face? 1. bile salts 2. folic acid 3. vitamin A 4. vitamin K

4

a client with a long history of alcohol abuse develops cirrhosis of the liver. the client exhibits the presence of ascites. which would the nurse conclude is the most likely cause of the client's ascites? 1. impaired portal venous return 2. impaired thoracic lymph channels 3. excess production of serum albumin 4. enhanced hepatic deactivation of aldosterone secretion

1

for which sign of hepatic encephalopathy would the nurse assess client with cirrhosis of the liver? select all that apply 1. mental confusion 2. increased cholesterol 3. brown-colored stools 4. flapping hand tremors 5. musty, sweet breath odor

1, 4, 5

which manifestations of surgically induced hypothyroidism might the client exhibit after a thyroidectomy? select all that apply 1. fatigue 2. dry skin 3. insomnia 4. excitability 5. weight loss 6. intolerance to heat

1, 2

which finding in a client with hypothyroidism and hypertension who reports taking an extra dose of levothyroxine indicates the need to obtain a thyroid function panel? select all that apply 1. tremors 2. diaphoresis 3. nervousness 4. temperature 101 F 5. heart rate 116 beats/min

1, 2, 3, 4, 5

which finding would be expected in a client with a history of hypothyroidism? select all that apply 1. cold intolerance 2. lethargy and fatigue 3. hemoglobin 11.2 g/dL 4. 15 pound weight gain 5. heart rate 59 bpm

1, 2, 3, 4, 5

which interventions would the nurse implement when providing care to a client after a subtotal thyroidectomy? select all that apply 1. assess for frequent swelling 2. ambulate the client the evening of surgery 3. assess for facial spasms, apprehension, or tingling of the lips, fingers, or toes 4. instruct the client to support the head and maintain the neck in a flexed position 5. ensure that oxygen, suction equipment, and a tracheostomy tray are at the bedside

1, 2, 3, 5

which skin condition would the nurse expect when performing a physical assessment on a client with a new diagnosis of hyperthyroidism? select all that apply 1. warm 2. moist 3. pale 4. smooth 5. coarse 6. dry

1, 2, 4

the nurse is admitting a client with severe myxedema coma. which interventions would the nurse include in the plan of care? select all that apply? 1. administer intravenous levothyroxine 2. avoid use of corticosteroids 3. give IV normal saline 4. wait for laboratory results before treating 5. monitor blood pressure every 4 hours

1, 3

the nurse is taking care of a client with cirrhosis of the liver. which clinical manifest stations would the nurse assess in the client? select all that apply 1. ascites 2. hunger 3. prurits 4. jaundice "headache"

1, 3, 4

which clinical manifestation exhibited by a client taking levothyroxine for hypothyroidism for 3 moths would cause a nurse to suspect that a decrease is dosage is needed? select all that apply 1. tremors 2. bradycardia 3. somnolence 4. heat intolerance 5. decreased blood pressure

1, 4

the nurse is caring for a client with hepatic encephalopathy and ascites. which elements are important to include in the client's diet? select all that apply 1. high fat 2. low sodium 3. high vitamins 4. moderate protein 5. low carbohydrates

2, 3, 4

which manifestations would the nurse expect to find when assessing a client with hyperthyroidism? select all that apply 1. dry skin 2. weight loss 3. tachycardia 4. restlessness 5. constipation 6. exophthalmos

2, 3, 4, 6

the nurse is caring for a client that is scheduled to have a percutaneous liver biopsy. which assessment findings warrant the postponentment of the procedure? select all that apply 1. hemosiderosis 2. marked ascites 3. hepatic cirrhosis 4. hemoglobin of less than 9 g?dL 5. platelet count of 150,000/mm3

2, 4

the nurse is providing discharge instructions to a client diagnosed with cirrhosis and varies. which information would the nurse include in the teaching session? select all that apply 1. adhering to a low-carb diet 2. avoiding aspirin and aspirin-containing products 3. limiting alcohol consumption to two drinks weekly 4. avoiding acetaminophen and products containing acetaminophen 5. avoiding coughing, sneezing, and straining to have a bowel movement

2, 4, 5

which metabolic manifestations are likely to be observed in a client with hypothyroidism? select all that apply 1. impaired memory 2. intolerance to cold 3. difficulty breathing 4. decreased blood pressure 5. decreased body temperature

2, 5

a client who had a subtotal thyroidectomy asks how hypothyroidism may develop when the problem was hyperthyroidism. which would the nurse consider when formulating a response? 1. hypothyroidism is a gradual slowing of the body's function 2. a decrease in pituitary thyroid-stimulating hormone (TSH) will occur 3. less thyroid tissue is available to supply thyroid hormone after surgery 4. atrophy of tissue remaining after surgery reduces secretion of thyroid hormones

3

assessment findings of a client include fatigue, hair loss, weight gain, and diagnostic tests indicating anemia. the nurse anticipates a prescription for which therapy? 1. iodine 2. methimazole 3. levothyroxine 4. propylthiouracil

3

the nurse is performing an assessment and notes that the client has exophthalmos and complains of double vision. these assessment findings are consistent with which condition? 1. glaucoma 2. hypertension 3. hyperthyroidism 4. sinus infection

3

which information about a client's condition would the nurse consider when providing care to a client who just received radioactive iodine for Graves disease? 1. not radioactive and can be handled as any other individual 2. highly radioactive and should be isolated as much as possible 3. mildly radioactive and should be treated with routine safety precautions 4. not radioactive but may still transmit some dangerous radiations and must be treated with precautions

3

which situation in a client with hyperthyroidism may precipitate thyroid crisis (thyroid storm)? 1. increased iodine in the blood 2. removal of the parathyroid glands 3. high levels of the hormone triiodothyronine 4. rebound increase in metabolism after anesthesia

3

while inspecting the external eye structure of a client, the nurse finds bulging of the eyes. which condition would be suspect in the client? 1. eye tumors 2. hypothyroidism 3. hyperthyroidism 4. neuromuscular injury

3

why would lactulose be prescribed for a client with a history of cirrhosis of the liver? 1. the desire to drink alcohol is decreased 2. diarrhea is controlled and prevented 3. elevated ammonia levels are lowered 4. abdominal distention secondary to ascites is decreased

3

the nurse is performing a physical assessment of a client admitted to the hospital with a diagnosis of cirrhosis. the nurse expects to observe which skin conditions? select all that apply 1. vitiligo 2. hirsutism 3. melanosis 4. ecchymoses 5. telangiectasia

4, 5