Exam Three Study Questions

The nurse is teaching a client with hyperparathyroidism how to manage the condition at home. Which response by the client indicates the need for additional teaching? a. "I should limit my fluids to 1 liter per day" b. "I should use my treadmill or go for walks daily" c. "I should follow a moderate-calcium, high-fiber diet" d. "My alendronate helps to keep calcium from coming out of my bones"

a. "I should limit my fluids to 1 liter per day" When PTH levels are high, there is excess calcium levels, there is a risk of nephrolithiasis. One to two liters of fluids daily should be encouraged to protect the kidneys and decrease risk of nephrolithaliasis.

A client with hyperthyroidism has been given methimazole. Which nursing considerations are associated with this medication? Select all that apply. a. Administer methimazole with food b. Place the client on a low-calorie, low-protein diet c. Assess the client for unexplained bruising or bleeding d. Instruct the client to report side and adverse effects such as sore throat, fever, or headaches e. Use special radioactive precautions when handling the client's urine for the first 24 hours following initial administration

a. Administer methimazole with food c. Assess the client for unexplained bruising or bleeding d. Instruct the client to report side and adverse effects such as sore throat, fever, or headaches Common side effects for methimazole include nausea, vomiting, and diarrhea. To address these side effects, this medication should be taken with food. Because an increase in metabolism that occurs in hyperthyroidism

A client is diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms indicating a complication of this disorder? Select all that apply. a. Fever b. Nausea c. Lethargy d. Tremors e. Confusion f. Bradycardia

a. Fever b. Nausea d. Tremors e. Confusion Thyroid storm is an acute and life-threatening complication that occurs in a client with uncontrollable hyperthyroidism. Signs and symptoms of thyroid storm include elevated tempurature (fever), nausea, and tremors. In addition, as the condition progresses, the client becomes confused. The client is restless and anxious and experiences tachycardia.

A client with a diagnosis of addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? Select all that apply. a. Hypotension b. Leukocytosis c. Hyperkalemia d. Hypercalcemia e. Hypernatremia

a. Hypotension c. Hyperkalemia Hypotension occurs when vascular tone is decreased and blood vessels cannot respond to epinephrine and norepinephrine. When there is insufficient aldosterone, salt and water are lost and potassium builds up; this leads to hypotension from decreased vascular volume, hyponatremia, and hyperkalemia. The remaining options are not associated with addisonian crisis.

The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) and has a serum sodium of 118 mEq/L. Which health care provider prescriptions should the nurse anticipate receiving? Select all that apply. a. Initiate an infusion of 3% NaCl b. Administer IV furosemide c. Restrict fluids to 800 mL over 24 hours d. Elevate the head of the bed to high Fowler's e. Administer a vasopressin antagonist as prescribed

a. Initiate an infusion of 3% NaCl c. Restrict fluids to 800 mL over 24 hours e. Administer a vasopressin antagonist as prescribed Clients with SIADH experience excess secretion of antidiuretic hormone (ADH), which leads to excess intravascular volume, a declining serum osmolality, and dilutional hyponatremia. Management is directed at correcting the hyponatremia and preventing cerebral edema. Hypertonic saline is prescribed when the hyponatremia is severe. Fluid restriction is a useful strategy aimed at correcting dilutional hyponatremia. Vasopressin antagonists are used to treat SIADH (furosemide is only safe to use if the serum sodium is at least 125 mEq/L).

The nurse is completing an assessment on a client who is primary hyperparathyroidism. Which client complaint would be characteristic of this disorder? Select all that apply. a. Polyuria b. Headache c. Bone pain d. Nervousness e. Weight gain

a. Polyuria c. Bone pain In hyperparathyroidism, PTH levels are high, which causes bone reabsorption. Elevated serum calcium levels produce osmotic diuresis and thus polyuria.

The nurse is monitoring a client diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the intensive care unit. Which findings should alert the nurse to the presence of a possible postoperative complications? Select all that apply. a. Anxiety b. Leukocytosis c. Chvostek's sign d. Urinary output of 800 mL/hour e. Clear drainage on nasal dripper pad

b. Leukocytosis d. Urinary output of 800 mL/hour e. Clear drainage on nasal dripper pad Leukocytosis, or elevated white blood cell count, may indicate infection. Diabetes insipidus is a possible complication, which is shown by a decrease in ADH resulting in large excretion of urine. Clear drainage on the dripper pad is suggestive of cerebrospinal fluid, which poses a risk for meningitis.

A client is administered to an emergency department, and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out initially? a. Warm the client b. Maintain a patent airway c. Administer thyroid hormone d. Administer fluid replacement

b. Maintain a patent airway In myxedema coma, the initial nursing action is to maintain a patent airway. Oxygen should be administered, followed by fluid replacement, keeping the client warm, monitor for vital signs, and administering thyroid hormones by the intravenous route.

The nurse is performing an assessment on a client with phenochromocytoma. Which assessment data would indicate a potential complication associated with this disorder? a. A urinary output of 50 mL/hr b. A coagulation time of 5 minutes c. A heart rate that is 90 beats/minute and irregular d. A blood urea nitrogen level of 20 mg/dL

c. A heart rate that is 90 beats/minute and irregular Excessive amounts of epinephrine and norepinephrine are secreted and the complications associated include hypertensive retinopathy and nephropathy, myocarditis, increased platelet aggregation, and stroke. Death can occur from shock stroke, kidney failure, dysrhythmias, or dissecting aortic aneurysm. An irregular heart rate indicates the presence of a dysrhythmia.

The nurse is preparing a client with a new diagnosis of hypothyroidism for discharge. The nurse determines that the client understands discharge instructions if the client states that which signs and symptoms are associated with this diagnosis? Select all that apply. a. Tremors b. Weight loss c. Feeling cold d. Loss of body hair e. Persistent lethargy f. Puffiness in the face

c. Feeling cold d. Loss of body hair e. Persistent lethargy f. Puffiness in the face Feeling cold, hair loss, lethargy, and facial puffiness are signs of hypothyroidism.

A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client? a. Hypoglycemia b. Level of hoarseness c. Respiratory distress d. Edema at surgical site

c. Respiratory distress Thyroidectomy is the removal of the thyroid gland, which is located in the anterior neck. It is important to maintain airway status, as any swelling to the surgical site could cause respiratory distress.