Unit IV Practice Questions
The nurse caring for a client who has had a subtotal thyroidectomy reviews the plan of care and determines which problem is the priority for this client in the immediate postoperative period?
Bleeding
Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?
Fluid intake is less than 2500 mL/day
Which signs/symptoms should make the nurse suspect the client is experiencing a thyroid storm?
Hyperpyrexia and extreme tachycardia
A 60 y/o female is diagnosed with hypothyroidism. The nurse should assess the client for:
Weight gain
Which sign/symptom indicates to the nurse the client is experiencing hypoparathyroidism?
A positive Chvostek's sign
Thyroid drugs for hypothyroidism:
Levothyroxine, liothyronine, Liotrix, Thyroid
Which manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine?
Tachycardia
The client diagnosed with hypothyroidism is prescribed the thyroid hormone levothyroxine (synthroid). Which assessment data indicate the medication has been effective?
The client's temperature is WNL
The client diagnosed with hypothyroidism is prescribed the thyroid hormone levothyroxine. Which assessment data indicate the medication has been effective?
The client's temperature is WNL
The client diagnosed with hypothyroidism is prescribed the thyroid hormone levothyroxine (Synthroid). Which assessment data indicate the medication has been effective?
The client's temperature is WNL *the client with hypothyroidism frequently has a subnormal temperature, so a temperature WNL indicates the medication is effective
The nurse is instructing the client with hypothyroidism who takes levothyroxine 100 mcg digoxin, and simvastatin. Teaching regarding the use of these medications is effective if the client will take:
The levothyroxine before breakfast and the other medications 4 hours later
The nurse determines that the patient in acute adrenal insufficiency is responding favorably to treatment when
The patient appears alert and oriented *confusion, irritability, disorientation, or depression is often present in the patient with Addison's, and a positive response to therapy would be indicated by a return to alertness and orientation
When caring for a patient with nephrogenic DI, the nurse would expect the treatment to include:
Thiazide diuretics *in nephrogenic DI, the kidney is unable to respond to ADH, so vasopressin or homrone analogs are not effective. Thiazide diuretics slow the glomerular filtration rate in the kidney and produce a decrease in urine output.
Which medication should be available to provide emergency treatment if a client develops tetany after a subtotal thyroidectomy?
Calcium gluconate
A patient with Graves' disease is treated with iodine-131 therapy. Which statement by the patient would indicate understanding of the treatment's effects?
"I'll tell my doctor if I have fatigue, hair loss, or cold intolerance"
A patient with Grave's disease asks the nurse what caused the disorder. The best response by the nurse is:
"In genetically susceptible persons antibodies from that attack thyroid tissue and stimulate overproduction of thyroid hormones
When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect:
A blood pressure of 176/88 mmHg
What is the priority action for the nurse to take if the patient with type 2 diabetes complains of blurred vision and irritability?
Check the patient's blood glucose level
The nurse is assisting a patient with newly diagnosed type 2 diabetes to learn dietary planning as part of the initial management of diabetes. The nurse would encourage the patient to limit intake of which foods to help reduce the percent of fat in the diet?
Cheese *derived from animal sources and is higher in fat and calories
The nurse has been teaching a patient with diabetes mellitus how to perform self-monitoring of blood glucose (SMBG). During evaluation of the patient's technique, the nurse identifies a need for additional teaching when the patient does what?
Chooses a puncture site in the center of the finger pad
A nurse is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:
Consuming a low-carbohydrate, high protein diet and avoid fasting
A client with hyperthyroidism is hospitalized to have a thyroidectomy. The healthcare provider has prescribed propanolol. In reviewing the client's history, the nurse notes that the client has asthma. The nurse should next:
Contact the healthcare provider and discuss the prescription for propranolol because of the client's history of having asthma
A college student is newly diagnosed with type 1 diabetes. She now has a headache, changes in her vision, and is anxious, but does not have her portable blood glucose monitor with her. Which action should the campus nurse advise her to take?
Eat 15g of simple carbohydrates
A patient is admitted to the hospital in thyrotoxic crisis. On physical assessment of the patient, the nurse would expect to find:
Elevated temperature and signs of heart failure *a hyperthyroid crisis results in marked manifestations of hyperthyroidism, fever tacycardia, heart failure, shock, hyperthermia, agitation, delirium, and coma
A patient with type 2 diabetes has sensory neuropathy of the feet and legs and peripheral vascular disease evidenced by decreased peripheral pulses and dependent rubor. The nurse teaches the patient that:
Flat-soled leather shoes are the best choice to protect the feet from injury
A patient with type 2 diabetes has sensory neuropathy of the legs and feet and peripheral vascular disease evidenced by decreased peripheral pulses and dependent rubor. The nurse teaches the patient that:
Flat-soled leather shoes are the best choice to protect the feet from injury
Polydipsia and polyuria related to diabetes mellitus are primarily due to:
Fluid shifts resulting from the osmotic effect of hyperglycemia
After consuming a banana split, which hormone would be expected to increase?
Insulin
A client has abnormal amounts of circulating thyronine (T3) and thyroxine (T4). While obtaining the health history, the nurse asks the client about dietary intake. Lack of which dietary element is most likely the cause?
Iodine
A nurse is caring for a client following a thyroidectomy. The client tells the nurse that she is concerned because of voice hoarseness. The client asks the nurse whether the hoarseness will subside. The nurse tells the client that the hoarseness:
Is normal and will gradually subside
A patient, who is admitted with diabetes mellitus, has a glucose level of 380 mg/dL and a moderate level of ketones in the urine. As the nurse assesses for signs of ketoacidosis, which respiratory pattern would the nurse expect to find?
Kussmaul respirations
Following a subtotal thyroidectomy, the nurse asks the client to speak immediately upon regaining consciousness. The nurse does this to monitor for signs of:
Laryngeal nerve damage
A nurse is caring for a postoperative parathyroidectomy client. Which of the following would require the nurse's immediate attention?
Laryngeal stridor
A client has been diagnosed with hypoparathyroidism. The nurse teaches the client to include foods in the diet that are:
Low in phosphorus and high in calcium *hypoparathyroidism results in hypocalcemia
The nurse is beginning to teach a diabetic patient about vascular complications of diabetes. What information is appropriate for the nurse to include?
Microangiopathy is specific to diabetes and most commonly affects the capillary membranes of the eyes, kidneys and skin
A 51 y/o patient with diabetes mellitus is scheduled for a fasting blood glucose level at 8:00 AM. The nurse instructs the patient to only drink water after what time?
Midnight before the test
A client with hypoparathyroidism has hypocalcemia. The nurse avoids giving the client the prescribed vitamin and calcium supplement with which of the following liquids?
Milk *milk products are high in phosphates, which should be avoided by a client with hypoparathyroidism
During care of a patient with SIADH, the nurse should:
Monitor neurologic status Q2H or more often as needed *patients with SIADH have marked dilution hyponatremia and should be monitored for decreased neurologic function.
Following a unilateral adrenalectomy, the nurse would assess for hyperkalemia shown by which of the following?
Muscle weakness
When caring for a female client with a history of hypoglycemia, the nurse should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description?
Sulfisoxazole (Gantrisin) *Sulfisoxazole and other sulfonamides are chemically related to oral antidiabetic agents and may precipitate hypoglycemia
A young woman makes an appointment to see a physician at the clinic. She complains of tiredness, weight gain, muscle aches and pains, and constipation. The physician will likely order:
T3 and T4 serum level laboratory tests
The nurse is completing a health assessment of a 42 y/o female with suspected Graves disease. The nurse should assess the client for:
Tachycardia
The nurse is completing a health assessment of a 42 y/o female with suspected Graves' disease. The nurse should assess this client for:
Tachycardia
A nurse is preparing to discharge a client who has had a parathyroidectomy. When teaching the client about the prescribed oral calcium supplement, what information should the nurse include?
Take the calcium 30 to 60 minutes following a meal *oral calcium supplements can be taken 30 to 60 minutes after meals to enhance their absorption and decrease GI irritation
After treatment with radioactive iodine, the nurse should teach the client to:
Take thyroxine replacement for the remainder of the client's life
A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what "type 2" means in relation to the patient that type 2 diabetes different from type 1 diabetes primarily in that type 2 diabetes:
There is decreased insulin secretion and cellular resistance to insulin that is produced
A type 1 diabetic patient who was admitted with severe hypoglycemia and treated tells the nurse, "I did not have any of the usual symptoms of hypoglycemia." Which question by the nurse will help identify a possible reason for the patient's hypoglycemic unawareness?
"Do you notice any bloating feeling after eating?"
The nurse is evaluating a client with hyperthyroidism who is taking propylthioracil (PTU) 100mg/day in three divided doses for maintenance therapy. Which statement from the client indicates the drug is effective?
"I am able to sleep and rest at night"
Which statement by the patient with type 2 diabetes is accurate?
"I am supposed to have a meal or snack if I drink alcohol"
Which statement made by the client makes the nurse suspect the client is experiencing hyperthyroidism?
"I have noticed all my collars are getting tighter" *the thyroid gland (in the neck) enlarges as a result of the increased need for thyroid hormone production; an enlarged gland is called a goiter
A nurse has reinforced instructions to the client with hyperparathyroidism regarding home care measures related to exercise. Which statement by the client indicates a need for further instruction? Select all that apply.
"I need to limit playing football to only the weekends" "I should exercise in the evening to encourage a good sleeping pattern"
The nurse has taught a patient admitted with diabetes, cellulitis, and osteomyelitis about the principles of foot care. The nurse evaluates that the patient understands the principles of foot care if the patient makes what statement?
"I should look at the condition of my feet every day"
Which of the following clients is at risk for developing thyrotoxicosis?
A client with Graves' disease who is having surgery
The nurse teaches the diabetic patient who rides a bicycle to work every day to administer morning insulin into the:
Abdomen *patients should be taught not to administer insulin into a site that will be exercised because exercise will increase the rate of absorption
A client weighs 95kg and has been diagnosed with hyperglycemia and tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client's hyperglycemia?
Acromegaly
The nurse is aware that the following is the most common cause of hyperaldosteronism?
An adrenal adenoma *an autonomous aldosterone-producing adenoma is the most common cause of hyperaldosteronism
A patient recovering from DKA asks the nurse how acidosis occurs. The best response by the nurse is that:
An insulin deficit promotes metabolism of fat stores, which produces large amounts of acidic ketones
A nurse is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?
Antidiuretic hormone (ADH)
The nurse should assess a client with hypothyroidism for:
Decreased activity due to fatigue
Physical changes of hypothyroidism that must be monitored when replacement therapy is started include
Decreased cardiac contractility and coronary atherosclerosis *hypothyroidism affects the heart in many ways causing cardiomyopathy, coronary atherosclerosis, bradycardia, pericardial effusions, and weakened cardiac contractility
A 34 y/o female is diagnosed with hypothyroidism. What should the nurse assess the client for? Select all that apply.
Decreased energy and fatigue Weight gain of 10lb Constipation Menorrhagia
A patient is admitted to the hospital with a diagnosis of Cushing syndrome. On physical assessment of the patient, the nurse would expect to find:
HTN, peripheral edema, and petechiae *the effects of glucocorticoid excess include weight gain from accumulation and redistribution of adipose tissue, sodium and water retention, glucose intolerance, protein wasting, loss of bone structure, loss of collagen, and capillary fragility
A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are only effective if the client:
Has type 2 diabetes
When the patient with parathyroid disease experiences symptoms of hypocalcemia, a measure that can be used to temporarily raise serum calcium levels is to:
Have the patient rebreathe in a paper bag *rebreathing in a paper bag promotes carbon dioxide retention in the blood, which lowers pH and creates an acidosis. An academia enhances the solubility and ionization of calcium, increasing the proportion of total body calcium available in physiologically active form and relieving the symptoms of hypocalcemia
Preoperative instructions for the patient scheduled for a subtotal thyroidectomy includes teaching the patient:
How to support the head with the hands when moving *to prevent strain on the suture line postoperatively, the head must be manually supported while turning and in bed
Which signs/symptoms should make the nurse suspect the client is experiencing a thyroid storm?
Hyperpyrexia and extreme tachycardia *hyperpyrexia (high fever) and heart rate above 130 bpm are signs of thyroid storm, a severely exaggerated hyperthyroidism
A nurse is caring for a client after a thyroidectomy and monitoring for signs of thyroid storm. The nurse understands that which of the following is a manifestation associated with this disorder?
Hypotension
Myxedema, which includes fatigue, general weakness, and muscle cramps, is a symptom of which endocrine disorder treated with levothyroxine?
Hypothyroidism
A patient with SIADH is treated with water restriction and administration of IV fluids. The nurse evaluates that treatment has been effective when the patient experiences:
Increased urine output, increased serum sodium, decreased urine specific gravity *patients with SIADH have water retention with hyponatremia, decreased urine output and concentrated urine with high specific gravity
A client is admitted to the ED, and a diagnosis of myxedema coma is made. Which action would the nurse prepare to carry out initially?
Maintain a patent airway
The most important nursing intervention during the medical and surgical treatment of the patient with a pheochromocytoma is:
Monitoring blood pressure *a pheochromocytoma is a catecholamine-producing tumor in the adrenal medulla, which may cause severe, episodic hypertension: severe, pounding headache, and profusely sweating
When discussing recent onset of feelings of sadness and depression in a client with hypothyroidism who has just started taking thyroid hormone replacement, the nurse should inform the client that these feelings are:
Most likely related to low thyroid hormone levels and will improve with treatment
An incoherent female client with a history of hypothyroidism is brought to the ED. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these are findings suggesting severe hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of:
Myxedema coma
One day following a subtotal thyroidectomy a client begins to have tingling in the fingers and toes. The nurse should first:
Notify the healthcare provider
A client with Graves' disease has exophthalmos and is experiencing photophobia .Which intervention would best assist the client with this problem?
Obtaining dark glasses for the client
When conducting a health history with a female client with thyrotoxicosis, the nurse should ask about which changes in the menstrual cycle?
Oligomenorrhea
A client who has undergone a subtotal thyroidectomy is subject to complications in the first 48 hours after surgery. The nurse should obtain and keep at the bedside equipment to:
Perform a tracheotomy
A nurse is caring for a client with a diagnosis of hypoparathyroidism. The nurse reviews the laboratory results drawn on the client and notes that the calcium level is extremely low. The nurse would expect to note which of the following on data collection of the client?
Positive Trousseau's sign
Propylthioracil (PTU) is prescribed for a client with Graves disease. The nurse should teach the client to immediately report:
Sore throat
A patient with type 2 diabetes is scheduled for an outpatient coronary arteriogram. Which information obtained by the nurse when admitting the patient indicates a need for a change in the patient's regimen?
The patient takes metformin (Glucophage) every morning *to avoid lactosis, metformin should not be used for 48 hours after IV contrast media are administered.
The healthcare provider orders oral glucose tolerance testing for a patient seen in the clinic. Which information from the patient's health history is most important for the nurse to communicate to the healthcare provider?
The patient uses oral contraceptives *oral contraceptive use may falsely elevate oral glucose tolerance test values
A nurse is collecting data on a client with hyperparathyroidism. Which of the following questions would elicit the accurate information about this condition from the client?
"Are you experiencing pain in your joints?"
When assessing the patient experiencing the onset of symptoms of type 1 diabetes, which question should the nurse ask?
"Have you lost any weight lately?"
A newly diagnosed type 1 diabetic patient likes to run 3 miles several mornings a week. Which teaching will the nurse implement about exercise for this patient?
"Plan to eat breakfast about an hour before you run"
When teaching a patient with type 2 diabetes about taking glipizide (Glucotrol), the nurse determines that additional teaching about the medication is needed when the patient says:
"Since I can take oral drugs rather than insulin, my diabetes is not serious and won't cause many complications"
A 54 y/o patient admitted with type 2 diabetes asks the nurse what "type 2" means. What is the most appropriate response by the nurse?
"With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased"
Which statement is the most important for a nurse to make to a patient who is taking methimazole?
"You need to notify your doctor if you have a sore throat and fever"
A client with thyrotoxicosis says to the nurse, "I am so irritable. I am having problems at work because I lose my temper very easily." Which response by the nurse would give the client the most accurate explanation of this behavior?
"Your behavior is caused by the excess thyroid hormone in your system"
The nurse identifies the client problem "risk for imbalanced body temperature" for the client diagnosed with hypothyroidism. Which intervention should be included in the plan of care?
Discourage the use of an electric blanket
The nurse identifies the client problem "risk for imbalanced body temperature" for the client diagnosed with hypothyroidism. Which intervention should be included in the plan of care?
Discourage the use of an electric blanket *external heat sources should be discouraged because they increase the risk of peripheral vasodilation and vascular collapse
When caring for a patient with primary hyperaldosteronism, the nurse would question the physician's order for the use of:
Lasix *hyperaldosteronism is an excess of aldosterone, which is manifested by sodium and water retention and potassium excretion. Lasix is a potassium-wasting diuretic that would increase the potassium deficiency
A patient with DI is treated with nasal desmopression. The nurse recognizes that the drug is not having an adequate therapeutic effect when the patient experiences:
A urine specific gravity of 1.002 *normal urine specific gravity is 1.003 to 1.030, and urine with a specific gravity of 1.002 is very dilute, indicating that there continues to be excessive loss of water and that treatment of DI is inadequate
A nurse is collecting data from a client who is being admitted to the hospital for a diagnostic workup for primary hyperparathyroidism. The nurse understands that which client complaint would be a characteristic of this disorder?
Polyuria *hypercalcemia is the hallmark of hyperparathryoidism. Elevated serum calcium levels produce osmotic diuresis (polyuria)
Causes of primary hypothyroidism in adults include:
Autoimmune-induced atrophy of the gland *Graves disease and Hashimotos thyroiditis are autoimmune disorders that eventually destroy the thyroid gland, leading to primary hypothyroidism. Thyroid tumors most often result in hyperthyroidism.
When providing discharge instructions to a patient following a subtotal thyroidectomy, the nurse advises the patient to:
Avoid eating foods such as soybeans, turnips, and rutabagas *when a patient has had a subtotal thyroidectomy, thyroid replacement therapy is not given because exogenous hormone inhibits pituitary production of TSH and delays or prevents the restoration of thyroid tissue regeneration. The patient should avoid goitrogens, foods that inhibit the thyroid, such as soybeans, turnips, rutabagas, and peanut skins
A nurse is collecting data on a client with a diagnosis of hypothyroidism. Which of these behaviors, if present in the client's history, would the nurse determine as being likely related to the manifestations of this disorder?
Depression
The nurse is performing an assessment on a client with a diagnosis of hyperthyroidism. Which assessment finding should the nurse expect to note in this client?
Bulging eyeballs
The nurse is administering a saturated solution of potassium iodide (SSKI). The nurse should:
Dilute the solution with water, milk, or fruit juice and have the client drink it with a straw
The nurse identifies the client problem "risk for imbalanced body temperature for the client diagnosed with hypothyroidism. Which intervention should be included in the plan of care?
Discourage the use of an electric blanket
A client has returned to the nursing unit after a thyroidectomy. The nurse notes that the client is complaining of tingling sensations around the mouth, fingers, and toes. On the basis of these findings, the nurse should next assess the results of which serum laboratory study?
Calcium
To prevent complications in the patient with Cushing syndrome, the nurse monitors the patient for:
Cardiac arrhythmias *electrolyte changes that occur in Cushing syndrome include sodium retention and potassium excretion by the kidney, resulting in hypokalemia, which may lead to arrhythmias or arrest
A nurse working on an endocrine nursing unit understands that which correct concept is used in planning nursing care?
Clients who have hyperparathyroidism should be protected against falls
The client is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the client to exhibit?
Complaints of extreme fatigue and hair loss
The client is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the client to exhibit?
Complaints of extreme fatigue and hair loss *a decrease in thyroid hormone causes decreased metabolism, which leads to fatigue and hair loss
A nurse is caring for a client diagnosed with hyperparathyroidism who is prescribed furosemide (Lasix). The nurse reinforces dietary instructions to the client. Which of the following is an appropriate instruction?
Drink at least 2-3 L of fluid daily
The nurse is evaluating a 45 y/o patient diagnosed with type 2 diabetes mellitus. Which symptom reported by the patient is considered one of the classic clinical manifestations of diabetes?
Excessive thirst
The 68 y/o client diagnosed with hyperthyroidism is being treated with radioactive iodine therapy. Which interventions should the nurse discuss with the client?
Explain it will take up to a month for symptoms of hyperthyroidism to subside
A nurse is monitoring a client with Graves' disease for signs of thyrotoxic crisis (thyroid storm). Which of the following signs and symptoms, if noted by the client, will alert the nurse to the presence of this crisis? Select all that apply.
Fever, Sweating, Agitation
Polydipsia and polyuria related to diabetes mellitus are due to:
Fluid shifts resulting from the osmotic effect of hyperglycemia
After having a double-bacon cheeseburger with a milkshake, which of the following hormones would NOT be expected to increase?
Glucagon
The nurse caring for a patient hospitalized with diabetes mellitus would look for which laboratory test result to obtain information on the patient's past glucose control?
Glycosylated hemoglobin level *a glycosylated hemoglobin level detects the amount of glucose that is bound to RBCs.
Which disease is characterized by increased body metabolism, tachycardia, increased body temperature, and anxiety and treated with PTU?
Graves' disease
A nurse is caring for a patient with decreased triiodothyronine (T3) and thyroxine (T4) and elevated thyroid-stimulating hormone (TSH) levels. The nurse knows the patient is likely suffering from what?
Hypothyroidism
A patient with Addison's disease comes to the ED with complaints of N/V/D, and fever. The nurse would expect collaborative care to include:
IV administration of hydrocortisone *vomiting and diarrhea are early indicators of addisonian crisis and fever indicates infection, which is causing additional stress for the patient. Treatment of a crisis requires immediate glucocorticoid replacement, and IV hydrocortisone, fluids, sodium and glucose as necessary for 24 hours
An appropriate nursing intervention for the patient with hyperparathyroidism is to:
Increase fluid intake to 3-4000 mL/day *a high fluid intake is indicated in hyperparathyroidism to dilute hypercalcemia and flush the kidneys so that calcium stone formation is reduced
A patient is scheduled for bilateral adrenalectomy. During the postoperative period, the nurse would expect administration of corticosteroids to be:
Increased to promote an adequate response to the stress of surgery *removal of the glands and the stress of surgery require high doses of cortisone be administrated postoperatively for several days
For a male client with hyperglycemia, which assessment finding best supports a nursing diagnosis of deficient fluid volume?
Increased urine osmolarity
A nurse is collecting data on a client admitted to the hospital with a diagnosis of myxedema. Which data collection technique will provide data necessary to support the admitting diagnosis?
Inspection of facial features
A nurse is caring for a client experiencing thyroid storm. Which of the following would be a priority concern for this client?
Potential for cardiac disturbances
What would the nurse anticipate being included in the plan of care for a client who has been diagnosed with Graves' disease?
Provide a restful environment
Which nursing intervention should be included in the plan of care for the client diagnosed with hyperthyroidism?
Provide six small, well-balanced meals a day *the client with hyperthyroidism has an increased appetite; therefore, well-balanced meals served several times throughout the day will help with the client's constant hunger
A patient with hypothyroidism is treated with Synthroid. When teaching the patient about the therapy, the nurse:
Provides written instruction for all information related to the medication therapy *because of the mental sluggishness, inattentiveness, and memory loss that occur with hypothyroidism, it is important to provide written instructions and repeat information when teaching the patient
The nurse should expect a client with hypothyroidism to report which health concerns?
Puffiness of the face and hands *hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight gain
The client is admitted to the ICU department diagnosed with myxedemacoma. Which assessment data warrant immediate intervention by the nurse?
Pulse oximeter reading of 90%
A nurse is collecting data regarding a client after a thyroidectomy and notes that the client has developed hoarseness and a weakened voice. Which nursing action is appropriate?
Reassure the client that this is usually a tmeporary condition
A client with a large goiter is scheduled for a subtotal thyroidectomy to treat thyrotoxicosis. Saturated solution of potassium iodide (SSKI) is prescribed preoperatively for the client. The expected outcome of using this drug is that it helps:
Reduce the vascularity of the thyroid gland
The newly diagnosed patient with type 2 diabetes has been prescribed metformin (Glucophage). What should the nurse tell the patient to best explain how this medication works?
Reduces glucose production by the liver and enhances insulin sensitivity
A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of risk for injury. To complete the nursing diagnosis statement for this client, which "related-to" phrase should the nurse add?
Related to bone demineralization resulting in pathologic fractures
A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?
Restricting fluids
Which medication order should the nurse question in the client diagnosed with untreated hypothyroidism?
Sedatives *untreated hypothyroidism is characterized by an increased susceptibility to the effects of most hypnotic and sedative agents; therefore the nurse should question this medication
After the home health nurse has taught a patient and family about how to use glargine and regular insulin safely, which action by the patient indicates that the teaching has been successful?
The patient disposes of the open insulin vials after 4 weeks
Common signs and symptoms of hypothyroidism:
Thickened skin, hair loss, constipation, lethargy, and anorexia
Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client, who now has nausea, temperature of 40.5C, tachycardia, and extreme restlessness. What is the most likely cause of these signs?
Thyroid crisis
A nurse is monitoring a client following a thyroidectomy for signs of hypocalcemia. Which of the following signs, if noted in the client, likely indicates the presence of hypocalcemia?
Tingling around the mouth
The nurse is monitoring a client for signs of hypocalcemia after a thyroidectomy. Which sign or symptom, if noted by the client, would most likely indicate the presence of hypocalcemia?
Tingling around the mouth
In administration of a drug such as levothyroxine, the nurse should teach the client:
To report weight loss, anxiety, insomnia, and palpitations
A female client has a serum calcium level of 7.2 mg/dL. During the physical examination, the nurse expects to assess:
Trousseau's sign
A nurse has reinforced dietary instructions to a client with a diagnosis of hypoparathyroidism. The nurse instructs the client to include which of the following items in the diet?
Vegetables
The nurse should teach the client with Graves disease to prevent corneal irritation from mild exophthalmos by:
Wearing dark-colored glasses
In a patient with central diabetes insipidus, administration of aqueous vasopressin during a water deprivation test will result in a:
increase in urine osmolality *patients with DI have a deficiency of ADH with excessive loss of water from the kidneys, hypovolemia, hypernatremia, and dilute urine with a low specific gravity. When vasopressin is administered, the symptoms are reversed
Which of these laboratory values noted by the nurse when reviewing the chart of a diabetic patient indicates the need for further assessment of the patient?
noon blood glucose of 52 mg/dL
