NCLEX-RN Test Integumentary & Endocrine Part 1

The nurse reviews prescriptions for assigned adult clients. Which prescription should the nurse question? 1. 0.45% sodium chloride solution prescribed for a client with SIADH who has a sodium level of 120 2. 0.9% NaCl solution prescribed for a client with gastrointestinal bleeding who has a hemoglobin level of 8.9 3. 1,000 mL bolus of 0.9% NaCl solution prescribed for a client with septic shock who has a white blood cell count of 18,000/mm3 4. Lactated Ringer's solution prescribed for a male client with hypovolemic shock and a thermal burn who has a hematocrit level of 56%

1. 0.45% sodium chloride solution prescribed for a client with SIADH who has a sodium level of 120 SIADH is associated with increased water reabsorption and excessive extracellular fluid. Which results in hypervolemia from fluid retention and hyponatremia.

The nurse educates a 30 year old female client who is being evaluated for hyperthyroidism with a radioactive iodine uptake (RAIU) test. Which instructions should the nurse include in the teaching plan? SATA 1. A pregnancy test must be obtained prior to RAIU test administration 2. All jewelry or metal around the neck area should be removed before the RAIU test 3. Antithyroid medications should be held for 5-7 days before the RAIU test 4. Conscious sedation will be used to help with relaxation during the RAIU test 5. It is important to refrain from eating or drinking for at least 12 hours before the RAIU test

1. A pregnancy test must be obtained prior to RAIU test administration 2. All jewelry or metal around the neck area should be removed before the RAIU test 3. Antithyroid medications should be held for 5-7 days before the RAIU test

The nurse cares for a client who is experiencing exophthalmos as a complication of Graves disease. Which nursing action should be included in the client's plan of care? SATA 1. Administer artificial tears to moisten the conjunctiva 2. If eyelids don't close during sleep, lightly tape them shut 3. Recommend the use of dark glasses to prevent irritation 4. Teach about the importance of smoking cessation 5. Teach avoidance of eye movement to prevent further damage

1. Administer artificial tears to moisten the conjunctiva 2. If eyelids don't close during sleep, lightly tape them shut 3. Recommend the use of dark glasses to prevent irritation 4. Teach about the importance of smoking cessation

The nurse in the intensive care unit cares for a client with primary adrenocortical insufficiency (Addison). The client reports feeling nausea and abdominal pain. The blood pressure suddenly drops fro 120/74 to 88/48, heart rate increases from 80 to 100/min, and the client appears confused. Which action should the nurse take first? 1. Administer as needed as of hydrocortisone intravenous push 2. Complete a head to toe assessment to identify any sources of infection 3. Document the findings in the client's electronic medical record 4. Take blood pressure sitting and standing to assess for orthostatic hypotension

1. Administer as needed as of hydrocortisone intravenous push

In the intensive care unit, the nurse cares for a client who develops diabetes insipidus 2 days after pituitary adenoma removal via hypophysectomy. Which intervention should the nurse implement? 1. Administer desmopressin 2. Assess fasting blood glucose 3. Initiate fluid resuscitation 4. Place the client in the Trendelenburg position.

1. Administer desmopressin Diabetes Insipidus is a condition that occurs due to insufficient production of antidiuretic hormone. Neurogenic DI that results from ADH secretion. DI causes polydipsia, polyuria, and low urine specific gravity. Desmopressin DDAVP is without vasopressor and is preferred.

A nurse is caring for a client admitted to the intensive care unit for toxic epidermal necrolysis. Which interventions should be included in the client's plan of care? SATA 1. Administer prescribed eye lubricants on schedule 2. Apply sterile, moist dressings and ointments to denuded areas of skin 3. Implement reverse isolation precautions and strict aseptic technique 4. Keep room temperature warm to prevent shivering 5. Provide gentle massage as needed to relieve pain

1. Administer prescribed eye lubricants on schedule 2. Apply sterile, moist dressings and ointments to denuded areas of skin 3. Implement reverse isolation precautions and strict aseptic technique 4. Keep room temperature warm to prevent shivering

A nurse is making a presentation on skin cancer prevention with special focus on melanoma at a community health forum. Which statement should the nurse include? SATA 1. Apply a broad spectrum sunscreen before and during outdoor sports 2. Apply sunscreen a few minutes before outdoor activities 3. Reapply sunscreen after swimming even if waterproof sunscreen was used earlier 4. Serious sunburns can occur even on overcast days 5. Use tanning beds for < 15 minutes for a base tan that is less likely to burn

1. Apply a broad spectrum sunscreen before and during outdoor sports 3. Reapply sunscreen after swimming even if waterproof sunscreen was used earlier 4. Serious sunburns can occur even on overcast days

The nurse cares for a client with Addison's disease who was involved in a motor vehicle accident and hospitalized for a fracture of the right femur. Which client information is most important to report to the primary health care provider? 1. Blood pressure change from 128/80 mmHg to 90/50 2. Development of a 1st degree AV block on ECG 3. Reports of right femur pain of 7 on a scale of 1-10 4. Vesicular breath sounds auscultated over the lung tissue

1. Blood pressure change from 128/80 mmHg to 90/50

The clinic nurse is reviewing the laboratory results of a 35 year old client who reports fatigue for the last month. Based on the lab results, which additional clinical manifestation would the nurse expect? SATA 1. Bradycardia 2. Cold intolerance 3. Constipation 4. Hair loss 5. Warm, moist skin 6. Weight loss TSH= 8.6 (0.4-4.2) T3= 30 (70-204) T4= 0.2 (0.8-2.7)

1. Bradycardia 2. Cold intolerance 3. Constipation 4. Hair loss Primary Hypothyroidism is an endocrine disorder identified by low thyroid hormone (T3 and T4) and a high (TSH). TSH is elevated in Hypothyroidism in an attempt to normalize the thyroid. S/S of Hypo: weight gain, constipation, dry skin, hair loss, cold intolerance, bradycardia and confusion.

The nurse assesses a female client with a diagnoses of primary adrenal insufficiency (Addison). The nurse recognizes which finding associated with the disease? 1. Bronze pigmentation of the skin 2. Increased body or facial hair 3. Purple or red striae on the abdomen 4. Supraclavicular fat pad

1. Bronze pigmentation of the skin

The clinic nurse is taking vital signs on a client who reports being fatigued every day and gaining weight lately despite not eating much. The nurse should also ask about which symptoms SATA 1. Cold intolerance 2. Constipation 3. Fever 4. Menstrual irregularities 5. Night sweats 6. Tachycardia

1. Cold intolerance 2. Constipation 4. Menstrual irregularities

The nurse is teaching a group of clients diagnosed with diabetes mellitus. Which lesson regarding foot care should be included? SATA 1. Cut toenails straight across and file along the curves of the toes 2. Rub feet vigorously with a towel after bathing to ensure dryness 3. Use a mild foot powder on perspiring feet 4. Use cotton or lamb's wool to separate overlapping toes 5. Use an OTC corn removal kit to remove corns or calluses

1. Cut toenails straight across and file along the curves of the toes 3. Use a mild foot powder on perspiring feet 4. Use cotton or lamb's wool to separate overlapping toes

In the intensive care unit, the nurse cares for a client admitted with a head injury who develops syndrome of inappropriate antidiuretic hormone. Which data should the nurse expect with the onset of this condition? SATA 1. Decreased serum osmolality 2. High serum osmolality 3. High urine specific gravity 4. Increased urine output 5. Low serum sodium

1. Decreased serum osmolality 3. High urine specific gravity 5. Low serum sodium

A client is diagnosed with diabetic ketoacidosis (DKA). The client reports frequent urination, thirst and weakness. The nurse assesses a temperature of 102.4, fruity breath, deep labored respiration with a rate of 30/min, and dry mucous membranes. What is the priority nursing diagnosis at this time? 1. Deficient fluid volume related to osmotic diuresis 2. Imbalanced nutrition, less than body requirements related to inability to metabolize glucose 3. Ineffective breathing pattern related to the presence of metabolic acidosis 4. Ineffective health maintenance related to the inability to manage DM during illness

1. Deficient fluid volume related to osmotic diuresis

The nurse teaches disease management to a group of clients with type 1 diabetes mellitus. Which of the following should the nurse teach as signs or symptoms associated with hypoglycemia? SATA 1. Diaphoresis 2. Flushing 3. Pallor 4. Polyuria 5. Trembling

1. Diaphoresis 3. Pallor 5. Trembling

The nurse assesses a client with Cushing syndrome. Which clinical manifestations should the nurse expect? SATA 1. Hyperglycemia 2. Hypertension 3. Hyponatremia 4. Truncal obesity 5. Weight loss

1. Hyperglycemia 2. Hypertension 4. Truncal obesity

The nurse is conducting an educational community outreach program on melanoma screening. Which statement by a resident would indicate the need for further education? 1. Abrupt changes in the size or color of a mole are warning signs 2. All new growths and pigmentations must be biopsied to rule out cancer 3. Melanoma can occur as any color 4. Melanoma does not always occur as a new mole.

2. All new growths and pigmentations must be biopsied to rule out cancer

The nurse is assessing a 2 year old who has a blistered sunburn across the back and shoulders. Which of the following parent statements indicates an appropriate understanding of care for sunburn? SATA 1. I am allowing my child to play outdoors only very early in the morning and late in the evening since the sunburn 2. I am encouraging extra fluids since my child got sunburned 3. I have been giving my child acetaminophen to help relieve the pain 4. I have been placing cool wet washcloths on my child's back 5. I have rubbed hydrocortisone cream on the area to help reduce inflammation and promote healing

1. I am allowing my child to play outdoors only very early in the morning and late in the evening since the sunburn 2. I am encouraging extra fluids since my child got sunburned 3. I have been giving my child acetaminophen to help relieve the pain 4. I have been placing cool wet washcloths on my child's back

The nurse is providing discharge teaching for a client who suffered full-thickness burns. Which statement by the client demonstrates a need for further instruction on the rehabilitation phase of a burn injury? 1. I should avoid using lotion to prevent infection 2. I should perform range of motion exercises daily 3. I will avoid direct sun exposure for at least 3 months 4. I will wear pressure garments to minimize scars

1. I should avoid using lotion to prevent infection Lotion is necessary to minimize scar formation and alleviate itching. Infection is not likely as the rehabilitation phase begins after the wounds are fully healed.

A client with Type 1 diabetes mellitus is on intensive insulin therapy. The client is of the Islamic faith and insists on fasting during Ramadan. What is the most important nursing action? 1. Advise the client of the risks of fasting when diabetic 2. Assess the client's stability and glycemic control 3. Refer the client to the health care provider for adjustment of the insulin therapy 4. Refer the client to the registered dietitian for meal planning

2. Assess the client's stability and glycemic control

The emergency department nurse cares for a client admitted with a diagnosis of hyperosmolar hyperglycemic state. The nurse understands which characteristics are commonly associated with this complication? SATA 1. Abdominal pain 2. Blood glucose level >600 3. History of type 2 diabetes 4. Kussmaul respirations 5. Neurological Manifestations

2. Blood glucose level >600 3. History of type 2 diabetes 5. Neurological Manifestations

When no changes are made to the diet or prescribed insulin, which client with type 1 diabetes mellitus does the nurse anticipate having the highest risk of developing hypoglycemia? 1. 29 year old with new onset of influenza 2. 40 year old experienced cyclist who rides an extra 10 miles 3. 65 year old with cellulitis of the right leg 4. 72 year old with emphysema who is taking prednisone

2. 40 year old experienced cyclist who rides an extra 10 miles

The nurse is caring for an adolescent client diagnosed with Type 1 Diabetes. The client exhibits hot, dry skin and a glucose level of 350 mg/dL (19.4 mmol/L) Arterial blood gases show a pH of 7.27. STAT serum chemistry labs have been drawn. Cardiac monitoring shows a sinus rhythm with peaked T waves, and the client has minimal urine output. What is the nurse's next priority action? 1. Administer IV regular insulin 2. Administer normal salin infusion 3. Obtain urine for urinalysis 4. Request prescription for potassium infusion

2. Administer normal salin infusion Patients with diabetic ketoacidosis experience dehydration due to osmotic diuresis. Prompt and adequate fluid therapy restores tissue perfusion and suppresses the elevated levels of stress hormones. Initial hydrating solution is 0.9% saline infusion

During a screening clinic, the nurse performs a health assessment on several adult clients. Which finding by the nurse is most important to report to the primary health care provider? 1. Body mass index of 23 2. Brownish skin thickening on the neck 3. Fasting total cholesterol of 180 4. Round 3x3 mm pale pink mole

2. Brownish skin thickening on the neck Acanthosis nigricans is a skin disorder characterized by presence of symmetric, hyperpigmented velvety plaques located in flexural and intertiginous regions of the skin. (axilla and neck)

A client with type 1 diabetes is prescribed NPH insulin before breakfast and dinner. Although the client reports feeling well, the 6 AM blood glucose level has averaged 60 mg/dL over the past week. Which action is appropriate for the nurse to recommend to the client? 1. Collect urine sample to check for urine ketones 2. Consume a snack of milk and cereal at bedtime 3. Increase carbohydrate intake at each meal 4. Take only the pre-breakfast dose of NPH

2. Consume a snack of milk and cereal at bedtime

A client with type 1 diabetes is prescribed NPH insulin before breakfast and dinner. Although the client reports feeling well, the 6 AM blood glucose levels has averaged 60 mg/dL over the past week. Which action is appropriate for the nurse to recommend to the client? 1. Collect urine sample to check for urine ketones 2. Consume a snack of milk and cereal at bedtime 3. Increase carbohydrate intake at each meal 4. Take only the pre-breakfast dose of NPH

2. Consume a snack of milk and cereal at bedtime

The nurse is assessing a group of clients in the community health clinic for metabolic syndrome. Which client exhibit features of the syndrome? SATA 1. Female with a LDL level of 96 2. Female with a waist circumference of 38 in 3. Female with blood pressure of 148/90 4. Male with a fasting blood glucose of 99 5. Male with a triglyceride level of 201

2. Female with a waist circumference of 38 in 3. Female with blood pressure of 148/90 5. Male with a triglyceride level of 201

The nurse cares for a client admitted to the hospital due to confusion. The client has a non-metastatic lung mass and a diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Which actions should the nurse expect to implement? SATA 1. Fluid bolus 2. Fluid restriction 3. Salt restriction 4. Seizure precautions 5. Strict record of fluid intake output

2. Fluid restriction 4. Seizure precautions 5. Strict record of fluid intake output

The nurse cares of a client with type 2 Diabetes mellitus. The client is alert and oriented but also shaky, pale and diaphoretic. The client's fingerstick bloock glucose is 50 mg/dL. Which of the following is the best next step the nurse can take? 1. Administer dextrose 50 mg IV push 2. Give client 6 oz of orange juice or low-fat milk 3. Inject the client with glucagon 2 mg IM 4. Verify finger stick blood glucose with serum blood draw.

2. Give client 6 oz of orange juice or low-fat milk

The nurse is caring for an adult client at the clinic who asks the nurse to look at a "black skin lesion." What assessment findings would be a classic indication of a potential malignant skin neoplasm? SATA 1. Blanches with manual pressure 2. Half of the lesion is raised and half is flat 3. History of purulent drainage 4. Lesion is the size of a nickel 5. Various color shades are present

2. Half of the lesion is raised and half is flat 4. Lesion is the size of a nickel 5. Various color shades are present Examination for skin cancer is ABCDE: Asymmetry Border Color changes Diameter (6mm or larger) Evolving (shape, size, color)

A client is admitted to the intensive care unit with diagnosis of a brain tumor complicated by transient diabetes insipidus. Which client related to this complication should the nurse expect? SATA 1. Dark amber urine with sediment 2. High serum osmolality 3. Low urine specific gravity 4. Recent weight gain 5. Reports of excessive thirst

2. High serum osmolality 3. Low urine specific gravity 5. Reports of excessive thirst

The nurse is conducting a health screening clinic at an industrial work site. The nurse should be most concerned about which client's risk for metabolic syndrome? 1. 27 year old woman with triglycerides of 210, BP of 128/82, and fasting blood glucose of 98 2. 45 year old man with waist circumference of 38 in, HDL of 49, and fasting blood glucose of 118 3. 55 year old woman with waist circumference of 37 in, triglycerides of 190, and fasting blood glucose of 120 4. 82 year old man with HDL of 45, BP of 148/88, and fasting blood glucose of 104

3. 55 year old woman with waist circumference of 37 in, triglycerides of 190, and fasting blood glucose of 120 Metabolic syndrome is presence that increase's a client's risk for stroke, diabetes mellitus and cardiovascular disease. Metabolic syndrome includes: abdominal obesity high serum triglycerides level levels of LDL hypertension hyperglycemia

The nurse is performing an initial assessment on a client diagnosed with Addison's disease. Which assessment findings should the nurse anticipate? SATA 1. Acanthosis nigricans 2. Hirsutism 3. Hyperpigmented skin 4. Truncal obesity 5. Weight loss

3. Hyperpigmented skin 5. Weight loss

The nurse participating in an out patient clinic cares for a client recently diagnosed with hyperthyroidism. Which diet-related teaching should the nurse add to the client's plan of care? SATA 1. Emphasize the important of a low carb diet 2. Encourage the client to increase high fiber foods in the diet 3. Include meals and snacks high in protein content 4. Teach avoidance of caffeine containing liquids 5. Teach the client about consumption of a high calorie diet of 4,000-5,000 calories/day

3. Include meals and snacks high in protein content 4. Teach avoidance of caffeine containing liquids 5. Teach the client about consumption of a high calorie diet of 4,000-5,000 calories/day

The emergency nurse admits a client who was rescued from a burning building. The client's arms and chest are covered with dry, leathery, charred skin that does not blanch. Which new prescription should the nurse implement first? 1. Administer 50-100 mcg fentanyl IV push every 30 minutes PRN for pain 2. Apply topical bacitracin ointment to burn wounds, twice daily 3. Infuse 150 mL.hr lactated Ringer solution IV continuously 4. Obtain equipment and prepare client for escharotomy

3. Infuse 150 mL.hr lactated Ringer solution IV continuously

In the intensive care unit, the nurse cares for a client who has been admitted with diabetic ketoacidosis. The client is on a continuous infusion of regular insulin at 5 units/hr via IV pump. Which action should the nurse expect to implement? 1. Check serum BUN and creatinine levels every hour 2. Discontinue insulin infusion when blood glucose is <350 3. Increase insulin infusion rate when blood glucose levels decrease 3. Initiate potassium IV when serum potassium is 3.5-5.0

3. Initiate potassium IV when serum potassium is 3.5-5.0 DKA includes fluid resuscitation, IV insulin and hourly blood glucose monitor. Hypokalemia often occurs with resolution of acidosis which shifts potassium. So to prevent hypokalemia and life-threatening arrhythmias.

The nurse assigned to care for a client who had a thyroidectomy 24 hours ago. On initial assessment, which finding requires the most immediate action by the nurse? 1. Calcium 8.8 2. Heart rate 110/min 3. Laryngeal stridor 4. Pain rated 8 out of 10

3. Laryngeal stridor A life threatening complication that is a high-pitched vibratory, harsh sound during inspiration or expiration that indicates partial airway obstruction.

A client with Type 1 diabetes mellitus is brought to the emergency department by his wife. The client has fruity breath with rapid, deep respirations at 36 breaths per minute, reports abdominal pain and appears weak. The nurse should anticipate implementation of which prescriptions? SATA 1. Administer dextrose 50 mg IV push 2. Instruct client to breath into a paper bag to treat hyperventilation 3. Perform a fingerstick and serum blood glucose test 4. Prepare to administer an IV infusion of regular insulin 5. Start an IV line and administer a bolus of normal saline

3. Perform a finger stick and serum blood glucose test 4. Prepare to administer an IV infusion of regular insulin 5. Start an IV line and administer a bolus of normal saline Diabetic ketoacidosis DKA is an acute life threatening complication. DKA is caused by an intense deficit of insulin and should be treated first with rehydration (normal saline) and then insulin administration. Glucose cannot be used properly for energy when this deficit occurs and the body begins to break down fat stores, producing ketones resulting in metabolic acidosis.

The nurse cares for a client admitted with severe burns who is now on fluid resuscitation therapy. Which assessment findings would best indicate that fluid resuscitation has been successful? 1. Heart rate 89/min, blood pressure 99/52 2. Potassium decreases from 5.7 to 5.0 3. Urine output 31 mL/hr 4. Weight gain of 2.2 lbs in last 8 hours and palpable pulses

3. Urine output 31 mL/hr Aggressive fluid resuscitation is essential to correct hypovolemia in a client with severe burns. A urine output more than 30 mL/hr

The nurse in the endocrinology clinic is reviewing phone messages from clients. Which client would be the priority to call first? 1. Client with a history of thyroidectomy who needs a refill for levothyroxine 2. Client with Addison disease who is taking corticosteroids and reports new mood swings 3. Client with diabetes who reports blood sugars of 250-300 in the past week 4. Client with hyperthyroidism who has a new temperature reading of 101.5

4. Client with hyperthyroidism who has a new temperature reading of 101.5 Hyperthyroidism results from excessive secretion of thyroid hormone. Client is at risk for developing thyroid storm. S/S of storm are fever, tachycardia, dysrhythmias, nausea, vomiting, diarrhea and altered mental status.

A client is brought to the emergency department after sustaining third degree burns over 50 % of the body. Which solutions is the best choice for fluid resuscitation in this client? 1. 0.45% normal saline 2. 5% dextrose in 0/9% normal saline 3. 5% dextrose in water 4. Lactated Ringer's solution

4. Lactated Ringer's solution burn injuries is hypovolemic shock. This is due to cellular damage and increased capillary permeability caused by direct thermal trauma.

The nurse is giving report to a licensed practical nurse who will be helping to monitor a client who just had a total thyroidectomy. What will the nurse emphasize as most important to report immediately? 1. Elevated blood pressure 2. Heart rate irregularity 3. Low oxygen saturation 4. Noisy breathing

4. Noisy breathing Respiratory distress is a life threatening complication of thyroid surgery that occurs when swelling in the surgical area of the neck compresses the airway. Stridor/Difficulty breathing in the client who has had thyroid surgery should be reported immediately.

The nurse assess a 40 year old client with acromegaly in an outpatient health clinic. Which new finding is most important to report to the health care provider? 1. Complaints of knee pain when walking 2. Dark leathery skin 3. Fast blood glucose 126 4. Presence of S3 and S4 heart sounds

4. Presence of S3 and S4 heart sounds Acromegaly is an uncommon condition caused by an overproduction of growth hormone. Additional heart sounds require further assessment for cardiac conditions (heart failure)

The nurse cares for a group of clients on a medical surgical floor. The client with which condition is at highest risk for developing syndrome of inappropriate antidiuretic hormone SIADH? 1. Carpal tunnel syndrome 2. Diabetes mellitus 3. Sciatica 4. Small cell lung cancer

4. Small cell lung cancer ADH sometimes produced and secreted by cancer cells especially lung cancer causing SIADH, which too much ADH causing water retention, increased total water and dilutional hyponatremia.

A client is admitted to the intensive care unit with suspected pheochromocytoma. The client's vital signs are temperate of 99.6 F, blood pressure of 200/110 mmHg, heart rate of 110/min, and respirations of 20/min. The client is sweating profusely and reports a severe headache. Which prescription should the nurse implement first? 1. Draw labs to assess electrolyte panel 2. Give acetaminophen 650 my mouth as needed for headache 3. Place a fan in the client's room 4. Start nitroprusside infusion at 0.5

4. Start nitroprusside infusion at 0.5 mcg/kg/min

The nurse cares for a client with type 1 diabetes mellitus. Which action, by the nurse, best assesses the chronic complication of autonomic neuropathy? 1. Assess how far the client can walk 2. Check sensation in fingers and toes 3. Inspect extremities for diabetic ulcers 4. Take the blood pressure sitting and standing

4. Take the blood pressure sitting and standing Diabetic neuropathy is caused by nerve damage as a result of metabolic disturbances associated diabetes mellitus. Autonomic neuropathy is nerve damage to the autonomic nervous system, that is responsible for involuntary body functions such as blood pressure, heart rate, perspiration, sexual function and digestion.

The nurse is caring for a client in the intensive care unit who suffered partial thickness burns to 36% of the body. During the first 24 hours, the nurse would anticipate which of the following assessment? 1. Hemoglobin 10.2 2. Hyperactive bowel sounds 3. Serum sodium 152 4. Tall, peaked T waves on ECG

4. Tall, peaked T waves on ECG Burn injuries causes tissue damage that leads to increased vascular permeability and fluid shifts. Potassium is the predominant intracellular cation, released when cellular damaged occurs resulting in hyperkalemia. The patient will experience muscle weakness, Tall-peaked T waves, shortened QT interval and cardiac arrhythmias

The nurse is caring for a client recovering from a thyroidectomy to treat hyperthyroidism. Which assessment finding would require the nurse to immediately notify the health care provider? 1. 0.4 in of bright red blood on the surgical dressing on the client's neck 2. Client report of sore throat while talking and burning when swallowing 3. Pain rated as 8 on a scale of 0-10 at the surgical incision site 4. Temperature increase to 100 F from 98.9 30 minutes prior.

4. Temperature increase to 100 F from 98.9 30 minutes prior. Thyrotoxicosis (thyroid storm) is a life threatening condition by an increase in thyroid hormone levels that result in hypermetabolic state. Thyrotoxicosis causes fever, chills, tachycardia and small rise in body temperature. Without treatment, thyrotoxicosis can rapidly progress to lethal complications.