A client who has a history of hypothyroidism was admitted with lethargy and confusion. Which additional finding warrants immediate action by the nurse?

Haematocrit of 30% (0.30 volume fraction).

Facial puffiness and periorbital enema.

Further decline in level of consciousness.

Cold and dry skin.

Answer and Explanation

The Correct Answer is C

Choice A reason: A haematocrit of 30% is below the normal range and indicates anaemia, which is common in hypothyroidism. However, it does not require immediate intervention compared to a decline in consciousness.

Choice B reason: Facial puffiness and periorbital enema are common signs of hypothyroidism but do not require immediate intervention. They are more indicative of chronic, rather than acute, issues.

Choice C reason: A further decline in level of consciousness is critical and warrants immediate action. It can indicate a myxoedema coma, a severe complication of hypothyroidism that is life-threatening and requires urgent treatment.

Choice D reason: Cold and dry skin is a common symptom of hypothyroidism but does not require immediate intervention compared to a decline in consciousness.

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Correct Answer is D

Explanation

Choice A reason: Minimizing the intake of spicy foods can help reduce GERD symptoms, but it is not the most critical instruction for preventing reflux immediately after eating.

Choice B reason: Beginning a smoking cessation program is important for overall health and can help reduce GERD symptoms over time, but it is not the immediate priority for preventing reflux.

Choice C reason: Avoiding tight-fitting clothes can help reduce pressure on the abdomen and lessen reflux symptoms, but it is not the most urgent instruction to emphasize at discharge.

Choice D reason: Remaining upright following meals is crucial for preventing reflux. Lying down immediately after eating can cause stomach contents to flow back into the oesophagus, exacerbating GERD symptoms. This instruction is key to managing the condition effectively.

A. Haemoglobin A1C of 6.2%. B. Fasting plasma glucose of 189 mg/dL (10.49 mmol/L). C. Postprandial plasma glucose of 225 mg/dL (12.49 mmol/L). D. High-density lipoprotein of 40 mg/dL (1.03 mmol/L).

Correct Answer is A

Explanation

Choice A reason: Haemoglobin A1C of 6.2% is the best indication of long-term adherence to the prescribed diabetic regimen. The A1C test measures the average blood glucose levels over the past two to three months. A result of 6.2% indicates that the client has been maintaining good blood glucose control over this period, which reflects adherence to the regimen.

Choice B reason: Fasting plasma glucose of 189 mg/dL (10.49 mmol/L) is higher than the normal range. This result indicates poor short-term blood glucose control and suggests that the client may not be adhering to the prescribed regimen effectively.

Choice C reason: Postprandial plasma glucose of 225 mg/dL (12.49 mmol/L) is also higher than the recommended level for post-meal glucose. This result points to poor post-meal glucose control and suggests that the client may not be following their dietary or medication plan properly.

Choice D reason: High-density lipoprotein (HDL) of 40 mg/dL (1.03 mmol/L) is slightly below the recommended level for HDL cholesterol. While HDL is important for cardiovascular health, it is not a direct measure of blood glucose control or adherence to a diabetic regimen.

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A client who has a history of hypothyroidism was admitted with lethargy and confusion. Which additional finding warrants immediate action by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse reviews discharge instructions with a client who has gastroesophageal reflux disease (GERD). Which instruction is most important for the nurse to emphasize?

Correct Answer is D

Explanation

The nurse is assessing clients in an outpatient diabetic clinic. Which entry provides the best indication that the client is adhering to the prescribed diabetic regimen?

Correct Answer is A

Explanation

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