A nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect?

Drowsiness

Dry skin

Bradycardia

Heat intolerance

Answer and Explanation

The Correct Answer is D

A. Drowsiness is not a typical manifestation of thyrotoxicosis. Instead, individuals with thyrotoxicosis often experience restlessness and anxiety due to excessive thyroid hormone levels.

B. Dry skin is more commonly associated with hypothyroidism (insufficient thyroid hormone levels), rather than thyrotoxicosis (excessive thyroid hormone levels).

C. Bradycardia (slower than normal heart rate) is a symptom of hypothyroidism, not thyrotoxicosis. In thyrotoxicosis, tachycardia (an abnormally rapid heart rate) is a common finding.

D. Correct. Heat intolerance is a classic symptom of thyrotoxicosis. Excessive thyroid hormone levels can lead to an increased metabolic rate, making individuals more sensitive to heat.

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Correct Answer is B

Explanation

A. This option corresponds to the blood glucose range of 151-200. However, the patient's current blood glucose level is 264, which falls into the range of 251-300. Therefore, administering 2 units would not be appropriate in this case.

B. The patient's current blood glucose level is 264, which falls into the range of 251-300. According to the sliding scale insulin aspart orders, for this range, 6 units should be administered. This option aligns with the patient's blood glucose level and the prescribed protocol.

C. This option corresponds to the blood glucose range of 351-400. The patient's blood glucose level of 264 does not fall into this range, so administering 10 units would be excessive and potentially lead to hypoglycemia.

D. This option corresponds to the blood glucose range of 201-250. The patient's current blood glucose level is 264, which falls into the range of 251-300. Therefore, administering 4 units would not be sufficient to address the elevated blood glucose level.

A. Obtain a culture of the drainage. B. Check fine drainage for glucose. C. Document the amount of drainage. D. Notify the client's provider.

Correct Answer is B

Explanation

A. Obtaining a culture of the drainage may be necessary, but the immediate concern is to determine if the drainage is cerebrospinal fluid (CSF) or another type of fluid. Checking for glucose content is a rapid way to differentiate CSF from other fluids.

B. Correct. Clear drainage from the nose post-transsphenoidal hypophysectomy may indicate a CSF leak, which is a potential complication. Checking the drainage for glucose can help differentiate CSF from other fluids, as CSF contains glucose. If the drainage tests positive for glucose, it indicates the presence of CSF.

C. Documenting the amount of drainage is important, but determining the nature of the drainage (CSF or other fluid) takes precedence in this situation.

D. Notifying the client's provider is important, but the nurse should gather information about the drainage first by checking for glucose content. This information will be crucial for the healthcare provider to make decisions about further interventions

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A nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is caring for a client who is 1 day postoperative following a transsphenoidal hypophysectomy. While assessing the client, the nurse notes a large area of clear drainage seeping from the nasal packing. Which of the following should be the nurse's initial action?

Correct Answer is B

Explanation

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