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A nurse is caring for a client
Exhibits
Select the 3 interventions that the nurse should anticipate for this client.

Administer propylthiouracil (PTU).

Provide warm blankets.

Place the client on a cardiac monitor.

Place the client on a high-calorie diet.

Administer propranolol.

Administer acetaminophen.

Administer levothyroxine.

Answer and Explanation

Correct Answer : B,C,G

A. Administer propylthiouracil (PTU): PTU is used for treating hyperthyroidism by inhibiting thyroid hormone production. The client's lab results show low Free T4 and elevated TSH, indicating hypothyroidism, not hyperthyroidism. Therefore, PTU is not appropriate for this condition.
B. Provide warm blankets: The client is experiencing hypothermia (temperature 35.6°C or 96.1°F) and lethargy. Providing warm blankets helps in managing low body temperature and preventing further complications. This intervention is necessary to stabilize the client's body temperature.
C. Place the client on a cardiac monitor: The client has bradycardia (heart rate 49/min) and a slow respiratory rate (10/min), which are signs of possible cardiac involvement due to hypothyroidism. Cardiac monitoring is essential to detect and manage any potential arrhythmias or cardiac issues that may arise.
D. Place the client on a high-calorie diet: A high-calorie diet is usually recommended for managing hyperthyroidism due to increased metabolism. However, this client has hypothyroidism, characterized by reduced metabolism and low energy levels, so this intervention is not appropriate.
E. Administer propranolol: Propranolol is used to manage symptoms of hyperthyroidism, such as tachycardia and tremors. Given the client's symptoms and lab results indicating hypothyroidism, propranolol is not indicated for this condition.
F. Administer acetaminophen: Acetaminophen is used to reduce fever, but the client is hypothermic rather than febrile. Administering acetaminophen would not address the client's current issue of low body temperature.
G. Administer levothyroxine: The client has low Free T4 and elevated TSH, indicating hypothyroidism. Levothyroxine is the appropriate medication to manage hypothyroidism by supplementing thyroid hormone levels. This intervention is necessary to treat the underlying thyroid condition.
H. Prepare the client for a subtotal thyroidectomy: A subtotal thyroidectomy is a surgical option considered for severe thyroid disorders, such as thyroid cancer or uncontrollable hyperthyroidism. This client's presentation suggests hypothyroidism rather than a condition requiring surgical intervention.

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Correct Answer is B

Explanation

A. Hyperthermia: This is not commonly associated with hypothyroidism. Hypothyroidism is more likely to lead to a decreased metabolic rate and hypothermia rather than hyperthermia.
B. Hyperlipidemia: This is a common condition associated with hypothyroidism. Hypothyroidism can lead to increased levels of cholesterol and triglycerides due to decreased metabolism.
C. Agitation: Hypothyroidism typically presents with symptoms such as fatigue and depression rather than agitation. Agitation is more commonly associated with hyperthyroidism.
D. Insomnia: Insomnia is more often associated with hyperthyroidism. Hypothyroidism usually leads to symptoms like fatigue and sleepiness rather than insomnia.

A. Pain 7/10 at the surgical site B. Hyperglycemia C. Blood pressure 92/50 D. Sodium 152 mEq/L

Correct Answer is C

Explanation

A. Pain 7/10 at the surgical site: This level of pain is expected following major surgery, such as a bilateral adrenalectomy, and does not specifically indicate an Addisonian crisis.
B. Hyperglycemia: Although hyperglycemia can be associated with stress or corticosteroid treatment, it is not a hallmark of Addisonian crisis. Addisonian crisis is more related to adrenal insufficiency rather than hyperglycemia.
C. Blood pressure 92/50: Low blood pressure is a critical sign of an Addisonian crisis. This condition results from severe adrenal insufficiency where the body cannot maintain adequate blood pressure.
D. Sodium 152 mEq/L: High sodium levels are not characteristic of an Addisonian crisis. Addisonian crisis typically leads to hyponatremia (low sodium levels) due to inadequate aldosterone production.

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A nurse is caring for a client Exhibits Select the 3 interventions that the nurse should anticipate for this client.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client in a primary care provider's office has a new diagnosis of hypothyroidism. The nurse understands that the client should be screened for which of the following conditions common in people who have hypothyroidism?

Correct Answer is B

Explanation

The patient is returning to the unit after undergoing a bilateral adrenalectomy. Which clinical manifestation would indicate that the client is experiencing an Addisonian crisis?

Correct Answer is C

Explanation

A client with a history of hypothyroidism has accidentally been taking double her prescribed dose of levothyroxine. Which assessment findings would the nurse expect due to an excess of this medication?

A client seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be the most useful for diagnosing heart failure?

A nurse is caring for a client who has hypokalemia, hyperglycemia, and hypertension. A diagnosis of Cushing syndrome is suspected. Which of the following tests would the nurse anticipate the health care provider will order to help confirm the diagnosis of Cushing syndrome?

A nurse is caring for a client who has developed Cushing syndrome due to long-term corticosteroid therapy to treat multiple sclerosis. The nurse understands that Cushing syndrome puts the client at increased risk for which complication?

A nurse is providing education to a client who has Graves' disease and who will be returning home after receiving their first dose of radioactive iodine therapy. Which of the following information should the nurse include?

A nurse is caring for a female client who has a diagnosis of Cushing syndrome. The client is embarrassed that she is experiencing hirsutism and severe acne. The nurse understands that these manifestations are caused by which of the following?

A nurse is preparing to administer total parental nutrition (TPN) 1800 mL to infuse over 24 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A nurse is providing education to a client who has a new diagnosis of Addison's disease. The nurse determines that additional teaching is needed when the client makes which of the following statements?

A nurse is caring for a client
Exhibits
Select the 3 interventions that the nurse should anticipate for this client.