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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 A

Explanation

A. B-type natriuretic peptide (BNP): BNP levels are elevated in heart failure due to the heart's response to increased pressure and volume overload. This biomarker is used specifically to diagnose and assess the severity of heart failure.
B. Troponin I: This is a marker for myocardial injury and is used to diagnose acute myocardial infarction rather than heart failure.
C. Blood urea nitrogen (BUN): While elevated BUN can be associated with renal dysfunction or fluid overload in heart failure, it is not specific to diagnosing heart failure.
D. Platelet levels: These are not directly related to diagnosing heart failure and do not provide information about cardiac function.

A. IV hydrocortisone B. Ketoconazole and insulin C. Lactated Ringer's IV infusion D. Furosemide slow IV push

Correct Answer is A

Explanation

A. IV hydrocortisone: In an Addisonian crisis, there is an acute adrenal insufficiency which requires immediate treatment with IV hydrocortisone to replace the deficient glucocorticoids. This helps to rapidly correct the hormone imbalance and stabilize the patient.
B. Ketoconazole and insulin: Ketoconazole is an antifungal medication used to treat Cushing syndrome, not Addisonian crisis. Insulin is used for managing blood glucose levels and is not directly related to the treatment of an Addisonian crisis.
C. Lactated Ringer's IV infusion: While fluid replacement may be necessary in an Addisonian crisis, the immediate priority is to address the adrenal insufficiency with hydrocortisone. Lactated Ringer's may be used to support fluid balance but is not a substitute for glucocorticoid therapy.
D. Furosemide slow IV push: Furosemide is a diuretic used to manage fluid retention and is not indicated for treating Addisonian crisis. The primary treatment for Addisonian crisis is to address the adrenal hormone deficiency with hydrocortisone.

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

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

A nurse is admitting a client who is experiencing an Addisonian crisis. Which of the following should the nurse anticipate an order for?

Correct Answer is A

Explanation

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 client is experiencing tachycardia and tremors. Lab values show elevated Free T4 and low thyroid stimulating hormone (TSH). Which diagnostic study will help the practitioner differentiate Graves' disease from other forms of hyperthyroidism?

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

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?

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 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 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 client
Exhibits
Select the 3 interventions that the nurse should anticipate for this client.