A nurse is screening clients for adrenal insufficiency. The nurse recognizes that which client is at greatest risk for adrenal insufficiency?

A 19-year-old male on low dose steroids for a week

A 35-year-old female who completed 3 weeks of steroids.

An 80-year-old female who takes steroids daily.

A 45-year old male with COPD who uses intermittent steroids.

Answer and Explanation

The Correct Answer is C

A. A short-term, low-dose steroid use (one week) has minimal risk for adrenal suppression.
B. Three weeks of steroids increases risk, but daily use presents a higher risk.
C. Prolonged daily steroid use, especially in an older adult, poses the greatest risk for adrenal insufficiency due to suppression of the hypothalamic-pituitary-adrenal (HPA) axis.
D. Intermittent steroid use is less likely to cause adrenal insufficiency compared to daily long-term use.

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Correct Answer is {"dropdown-group-1":"E","dropdown-group-2":"A","dropdown-group-3":"E"}

Explanation

The nurse is assessing the client post-op and notes the client is complaining of tingling of the fingertips and assesses for Target 1: Chvostek sign; the nurse is aware if positive, the client likely has Target 2: hypocalcemia related to Target 3: disruption or removal of the parathyroid during surgery.

Rationale:

Target 1: Chvostek sign - This is a clinical sign used to assess for neuromuscular excitability due to hypocalcemia. A positive Chvostek sign, which involves twitching of the facial muscles when tapping the facial nerve, indicates low calcium levels.
Target 2: Hypocalcemia - The tingling sensation in the fingertips can be a symptom of hypocalcemia, which is a common complication following thyroidectomy due to potential damage or removal of the parathyroid glands.
Target 3: Disruption or removal of the parathyroid during surgery - Parathyroid glands regulate calcium levels in the body. If these glands are disrupted or removed during thyroid surgery, it can lead to hypocalcemia.

A. Elevate the head of the bed to 30-45 degrees. B. Administer intravenous fluids rapidly to increase intravascular volume. C. Keep the client in a calm and quiet environment. D. Administer morphine sulfate as prescribed for pain relief. E. Allow the client to perform Valsalva maneuver.

Correct Answer is ["A","C","D"]

Explanation

A. Elevating the head of the bed to 30-45 degrees helps facilitate venous drainage from the brain, thereby reducing ICP.
B. Administering intravenous fluids rapidly is not appropriate, as it can lead to fluid overload and increase ICP.
C. Keeping the client in a calm and quiet environment minimizes stimulation, which can contribute to increased ICP.
D. Administering morphine sulfate as prescribed can provide pain relief, which may help decrease ICP since pain can contribute to increased intracranial pressure.
E. The Valsalva maneuver increases intrathoracic pressure and can lead to increased ICP, making it contraindicated in this scenario.

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A nurse is screening clients for adrenal insufficiency. The nurse recognizes that which client is at greatest risk for adrenal insufficiency?

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Naxlex Comprehensive Predictor Exams

Correct Answer is {"dropdown-group-1":"E","dropdown-group-2":"A","dropdown-group-3":"E"}

Explanation

A nurse is caring for a client who is demonstrating signs of increasing intracranial pressure (ICP). The nurse recognizes that which nursing actions are indicated to decrease ICP?

Correct Answer is ["A","C","D"]

Explanation

A nurse is caring for a client newly diagnosed with hyperthyroidism. The nurse recognizes that which of the following is a potential severe complication of hyperthyroidism?

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A nurse is providing teaching to a client with Meniere's disease. The nurse recognizes that which of the following instructions should be given to the client regarding vertigo?

A nurse is caring for a client who has increased intracranial pressure (ICP) following a closed-head injury. Which of the following positioning techniques should the nurse implement?

A nurse is caring for a client who has elevated parathyroid hormone levels (PTH). The nurse is aware that the client is at high risk for which condition?

A nurse is caring for a client who is postoperative following a subtotal thyroidectomy. The nurse assesses for the presence of Chvostek's sign to indicate which of the following electrolyte imbalances?

A nurse is assisting a client diagnosed with hypothyroidism with meal planning. Which of the following foods should the nurse recommend that the client add to the diet?