At the beginning of the shift, a nurse receives report on the following four patients. Which patient should the nurse place priority on assessing first?
A 40-year-old patient with Cushing syndrome and gynecomastia.
A 58-year-old patient with Addison's disease who is exhibiting confusion.
A 45-year-old patient with Graves' disease and exophthalmos.
A 47-year-old patient with hypothyroidism who is asking for a warm blanket.
A 47-year-old patient with hypothyroidism who is asking for a warm blanket.
The Correct Answer is B
A. A 40-year-old patient with Cushing syndrome and gynecomastia: While Cushing syndrome requires ongoing management and monitoring, gynecomastia alone is not an urgent concern compared to the symptoms described in option B.
B. A 58-year-old patient with Addison's disease who is exhibiting confusion: Addison's disease can lead to adrenal insufficiency, and confusion could indicate an adrenal crisis or severe electrolyte imbalance. This is a critical situation requiring immediate assessment to prevent severe complications.
C. A 45-year-old patient with Graves' disease and exophthalmos: Graves' disease with exophthalmos is significant but does not typically represent an immediate life-threatening condition compared to the symptoms associated with Addison's disease.
D. A 47-year-old patient with hypothyroidism who is asking for a warm blanket: This patient’s request for a warm blanket suggests they might be experiencing symptoms related to hypothyroidism, such as feeling cold. However, this is less urgent compared to the confusion and potential crisis in option B.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Limit your intake of high sodium foods for several days after the procedure to prevent hypernatremia: This is not typically recommended for clients with Addison's disease. In fact, they often need more sodium.
B. Limit fluid intake to 1,500 mL per day for the next five days after the surgery to prevent fluid retention: This is not appropriate for clients with Addison's disease. They generally need to maintain adequate hydration.
C. You will need to increase your dose of corticosteroids due to the stress of surgery: Stress, including surgery, increases the body’s need for corticosteroids in clients with Addison's disease. Therefore, increasing the dose is crucial to prevent adrenal crisis.
D. Avoid taking hydrocortisone after the procedure due to the risk of surgical-site infection: Hydrocortisone should not be avoided. It is essential for managing Addison's disease and preventing an adrenal crisis, especially under stress.
Correct Answer is D
Explanation
A. "I will include protein and carbohydrates in every meal": This is appropriate for a client with Graves' disease. A balanced diet with adequate protein and carbohydrates helps meet increased caloric needs due to hypermetabolism.
B. "I will avoid caffeinated beverages": This is a correct statement. Clients with Graves' disease should avoid caffeine as it can exacerbate symptoms like tremors and palpitations.
C. "I will eat a high-fiber diet": This is beneficial for maintaining gastrointestinal health. Hyperthyroidism can cause increased bowel movements, so a high-fiber diet helps prevent diarrhea.
D. "I will eat six full meals per day, with snacks in between": This indicates a need for further teaching. While frequent meals may be needed, "six full meals" can be excessive. Instead, a high-calorie, nutrient-dense diet with smaller, more frequent meals may be recommended to address increased metabolic demands without overloading the digestive system.
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