Following a total thyroidectomy, the nurse plans to observe a client for complications. Which finding indicates that the client has developed a complication?

Denies muscle spasms in extremities.

Complains of back and joint tenderness and pain.

Complains of muscle twitching in hands and feet.

Diaphoretic, but denies any headache.

Answer and Explanation

The Correct Answer is C

Choice A reason: Denying muscle spasms is normal and not a complication. Muscle twitching indicates hypocalcemia, a thyroidectomy risk due to parathyroid damage. Absence of spasms is reassuring, per postoperative complication monitoring and endocrine surgical care standards in nursing.

Choice B reason: Back and joint pain are nonspecific and not typical thyroidectomy complications. Muscle twitching suggests hypocalcemia, a critical issue post-thyroidectomy. Pain requires assessment but is less urgent, per postoperative monitoring and complication management protocols in surgical nursing.

Choice C reason: Muscle twitching in hands and feet indicates hypocalcemia, a serious complication from parathyroid gland damage during thyroidectomy. This requires immediate calcium replacement to prevent tetany, per postoperative complication monitoring and endocrine surgical care protocols in nursing practice.

Choice D reason: Diaphoresis without headache is nonspecific and not a primary thyroidectomy complication. Muscle twitching signals hypocalcemia, needing urgent intervention. Diaphoresis requires monitoring but is less critical, per postoperative assessment and complication management standards in surgical nursing.

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Correct Answer is C

Explanation

Choice A reason: Discussing time-checking does not address compulsive lock-checking, likely obsessive-compulsive disorder (OCD), driven by serotonin dysregulation causing intrusive fears. Time management is unrelated to compulsions. Planning activities reduces idle time, distracting from OCD behaviors, addressing the neurobiological basis more effectively.

Choice B reason: Asking why the client checks locks may heighten anxiety in OCD, as compulsions arise from irrational fears, not logic, via cortico-striatal-thalamic dysfunction. This may reinforce obsessions. Activity planning distracts from compulsions, offering a therapeutic approach to improve function, making questioning less effective.

Choice C reason: Planning daily activities structures time, reducing compulsive lock-checking in OCD, where obsessive fears disrupt function. Engaging tasks modulate serotonin, distracting from cortico-striatal overactivity, improving behavioral control. This addresses the disorder’s impact, enhancing functionality by minimizing compulsion opportunities, making it the best action.

Choice D reason: Determining lock type is irrelevant to OCD’s compulsive checking, rooted in neurobiological fear responses, not lock characteristics. This does not address serotonin imbalance. Activity planning redirects focus to structured tasks, reducing compulsions, making lock assessment ineffective for managing the client’s behavior.

A. Dry skin with inelastic turgor. B. Apical rate of 110 beats/minute. C. Serum sodium of 185 mEq/L (185 mmol/L). D. Polyuria and excessive thirst.

Correct Answer is C

Explanation

Choice A reason: Dry skin and inelastic turgor reflect dehydration in DI from antidiuretic hormone deficiency, causing water loss. This is less urgent than hypernatremia (185 mEq/L), which dehydrates brain cells, risking seizures or coma, requiring immediate fluid correction to prevent neurological damage in this critical condition.

Choice B reason: Tachycardia (110 beats/minute) compensates for hypovolemia in DI, where water loss reduces preload, triggering sympathetic activation. This is less critical than hypernatremia (185 mEq/L), which causes cerebral dehydration, necessitating urgent hypotonic fluids to prevent neurological complications, making heart rate secondary.

Choice C reason: Serum sodium of 185 mEq/L indicates severe hypernatremia in DI, where water loss concentrates sodium, dehydrating neurons and risking seizures or coma. Immediate IV hypotonic fluids (e.g., 5% dextrose) correct osmolarity, preventing life-threatening cerebral complications, addressing the urgent pathophysiological crisis in DI.

Choice D reason: Polyuria and thirst are hallmark DI symptoms from water loss but expected and less urgent than hypernatremia (185 mEq/L), which threatens neurological function via osmotic brain injury. Correcting sodium is critical to prevent seizures, making these symptoms secondary to urgent electrolyte management.

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Following a total thyroidectomy, the nurse plans to observe a client for complications. Which finding indicates that the client has developed a complication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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