In preparation for a patient having a Schilling test, the nurse should explain that the test:

hoice A reason: Preparing for endotracheal intubation and ventilatory support is not the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with respiratory failure or impending airway obstruction, which are not the case for this client.

Choice B reason: Providing continuous sedation for pain relief is not the action that the nurse should take for a client with thyroid storm. This intervention may worsen the client's condition by suppressing the respiratory drive and lowering the blood pressure. The nurse should administer antithyroid medications, beta blockers, and corticosteroids as prescribed to reduce the thyroid hormone levels and the associated symptoms.

Choice C reason: Initiating cardiac monitoring and assessing for reflex bradycardia is not the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with hyperkalemia or digoxin toxicity, which are not the case for this client. The nurse should monitor the client's heart rate and rhythm, but not expect a reflex bradycardia, which is a paradoxical slowing of the heart rate in response to a rapid rise in blood pressure.

Choice D reason: Maintaining IV fluid infusion and assessing adequacy of hydration is the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with thyroid storm, as they are at risk of dehydration and electrolyte imbalance due to increased metabolic rate, fever, sweating, vomiting, and diarrhea. The nurse should administer isotonic fluids, such as normal saline, and monitor the client's fluid intake and output, urine specific gravity, and serum electrolytes.

Choice A reason: It is not the best intervention to exclude the family from the exercise program. Family involvement can provide support, motivation, and accountability for the client. Family members can also participate in the exercise program and benefit from its positive effects on blood pressure and overall health.

Choice B reason: This is the best intervention to help the client maintain the exercise program. Adapting the program to the client's needs and abilities ensures that the exercise is appropriate, safe, and effective for the client. It also increases the client's confidence, satisfaction, and adherence to the program.

Choice C reason: Providing the client with specific details of how to perform the exercises is an important intervention, but not the best one. The client may still have difficulties or barriers to maintaining the exercise program, such as lack of time, resources, or motivation. The nurse should also assess the client's readiness, preferences, and goals for the exercise program.

Choice D reason: Reassuring the client that they will be able to do the exercise program is a supportive intervention, but not the best one. The client may not feel reassured if the exercise program is too challenging, unrealistic, or unappealing for them. The nurse should also monitor the client's progress, feedback, and outcomes of the exercise program.