The nurse is assessing a client and suspects the client is experiencing DIC. Which of the following physical findings should the nurse anticipate?
Xerostomia
Bradycardia
Epistaxis
Hypertension
The Correct Answer is C
A. Xerostomia: Dry mouth, not typically associated with DIC.
B. Bradycardia: Not typically seen in DIC; usually, there is tachycardia due to the underlying condition.
C. Epistaxis. Epistaxis is a common physical finding in DIC due to bleeding tendencies. DIC leads to consumption of clotting factors and platelets, resulting in bleeding manifestations like epistaxis.
D. Hypertension: Hypotension is more common due to widespread clotting and bleeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "Take this medication before a meal or several hours after a meal." Levothyroxine absorption can be affected by food, so it's generally recommended to take it on an empty stomach to ensure consistent absorption. Food, particularly high-fiber or calcium-rich foods, can interfere with levothyroxine absorption, hence taking it before meals or a few hours after meals helps optimize its effectiveness.
B. "Take this medication during your morning meal.": This may not ensure consistent absorption as food can still interfere with medication absorption.
C. "Take this medication with a full glass of water or fruit juice.": While water is recommended for swallowing pills, it doesn't address timing or food interactions.
D. "Take this medication with high-protein foods.": Protein content in food does not affect levothyroxine absorption directly.
Correct Answer is B
Explanation
A. Hyperextend the client's neck: Incorrect; this can strain the surgical site. Neck should be supported in a neutral position.
B. Instruct the client to deep breathe every 4 hr: Deep breathing exercises prevent respiratory complications and promote lung expansion postoperatively. Helps prevent atelectasis and pneumonia.
C. Place the head of the client's bed in the flat position: Incorrect; semi-Fowler's position is preferred to reduce risk of airway compromise and edema.
D. Check the client's voice every 2 hr: Monitoring voice changes helps detect recurrent laryngeal nerve injury, a complication of thyroidectomy. Changes in voice quality can indicate vocal cord paralysis or injury.
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