The nurse is caring for a patient with Addison's disease in the emergency department.
The patient states that they were out in the sun gardening all day and is now lethargic, forgetful, and has a temperature of 101.5°F. What intervention will the nurse prioritize when caring for this patient?

Administer intravenous fluids with glucose.

Administer 1000 mg of acetaminophen orally.

Educate the patient about ordered hydrocortisone.

Explore options to minimize stress.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Administering intravenous fluids with glucose is essential for a patient with Addison's disease who has been exposed to stressors like prolonged sun exposure. Patients with Addison's disease may experience an adrenal crisis, characterized by low blood pressure, dehydration, and hypoglycemia. Intravenous fluids with glucose help to rehydrate the patient and restore blood sugar levels, which are critical in preventing shock and other severe complications.

Choice B rationale

Administering 1000 mg of acetaminophen orally is not the priority intervention for this patient. While it may help reduce fever, it does not address the underlying issues of Addison's disease, such as hypoglycemia and dehydration, which are more urgent. The primary concern should be stabilizing the patient's vital signs and electrolyte balance.

Choice C rationale

Educating the patient about ordered hydrocortisone is important for long-term management of Addison's disease, but it is not the immediate priority in an emergency situation. The patient requires prompt medical intervention to address the acute symptoms of adrenal insufficiency, such as lethargy and hypoglycemia.

Choice D rationale

Exploring options to minimize stress is relevant for managing Addison's disease in general, as stress can trigger an adrenal crisis. However, in the emergency department, the nurse's priority should be to stabilize the patient and manage acute symptoms. Stress management can be addressed once the patient's condition is stabilized.

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Correct Answer is ["B","C","E"]

Explanation

Choice A rationale

Levothyroxine should be taken on an empty stomach, typically 30-60 minutes before breakfast, to ensure proper absorption. Taking it with food can interfere with its effectiveness.

Choice B rationale

Monitoring for chest pain or symptoms of angina is crucial as levothyroxine can increase the heart rate and potentially exacerbate pre-existing heart conditions, especially in elderly patients.

Choice C rationale

Monitoring prothrombin time is important for patients taking warfarin because levothyroxine can enhance the anticoagulant effect of warfarin, increasing the risk of bleeding.

Choice D rationale

Stopping levothyroxine abruptly can cause severe hypothyroid symptoms, so it should not be discontinued without consulting a healthcare provider.

Choice E rationale

Hypothyroidism patients are often more sensitive to sedatives, so reducing the dose of any sedative agents can prevent excessive sedation and other adverse effects. .

A. Diagnostic surgery. B. Palliative surgery. C. Prophylactic surgery. D. Reconstructive surgery.

Correct Answer is C

Explanation

Choice A rationale

Diagnostic surgery involves procedures done to confirm a diagnosis, such as a biopsy. In this case, the patient has already received a positive result on a breast tumor marker test, so the purpose of surgery is not to diagnose but to prevent the development of breast cancer.

Choice B rationale

Palliative surgery is performed to relieve symptoms or improve quality of life in patients with serious illnesses, often in advanced stages of cancer. The patient’s request for a bilateral mastectomy is not intended to alleviate symptoms but rather to reduce the risk of developing breast cancer.

Choice C rationale

Prophylactic surgery is performed to reduce the risk of cancer in patients with a high predisposition to certain cancers, such as those with a family history or genetic mutations like BRCA1 or BRCA2. The patient’s request for a bilateral mastectomy falls into this category, as it aims to prevent the potential future development of breast cancer.

Choice D rationale

Reconstructive surgery is performed to restore the appearance or function of body parts after trauma, surgery, or congenital defects. While patients undergoing mastectomies may later opt for reconstructive surgery to restore breast appearance, the patient’s current request for a bilateral mastectomy is to proactively prevent breast cancer, not for reconstruction purposes. .

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The nurse is caring for a patient with Addison's disease in the emergency department.The patient states that they were out in the sun gardening all day and is now lethargic, forgetful, and has a temperature of 101.5°F. What intervention will the nurse prioritize when caring for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient newly diagnosed with hypothyroidism who has a new prescription for levothyroxine 50 mcg orally.Which interventions will the nurse include in the plan of care? Select All That Apply.

Correct Answer is ["B","C","E"]

Explanation

The nurse is caring for a woman with a family history of breast cancer who received a positive result on a breast tumor marker test.The patient is requesting a bilateral mastectomy.This is an example of which type of oncologic treatment?

Correct Answer is C

Explanation

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The nurse is caring for a patient with Addison's disease in the emergency department.
The patient states that they were out in the sun gardening all day and is now lethargic, forgetful, and has a temperature of 101.5°F. What intervention will the nurse prioritize when caring for this patient?