The nurse is preparing a client for discharge who was recently diagnosed with Addison’s disease. Which instruction is most important for the nurse to include in this client’s discharge teaching plan?

Take prescribed cortisone accurately.

Use a walker when weakness occurs.

Avoid extreme environmental temperatures.

Increase daily intake of sodium in diet.

Answer and Explanation

The Correct Answer is A

Choice A rationale
Taking prescribed cortisone accurately is the most important instruction for a client diagnosed with Addison’s disease. Cortisone is a type of glucocorticoid replacement therapy that helps to manage the symptoms of Addison’s disease and prevent adrenal crisis, a life-threatening condition characterized by acute insufficiency of adrenal hormones.
Choice B rationale
Using a walker when weakness occurs may be helpful for some clients with Addison’s disease, as muscle weakness is a common symptom. However, it is not the most important instruction. The primary treatment for Addison’s disease is hormone replacement therapy, which should help to alleviate symptoms such as muscle weakness.
Choice C rationale
Avoiding extreme environmental temperatures can be beneficial for individuals with Addison’s disease, as they may have difficulty regulating body temperature due to cortisol deficiency.
However, this is not the most important instruction. The cornerstone of managing Addison’s disease is hormone replacement therapy.
Choice D rationale
Increasing daily intake of sodium in the diet can be beneficial for some individuals with Addison’s disease, particularly during periods of gastrointestinal illness or intense physical activity. However, this is not the most important instruction. The primary treatment for Addison’s disease is hormone replacement therapy.

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Correct Answer is B

Explanation

Choice A rationale
Starting an intravenous infusion for antiviral drug administration is premature at this stage. The patient’s COVID-19 test results are not yet available, and antiviral drugs should not be administered without a confirmed positive test.
Choice B rationale
Moving the patient to a private room, keeping the door closed, and initiating droplet precautions is the most important action. Given the patient’s symptoms and the significant other’s COVID-19 status, these measures will help prevent potential spread of the virus.
Choice C rationale
Notifying the charge nurse for assignment to the COVID-19 specified area of the facility is important, but it is not the immediate priority. The first step should be to initiate droplet precautions to minimize the risk of transmission.
Choice D rationale
While it is important to inform the patient about potential exposure, the immediate priority is to prevent the spread of the virus within the healthcare facility.

A. Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter. B. Medicate for pain and monitor vital signs according to protocol. C. Encourage the client to splint the incision with a pillow to cough and deep breathe. D. Administer intravenous fluid bolus as prescribed by the healthcare provider.

Correct Answer is A

Explanation

Choice A rationale
Applying oxygen at 10 L via non-rebreather mask and monitoring pulse oximeter is the most important intervention for a patient in the post-anesthesia care unit (PACU) with a heart rate of 140 beats/minute, blood pressure 140/90 mm Hg, and respirations 26 breaths/minute.
These vital signs suggest that the patient may be experiencing hypoxia or respiratory distress, conditions that require immediate intervention.
Choice B rationale
Medicating for pain and monitoring vital signs according to protocol is important in the PACU, but it is not the most critical intervention in this scenario. The patient’s vital signs suggest a possible respiratory issue, which should be addressed immediately.
Choice C rationale
Encouraging the client to splint the incision with a pillow to cough and deep breathe is a common postoperative intervention to promote lung expansion and prevent atelectasis and pneumonia. However, in this scenario, the patient’s vital signs suggest a more immediate respiratory issue that requires prompt intervention.
Choice D rationale
Administering an intravenous fluid bolus as prescribed by the healthcare provider can be an appropriate intervention for certain conditions in the PACU, such as hypotension. However, in this scenario, the patient’s vital signs suggest a possible respiratory issue, which should be addressed immediately.

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The nurse is preparing a client for discharge who was recently diagnosed with Addison’s disease. Which instruction is most important for the nurse to include in this client’s discharge teaching plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Correct Answer is A

Explanation

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