The nurse provides care for a client who had a subtotal thyroidectomy 48 hours ago. Which question is the highest priority for the nurse to ask?

"Are you experiencing any nausea at this time?"

"Have you noticed any decrease in muscle weakness?"

"Do you have any numbness or tingling of your hands?"

"Do you have any breathing difficulties while walking?"

Answer and Explanation

The Correct Answer is C

Choice A reason: "Are you experiencing any nausea at this time?" is not the highest priority question because it is a common side effect of anesthesia, which is usually given during a thyroidectomy. Nausea is not a life-threatening complication, and it usually resolves within a few days after surgery.

Choice B reason: "Have you noticed any decrease in muscle weakness?" is not the highest priority question because it is a sign of improvement in the client's condition. A subtotal thyroidectomy is a surgical procedure that removes part of the thyroid gland, which is responsible for producing hormones that regulate the metabolism, growth, and development of the body. A client who has a thyroidectomy may have hypothyroidism, which is a condition where the thyroid gland does not produce enough hormones, causing symptoms such as fatigue, weight gain, and muscle weakness. A decrease in muscle weakness indicates that the client is responding well to the hormone replacement therapy, which is usually given after a thyroidectomy.

Choice C reason: "Do you have any numbness or tingling of your hands?" is the highest priority question because it is a sign of a possible complication of a thyroidectomy, which is hypocalcemia. Hypocalcemia is a condition where the blood has a low level of calcium, which is an electrolyte that helps regulate the nerve and muscle function, including the heart. A thyroidectomy can cause hypocalcemia if the parathyroid glands, which are small glands that are located behind the thyroid gland and produce a hormone that regulates the calcium level in the blood, are accidentally damaged or removed during the surgery. Hypocalcemia can cause symptoms such as numbness and tingling of the hands, feet, and lips, muscle spasms, seizures, and cardiac arrhythmias, which can be fatal if not treated promptly.

Choice D reason: "Do you have any breathing difficulties while walking?" is not the highest priority question because it is a sign of a possible complication of a thyroidectomy, which is tracheal compression. Tracheal compression is a condition where the trachea, which is the airway that connects the mouth and nose to the lungs, is squeezed or narrowed by the swelling or bleeding of the tissues around the thyroid gland. Tracheal compression can cause symptoms such as difficulty breathing, hoarseness, stridor, and cyanosis, which can be life-threatening if not treated promptly. However, tracheal compression is more likely to occur immediately after surgery, not 48 hours later.

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Correct Answer is D

Explanation

Choice A reason: Shallow respirations and a smooth, beefy red tongue are not the expected findings because they are signs of pernicious anemia, not acute blood loss. Pernicious anemia is a condition where the body cannot produce enough red blood cells due to a lack of vitamin B12, which is needed for DNA synthesis and cell division. Pernicious anemia can cause shallow respirations due to hypoxia, which is a low level of oxygen in the tissues, and a smooth, beefy red tongue due to atrophy of the tongue papillae, which are the small projections that give the tongue its rough texture.

Choice B reason: Facial flushing with distended neck veins are not the expected findings because they are signs of polycythemia, not acute blood loss. Polycythemia is a condition where the body produces too many red blood cells, which increases the blood volume and the blood viscosity, making the blood thicker and harder to flow. Polycythemia can cause facial flushing due to increased blood flow to the skin, and distended neck veins due to increased pressure in the venous system.

Choice C reason: Bilateral numbness and tingling of the extremities are not the expected findings because they are signs of peripheral neuropathy, not acute blood loss. Peripheral neuropathy is a condition where the nerves that carry signals from the brain and spinal cord to the rest of the body are damaged or impaired, causing sensory and motor disturbances. Peripheral neuropathy can cause bilateral numbness and tingling of the extremities due to reduced nerve conduction and sensation.

Choice D reason: Increased heart rate and decreased mental alertness are the expected findings because they are signs of acute blood loss. Acute blood loss is a condition where the body loses a large amount of blood in a short period of time, which reduces the oxygen-carrying capacity of the blood and the tissue perfusion. Acute blood loss can cause increased heart rate due to the compensatory mechanism of the body to increase the cardiac output and maintain the blood pressure, and decreased mental alertness due to the reduced oxygen delivery to the brain.

A. "My feet swell up during the evening." B. "It's harder to breathe during hot and humid weather." C. "I wake up at night being short of breath." D. "I have stomach pain that is worse after meals."

Correct Answer is C

Explanation

Choice A reason: "My feet swell up during the evening." is not a specific statement for systolic heart failure, but a general sign of fluid retention. Fluid retention may occur in both systolic and diastolic heart failure, as well as other conditions such as kidney disease, liver disease, or venous insufficiency.

Choice B reason: "It's harder to breathe during hot and humid weather." is not a specific statement for systolic heart failure, but a common complaint of many people with respiratory problems. Hot and humid weather may increase the workload of the lungs and the heart, but it does not indicate a reduced ejection fraction, which is the hallmark of systolic heart failure.

Choice C reason: "I wake up at night being short of breath." is the best statement for systolic heart failure, as it indicates a condition called paroxysmal nocturnal dyspnea. Paroxysmal nocturnal dyspnea is a sudden onset of breathlessness that occurs during sleep, usually due to fluid accumulation in the lungs. It is a sign of left-sided systolic heart failure, which is a failure of the left ventricle to pump blood effectively to the body.

Choice D reason: "I have stomach pain that is worse after meals." is not a specific statement for systolic heart failure, but a possible symptom of gastrointestinal disorders. Stomach pain may be caused by gastritis, ulcers, gallstones, or pancreatitis, among other conditions. It does not reflect the cardiac function or output, which are impaired in systolic heart failure.

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The nurse provides care for a client who had a subtotal thyroidectomy 48 hours ago. Which question is the highest priority for the nurse to ask?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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