74. Which of the following assessment findings when observed
in a post-thyroidectomy client is indicative of a thyroid
crisis?

1 Answer

Answer :

C. High fever

Related questions

Description : 75. At the start of thyroid replacement post-total thyroidectomy, the nurse must monitor for side effects. Which side effects would the nurse expect to assess? 1. Hypertension 2. Tremors 3. Hirsutism 4. Insomnia 5. Tachycardia 6. Hyperglycemia

Last Answer : A. 3, 4, 5, and 6

Description : Reviewing the laboratory findings of the client, the nurse would found which findings are elevated? 1. White blood cell count 2. Total serum bilirubin 3. Alkaline phosphate 4. Red blood cell count 5. Cholesterol 6. Serum amylase A. 1, 2, and 3 B. 2, 3, and 4 C. 3, 5, and 6 D. 1, 2, and 6

Last Answer : A. 1, 2, and 3

Description : 51. Albert came to the hospital with chest pain and fever. After a thorough assessment by the doctor, he was admitted for pericarditis management. The nurse positions the client to reduce pain and discomfort. Describe this position.

Last Answer : C. Sit the client upright and lean forward

Description : Which of the following observations in the patient who has undergone allograft for treatment of burn site must be reported to the physician immediately? a) Crackles in the lungs Crackles in the lungs ... pain at the recipient site is anticipated since the wound has been protected by the graft.

Last Answer : a) Crackles in the lungs Crackles in the lungs may indicate a fluid buildup indicative of congestive heart failure and pulmonary edema.

Description : The nurse notes that the patient demonstrates generalized pallor and recognizes that this finding may be indicative of a) anemia. In the light-skinned individual, generalized pallor is a ... . d) local arterial insufficiency. Local arterial insufficiency is characterized by marked localized pallor.

Last Answer : a) anemia. In the light-skinned individual, generalized pallor is a manifestation of anemia. In brown- and black-skinned individuals, anemia is demonstrated as a dull skin appearance.

Description : When the patient's eosinophil count is 50-90% of blood leukocytes, the nurse interprets the result as a) indicative of idiopathic hypereosinophilic syndrome. When eosinophils make up 50-90% of white cell ... d) normal. Eosinophils normally make up 1-3% of the total number of white blood cells.

Last Answer : a) indicative of idiopathic hypereosinophilic syndrome. When eosinophils make up 50-90% of white cell count, the patient is demonstrating severe eosinophilia.

Description : 77. Nurse Kristine is to inject Demerol 75 mg to a post-TURP (transurethral resection of the prostate) client who is in pain. When she checked the narcotic cabinet, she found out a ... next Demerol vial is available. The action of the nurse violates which of the following ethical principles?

Last Answer : A. Justice

Description : n assisting the client to do deep breathing, coughing and turning to the sides on the first post-operative day, which nursing action would be most helpful for the client? A. Restate ... the prescribed analgesic round the clock as prescribed D. Apply abdominal splint (pillow) while coughing

Last Answer : D. Apply abdominal splint (pillow) while coughing

Description : In the immediate post-operative period, the nurse assesses coarse, high-pitched sound on inspiration by listening over the trachea with a stethoscope. The nurse should immediately A. Position client to ... the client that he is doing fine C. Suction the tracheostomy tube D. Report to the surgeon

Last Answer : Which of the following expected outcomes for the patient is most relevant for the nursing diagnosis “At risk for imbalanced nutrition related to impaired swallowing”? A. Appropriate body weight maintained B. Fear of choking relieved C. Oral intake increased D. Swallowing of soft foods facilitated

Description : Pre-operatively, the nurse identified the nursing dagnosis, Knowledge Deficit: Post-operative communication strategies . Which of the following is a relevant nursing intervention? A. ... uses an alternative form of verbal communication D. Illustrate means of communicating post- operatively

Last Answer : D. Illustrate means of communicating post- operatively

Description : Diminished range of motion, loss of flexibility, stiffness, and loss of height are history and physical findings associated with agerelated changes of the a) joints. History and physical ... resolves with rest, crepitus, joint swelling/enlargement, and degenerative joint disease (osteoarthritis).

Last Answer : a) joints. History and physical findings associated with age-related changes of the joints include diminished range of motion, loss of flexibility, stiffness, and loss of height.

Description : Which of the following findings in the patient who has sustained a head injury indicate increasing intracranial pressure (ICP)? a) Widened pulse pressure Additional signs of increasing ICP ... regarded as unfavorable because hyperthermia may indicate brain stem damage, a poor prognostic sign.

Last Answer : a) Widened pulse pressure Additional signs of increasing ICP include increasing systolic blood pressure, bradycardia, rapid respirations, and rapid rise in body temperature.

Description : 97. The nursing student reviews the laboratory findings and finds which blood results are elevated?

Last Answer : A. RBC, WBC, and platelets

Description : Which nerve is assessed when the nurse asks the patient to spread all fingers? a) Ulnar Asking the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation ... The median nerve is assessed by asking the patient to touch the thumb to the little finger.

Last Answer : a) Ulnar Asking the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation while pricking the fat pad at the top of the small finger allows assessment of the sensory function affected by the ulnar nerve.

Description : To assess circulating oxygen levels the 2001 Kidney Disease Outcomes Quality Initiative: Management of Anemia Guidelines recommends the use of which of the following diagnostic tests? a) Hemoglobin ... gases Arterial blood gases assess the adequacy of oxygenation, ventilation, and acid-base status.

Last Answer : a) Hemoglobin Although hematocrit has always been the blood test of choice to assess for anemia, the 2001 Kidney Disease Outcomes Quality Initiative: Management of Anemia Guidelines, recommend that ... rather than hematocrit measurements, as it is more accurate in assessment of circulating oxygen.

Description : Asking the patient questions to determine if the person understands the health teaching provided would be included during which step of the nursing process? a) Evaluation Evaluation includes observing ... ) Implementation Implementation is the step during which the teaching plan is put into action.

Last Answer : a) Evaluation Evaluation includes observing the person, asking questions, and comparing the patient’s behavioral responses with the expected outcomes.

Description : During which step of the nursing process does the nurse analyze data related to the patient's health status? a) Assessment Analysis of data is included as part of the assessment. b) ... patient's responses to the nursing interventions and the extent to which the outcomes have been achieved.

Last Answer : a) Assessment Analysis of data is included as part of the assessment.

Description : Which of the following terms is given to hypertension in which the blood pressure, which is controlled with therapy, becomes uncontrolled (abnormally high) with the discontinuation of therapy? ... Secondary hypertension denotes high blood pressure from an identified cause, such as renal disease.

Last Answer : a) Rebound Rebound hypertension may precipitate a hypertensive crisis.

Description : A major problem in nutritional support is identifying patients at risk. Recent studies suggest that these patients can be identified. Which of the following findings identify the patient at risk? A. Weight ... transferrin of less than 220 mg. per 100 ml. E. Functional impairment by history.

Last Answer : Answer: ABCDE DISCUSSION: All of these are at least partially correct. It is not clear whether weight loss of 10% or 15% is the required threshold, but it certainly is close. Serum ... the hands of an experienced observer is quite a reasonable way of approaching and identifying patients at risk

Description : The percentage of patients over the age of 70 admitted to the hospital with delirium is about a) 25%. About 25% of patients over the age of 70 admitted to the hospital have delirium. The cause is ... delirium. d) 50%. About 25% of patients over the age of 70 admitted to the hospital have delirium.

Last Answer : a) 25%. About 25% of patients over the age of 70 admitted to the hospital have delirium. The cause is often reversible and treatable (as in drug toxicity, vitamin B12 deficiency or thyroid disease) or chronic and irreversible. Depression may produce impairment of attention and memory.

Description : Which of the following terms is used to describe rapid, jerky, involuntary, purposeless movements of the extremities? a) Chorea Choreiform movements, such as grimacing, may also be ... movements. d) Spondylosis Spondylosis refers to degenerative arthritis of the cervical or lumbar vertebrae.

Last Answer : a) Chorea Choreiform movements, such as grimacing, may also be observed in the face.

Description : When the nurse reviews the physician's progress notes for the patient who has sustained a head injury and sees that the physician observed Battle's sign when the patient was in the Emergency Department, the ... CSF) from the patient's nose. Escape of CSF from the patient's nose is termed rhinorrhea.

Last Answer : a) an area of bruising over the mastoid bone. Battle’s sign may indicate skull fracture.

Description : Which of the following patient behaviors, if observed by the nurse, would indicate that the cardiac patient's level of anxiety has decreased? a) Answers questions regarding status with ... in support groups. Participation in support groups indicates some degree of comfort with prognosis.

Last Answer : a) Answers questions regarding status with no problem. Generally, when anxiety begins to increase, the patient will be less likely to want to discuss prognosis.

Description : The nurse recognizes which of the following signs as typical of the patient in shock? a) Rapid, weak, thready pulse Pulse increases as the body tries to compensate. b) Flushed face Pallor is ... urine output Usually, a low blood pressure and concentrated urine are observed in the patient in shock.

Last Answer : a) Rapid, weak, thready pulse Pulse increases as the body tries to compensate.

Description : 89. A nurse has to attend a committee meeting for two hours. She delegates her work to another nurse. What primary consideration should be observed?

Last Answer : D. Competency to perform the given function

Description : When the female client reports a frothy yellow-brown vaginal discharge, the nurse suspects the client has a vaginal infection caused by a) trichomonas vaginalis. Trichomonas vaginalis causes a ... the external vulva and vaginal walls. d) chlamydia. Chlamydia causes a profuse purulent discharge.

Last Answer : a) trichomonas vaginalis. Trichomonas vaginalis causes a frothy yellow-white or yellow-brown vaginal discharge.

Description : 100. The client complained of generalized pruritus. The following are appropriate nursing interventions except

Last Answer : B. Regulate the temperature to 25 degrees centigrade or lower

Description : 99. The companion asks why the client was advised to avoid iron supplements or vitamins. The correct response of the nurse would be

Last Answer : A. “These supplements enhance the production of RBC.”

Description : 98. Phlebotomy was ordered as part of the therapy. You instructed the client and emphasized that the procedure can be repeated. The client inquired, “What is the primary aim of the procedure?” Your appropriate response is

Last Answer : D. “It keeps the hematocrit within normal range.”

Description : 96. You planned the nursing care of the client together with the nursing student. You asked the nursing student to enumerate the clinical manifestations of a client with polycythemia vera. You expect the nursing student to enumerate the following manifestations except

Last Answer : B. Hepatomegaly

Description : 88. When the nurse ensures that the client has plan for continuous care after leaving the health care facility and assists from the transition from one environment to another, she is doing a

Last Answer : A. Discharge plan

Description : 79. A scrub nurse is assisting an emergency Cesarian section on a 39-year-old laundry woman. Before closing the peritoneum, the surgeon asks, How old is the client? Holding the fallopian ... there is no signed consent for tubal ligation. The nurse just demonstrated which of the following?

Last Answer : C. Advocacy

Description : 76. A client is being positioned for radical vulvectomy and a couple of clinical clerks wanted to come in to watch the surgery. The circulating nurse advise them to enter the OR suite later. Foremost, this decision of the nurse is directed towards

Last Answer : D. Preserving privacy

Description : 73. When the client returns to the unit after surgery, which technique is most appropriate to monitor bleeding from the incision?

Last Answer : B. Assess for dampness at the back of the client’s neck

Description : 72. The client is to have surgery in 10 days. Lugol’s solution 4 gtts po was prescribed in 10 days. The client asked the nurse for the purpose of the drug. Which response of the nurse is correct?

Last Answer : A. It decreases the risk of bleeding

Description : 69. When Marina checked the capillary blood glucose of the client at 6 PM before meals as instructed by the senior nurse, the result showed 65 mg/dl. Which of the following will Marina do first?

Last Answer : C. Check the physician’s order in case CBG is below 70 mg/dl

Description : 66. From the nursing history obtained from the client, which information is most likely related to the development of gangrene on the client’s left toe?

Last Answer : D. Accidental cut in big toe while cutting toe nails

Description : 64. The client was placed on a low sodium diet. The wife asks the nurse which foods to include in the client’s diet while at home. The nurse should instruct to include which of these?

Last Answer : C. Fruits and vegetables

Description : 63. A hypertensive client is taking herbal supplement for his hypertension. He was prescribed antihypertensive medication. The client wants to continue taking his herbal medication to lower his blood pressure. The nurse’s most appropriate action is to

Last Answer : B. Tell the client that herbal supplements have no proven therapeutic effects

Description : 62. A 30-year-old client had cholesterol blood test before admission to the hospital. The nurse in charge would teach the family and significant others that the client should exercise to help keep the total cholesterol to a desired level of

Last Answer : A. 140 mg/dl

Description : 61. A client with gout asks the nurse what food must be avoided so that the family can provide support. Which food has the highest in purine content and must be excluded from the dietary plan?

Last Answer : D. Liver

Description : 60. Acromegaly often develops insidiously that nurses should understand that the client with this disorder would seek medical care because of

Last Answer : C. Changes in appearance

Description : 57. The client was prescribed Ocreotide acetate (Sandostatin). Nurse Carla would monitor for which of the following side effects?

Last Answer : A. Abdominal pain

Description : 55. The nurse wants to know if the client is aware of the side effects of NSAID. What would be the most appropriate question of the nurse?

Last Answer : B. “Have you ever vomited blood or noticed very black stools?”

Description : 42. The nurse is to inject Vitamin B intramuscularly to another elderly client. Before injecting, the nurse explained that the client may feel some discomfort. This is an example of

Last Answer : C. Anticipatory response

Description : 41. For a client complaining of mild musculoskeletal pain, the nurse will anticipate that the treatment for this client’s level of discomfort will include which of the following?

Last Answer : B. Acetaminophen

Description : 40. The nurse should ensure that all components of medications are documented. Identify all these components. 1. Dosage, route and frequency 2. Name of client and medication 3. Date and time ... and strength 5. Physician's signature and specialty 6. Physician's signature and PRC license number

Last Answer : C. All except 5 and 6