Medical –Sugical Nursing 10th Edition Exam
Questions And Answers Verified 100% Correct
1. A patient who had a subtotal thyroidectomy earlier today develops
laryngeal stridor and a cramp in the right hand upon returning to the
surgical nursing unit. Which collaborative action will the nurse
anticipate next?
a. Suction the patient's airway.
b. Administer IV calcium gluconate.
c. Plan for emergency tracheostomy.
d. Prepare for endotracheal intubation. - ANSWER -ANS: B The
patient's clinical manifestations of stridor and cramping are
consistent with tetany caused by hypocalcemia resulting from
damage to the parathyroid glands during surgery. Endotracheal
intubation or tracheostomy may be needed if the calcium does not
resolve the stridor. Suctioning will not correct the stridor.
2. Which nursing action will be included in the plan of care for a
patient with Graves' disease who has exophthalmos?
a. Place cold packs on the eyes to relieve pain and swelling.
b. Elevate the head of the patient's bed to reduce periorbital fluid.
c. Apply alternating eye patches to protect the corneas from irritation.
d. Teach the patient to blink every few seconds to lubricate the
corneas. - ANSWER -ANS: B
The patient should sit upright as much as possible to promote fluid
drainage from the periorbital area. With exophthalmos, the patient is
unable to close the eyes completely to blink. Lubrication of the eyes,
rather than eye patches, will protect the eyes from developing corneal
scarring. The swelling of the eye is not caused by excessive blood
flow to the eye, so cold packs will not be helpful.
,3. A 62-yr-old patient with hyperthyroidism is to be treated with
radioactive iodine (RAI). The nurse instructs the patient
a. about radioactive precautions to take with all body secretions.
b. that symptoms of hyperthyroidism should be relieved in about a
week.
c. that symptoms of hypothyroidism may occur as the RAI therapy
takes effect.
d. to discontinue the antithyroid medications taken before the
radioactive therapy. - ANSWER -ANS: C
There is a high incidence of postradiation hypothyroidism after RAI,
and the patient should be monitored for symptoms of
hypothyroidism. RAI has a delayed response, with the maximum
effect not seen for 2 to 3 months, and the patient will continue to take
antithyroid medications during this time. The therapeutic dose of
radioactive iodine is low enough that no radiation safety precautions
are needed.
4. Which nursing assessment of a 70-yr-old patient is most important
to make during initiation of thyroid replacement with levothyroxine
(Synthroid)?
a. Fluid balance
b. Apical pulse rate
c. Nutritional intake
d. Orientation and alertness - ANSWER -ANS: B
In older patients, initiation of levothyroxine therapy can increase
myocardial oxygen demand and cause angina or dysrhythmias. The
medication also is expected to improve mental status and fluid
balance and will increase metabolic rate and nutritional needs, but
these changes will not result in potentially life-threatening
complications.
, 5. An 82-yr-old patient in a long-term care facility is newly diagnosed
with hypothyroidism. The nurse will need to consult with the health
care provider before administering the prescribed
a. docusate (Colace).
b. ibuprofen (Motrin).
c. diazepam (Valium).
d. cefoxitin (Mefoxin). - ANSWER -ANS: C
Worsening of mental status and myxedema coma can be precipitated
by the use of sedatives, especially in older adults. The nurse should
discuss the use of diazepam with the health care provider before
administration. The other medications may be given safely to the
patient.
6. A patient who was admitted with myxedema coma and diagnosed
with hypothyroidism is improving. Discharge is expected to occur in 2
days. Which teaching strategy is likely to result in effective patient
self-management at home?
a. Delay teaching until closer to discharge date.
b. Provide written reminders of information taught.
c. Offer multiple options for management of therapies.
d. Ensure privacy for teaching by asking the family to leave. -
ANSWER -ANS: B
Written instructions will be helpful to the patient because initially the
hypothyroid patient may be unable to remember to take medications
and other aspects of self-care. Because the treatment regimen is
somewhat complex, teaching should be initiated well before
discharge. Family members or friends should be included in teaching
because the hypothyroid patient is likely to forget some aspects of
Questions And Answers Verified 100% Correct
1. A patient who had a subtotal thyroidectomy earlier today develops
laryngeal stridor and a cramp in the right hand upon returning to the
surgical nursing unit. Which collaborative action will the nurse
anticipate next?
a. Suction the patient's airway.
b. Administer IV calcium gluconate.
c. Plan for emergency tracheostomy.
d. Prepare for endotracheal intubation. - ANSWER -ANS: B The
patient's clinical manifestations of stridor and cramping are
consistent with tetany caused by hypocalcemia resulting from
damage to the parathyroid glands during surgery. Endotracheal
intubation or tracheostomy may be needed if the calcium does not
resolve the stridor. Suctioning will not correct the stridor.
2. Which nursing action will be included in the plan of care for a
patient with Graves' disease who has exophthalmos?
a. Place cold packs on the eyes to relieve pain and swelling.
b. Elevate the head of the patient's bed to reduce periorbital fluid.
c. Apply alternating eye patches to protect the corneas from irritation.
d. Teach the patient to blink every few seconds to lubricate the
corneas. - ANSWER -ANS: B
The patient should sit upright as much as possible to promote fluid
drainage from the periorbital area. With exophthalmos, the patient is
unable to close the eyes completely to blink. Lubrication of the eyes,
rather than eye patches, will protect the eyes from developing corneal
scarring. The swelling of the eye is not caused by excessive blood
flow to the eye, so cold packs will not be helpful.
,3. A 62-yr-old patient with hyperthyroidism is to be treated with
radioactive iodine (RAI). The nurse instructs the patient
a. about radioactive precautions to take with all body secretions.
b. that symptoms of hyperthyroidism should be relieved in about a
week.
c. that symptoms of hypothyroidism may occur as the RAI therapy
takes effect.
d. to discontinue the antithyroid medications taken before the
radioactive therapy. - ANSWER -ANS: C
There is a high incidence of postradiation hypothyroidism after RAI,
and the patient should be monitored for symptoms of
hypothyroidism. RAI has a delayed response, with the maximum
effect not seen for 2 to 3 months, and the patient will continue to take
antithyroid medications during this time. The therapeutic dose of
radioactive iodine is low enough that no radiation safety precautions
are needed.
4. Which nursing assessment of a 70-yr-old patient is most important
to make during initiation of thyroid replacement with levothyroxine
(Synthroid)?
a. Fluid balance
b. Apical pulse rate
c. Nutritional intake
d. Orientation and alertness - ANSWER -ANS: B
In older patients, initiation of levothyroxine therapy can increase
myocardial oxygen demand and cause angina or dysrhythmias. The
medication also is expected to improve mental status and fluid
balance and will increase metabolic rate and nutritional needs, but
these changes will not result in potentially life-threatening
complications.
, 5. An 82-yr-old patient in a long-term care facility is newly diagnosed
with hypothyroidism. The nurse will need to consult with the health
care provider before administering the prescribed
a. docusate (Colace).
b. ibuprofen (Motrin).
c. diazepam (Valium).
d. cefoxitin (Mefoxin). - ANSWER -ANS: C
Worsening of mental status and myxedema coma can be precipitated
by the use of sedatives, especially in older adults. The nurse should
discuss the use of diazepam with the health care provider before
administration. The other medications may be given safely to the
patient.
6. A patient who was admitted with myxedema coma and diagnosed
with hypothyroidism is improving. Discharge is expected to occur in 2
days. Which teaching strategy is likely to result in effective patient
self-management at home?
a. Delay teaching until closer to discharge date.
b. Provide written reminders of information taught.
c. Offer multiple options for management of therapies.
d. Ensure privacy for teaching by asking the family to leave. -
ANSWER -ANS: B
Written instructions will be helpful to the patient because initially the
hypothyroid patient may be unable to remember to take medications
and other aspects of self-care. Because the treatment regimen is
somewhat complex, teaching should be initiated well before
discharge. Family members or friends should be included in teaching
because the hypothyroid patient is likely to forget some aspects of
