Answers |2026/2027 Update | A+ Graded
The nurse is preparing to care for a client returning from the operating room following a
subtotal thyroidectomy. The nurse anticipates the need for which of the following items to be
placed at the bedside?
A. Hypothermia blanket
B. Emergency tracheostomy kit
C. Magnesium sulfate in a ready-to-inject vial
D. Ampule of saturated solution of potassium iodide (SSKI) - Answer -B- Respiratory distress can
occur following thyroidectomy as a result of swelling in the tracheal area. The nurse would
ensure that an emergency tracheostomy kit is available. Surgery on the thyroid does not alter
the heat control mechanism of the body. Magnesium sulfate would not be indicated because
the incidence of hypomagnesemia is not a common problem post-thyroidectomy. SSKI is
typically administered preoperatively to block thyroid hormone synthesis and release, as well as
to place the client in a euthyroid state.
A nurse is preparing postoperative discharge instructions for a client who had one adrenal gland
removed. The nurse includes which of the following in the instructions?
A. the reason for maintaining a diabetic diet
B. Teaching proper application of an ostomy pouch
C. Instructions about early signs of a wound infection
D. The need for lifelong replacement of all adrenal hormones - Answer -C- A client who had a
unilateral adrenalectomy will be placed on corticosteroids temporarily to avoid a cortisol
deficiency. These medications will be gradually weaned in the postoperative period until they
are discontinued. Also, because of the anti-inflammatory properties of corticosteroids produced
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,by the adrenals, clients who undergo an adrenalectomy are at increased risk of developing
wound infections. The client does not need to maintain a diabetic diet, and the client will not
have an ostomy following this surgery.
A client undergoes a thyroidectomy and the nurse monitors the client for signs of damage to the
parathyroid glands postoperatively. Which of the following findings would indicate damage to
the parathyroid glands?
A. Neck pain
B. Hoarseness
C. Respiratory distress
D. Tingling around the mouth - Answer -D- The parathyroid glands can be damaged or their
blood supply impaired during thyroid surgery. Hypocalcemia and tetany result when parathyroid
hormone (PTH) levels decrease. The nurse monitors for complaints of tingling around the mouth
or of the toes or fingers and muscular twitching because these are signs of calcium deficiency.
Additional later signs of hypocalcemia are positive Chvostek's and Trousseau's signs. Hoarseness
and neck pain are expected findings postoperatively. Respiratory distress indicates a
complication but is not a sign of damage to the parathyroid glands.
A client with Cushing's syndrome is being instructed by the nurse on follow-up care. Which
statement by the client would indicate a need for further instructions?
A. I should avoid contact sports
B. I should check my ankles for swelling
C. I need to avoid foods high in potassium
D. I need to check my blood glucose regularly - Answer -C- Hypokalemia is a common
characteristic of Cushing's syndrome, and the client is instructed to consume foods high in
potassium. Clients also experience activity intolerance, osteoporosis, and frequent bruising.
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, Excess fluid volume results from water and sodium retention. Hyperglycemia is caused by an
increased cortisol secretion.
A client with Grave's disease has exopthalmos and is experiencing photophobia. Which of the
following nursing interventions would best assist the client with this problem?
A. Obtain dark glasses for the client
B. Lubricate the eyes with tap water every 2 to 4 hours
C. Administer methimazole (Tapazole) every 8 hours around the clock
D. Instruct the client to avoid straining or heavy lifting because this can increase eye pressure -
Answer -A- Medical therapy for Graves' disease does not help alleviate the clinical manifestation
of exophthalmos. Because photophobia (light intolerance) accompanies this disorder, dark
glasses are helpful in alleviating the problem. Tap water, which is hypotonic, could actually
cause more swelling around the eye because it could pull fluid into the interstitial space. In
addition, the client is at risk for developing an eye infection because the solution is not sterile.
Methimazole inhibits the synthesis of thyroid hormone and is used to treat hyperthyroidism but
will not alleviate exophthalmos or photophobia. There is no need to avoid straining with
exophthalmos.
The nurse is completing a health history on a client with diabetes mellitus who has been taking
insulin for many years. At present the client states that he is experiencing periods of
hypoglycemia followed by periods of hyperglycemia. The most likely cause for this occurrence is
which of following?
A. Eating snacks between meals
B. Initiating the use of the insulin pump
C. Injecting insulin at a site of lipodystrophy
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