Exam (elaborations)
nightingale 265 Hesi med surg V1 Questions With Complete Solutions
- Course
- Hesi 265
- Institution
- Nightingale College
nightingale 265 Hesi med surg V1 Questions With Complete Solutions
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nightingale 265 Hesi med surg V1 QuestionsWith Complete Solutions
1. The nurse is completing a health assessment of a 42-year-old
female with
suspected Graves' disease. The nurse should assess this client
for:
1. Anorexia.
2. Tachycardia.
3. Weight gain.
4. Cold skin. Correct Answers 2. Graves' disease, the most
common type of thyrotoxicosis, is a state of
hypermetabolism. The increased metabolic rate generates heat
and produces tachycardia
and fine muscle tremors. Anorexia is associated with
hypothyroidism. Loss of weight,
despite a good appetite and adequate caloric intake, is a common
feature of
hyperthyroidism. Cold skin is associated with hypothyroidism.
CN: Physiological adaptation; CL: Analyze
10. A client with a large goiter is scheduled for a subtotal
thyroidectomy to treat
thyrotoxicosis. Saturated solution of potassium iodide (SSKI) is
prescribed
preoperatively for the client. The expected outcome of using this
drug is that it helps:
1. Slow progression of exophthalmos.
2. Reduce the vascularity of the thyroid gland.
3. Decrease the body's ability to store thyroxine.
,4. Increase the body's ability to excrete thyroxine. Correct
Answers 2. SSKI is frequently administered before a
thyroidectomy because it helps
decrease the vascularity of the thyroid gland. A highly vascular
thyroid gland is very
friable, a condition that presents a hazard during surgery.
Preparation of the client for
surgery includes depleting the gland of thyroid hormone and
decreasing vascularity.
SSKI does not decrease the progression of exophthalmos, and it
does not decrease the
body's ability to store thyroxine or increase the body's ability to
excrete thyroxine.
CN: Pharmacological and parenteral therapies; CL: Apply
100. When teaching a client about propranolol hydrochloride,
the nurse should base
the information on the knowledge that propranolol:
1. Blocks beta-adrenergic stimulation and thus causes decreased
heart rate,
myocardial contractility, and conduction.
2. Increases norepinephrine secretion and thus decreases blood
pressure and heart
rate.
3. Is a potent arterial and venous vasodilator that reduces
peripheral vascular
resistance and lowers blood pressure.
4. Is an angiotensin-converting enzyme inhibitor that reduces
blood pressure by
,blocking the conversion of angiotensin I to angiotensin II.
Correct Answers 1. Propranolol is a beta-adrenergic blocking
agent. Actions of propranolol
include reducing heart rate, decreasing myocardial contractility,
and slowing
conduction. Propranolol does not increase norepinephrine
secretion, cause vasodilation,
or block conversion of angiotensin I to angiotensin II.
CN: Pharmacological and parenteral therapies; CL: Apply
11. The nurse is administering a saturated solution of potassium
iodide (SSKI). The
nurse should:
1. Pour the solution over ice chips.
2. Mix the solution with an antacid.
3. Dilute the solution with water, milk, or fruit juice and have
the client drink it
with a straw.
4. Disguise the solution in a pureed fruit or vegetable. Correct
Answers 3. SSKI should be diluted well in milk, water, juice, or
a carbonated beverage
before administration to help disguise the strong, bitter taste.
Also, this drug is irritating
to mucosa if taken undiluted. The client should sip the diluted
preparation through a
drinking straw to help prevent staining of the teeth. Pouring the
solution over ice chips
will not sufficiently dilute the SSKI or cover the taste. Antacids
are not used to dilute or
cover the taste of SSKI. Mixing in a puree would put the SSKI
in contact with the teeth.
, CN: Pharmacological and parenteral therapies; CL: Apply
12. Following a subtotal thyroidectomy, the nurse asks the client
to speak
immediately upon regaining consciousness. The nurse does this
to monitor for signs of
which of the following?
1. Internal hemorrhage.
2. Decreasing level of consciousness.
3. Laryngeal nerve damage.
4. Upper airway obstruction. Correct Answers 3. Laryngeal
nerve damage is a potential complication of thyroid surgery
because of the proximity of the thyroid gland to the recurrent
laryngeal nerve. Asking the
client to speak helps assess for signs of laryngeal nerve damage.
Persistent or
worsening hoarseness and weak voice are signs of laryngeal
nerve damage and should
be reported to the physician immediately. Internal hemorrhage is
detected by changes in
vital signs. The client's level of consciousness can be partially
assessed by asking her to
speak, but that is not the primary reason for doing so in this
situation. Upper airway
obstruction is detected by color and respiratory rate and pattern.
CN: Reduction of risk potential; CL: Analyze
13. A client who has undergone a subtotal thyroidectomy is
subject to
complications in the first 48 hours after surgery. The nurse
should obtain and keep at the
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