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Example Questions
Example Question #1231 : Nclex
A middle-aged female client has just underwent a thyroidectomy for treatment of Graves' disease. The nurse caring for this client is aware she may need to monitor the client for what possible complication?
Tetany
Bone pain
Tetanus
Goiter
Oliguria
Tetany
Tetany is a complication due to hypocalcemia which can occur if the parathyroid glands which control calcium balance are accidentaly injured during thyroidectomy. Tetany is associated with nerve excitability and sustained muscle contractions, or spasms. Tetanus, bone pain, and oliguria are not associated with complications of a thyroidectomy. Goiter is a manifestation of an overactive thyroid.
Example Question #431 : Conditions And Treatments
A 45-year-old female client with Addison's disease has presented to the client for instruction on her medication regiment The nurse understands that the patient may require lifelong corticosteroid replacement. It will be necessary to educate the client about possible side effects of this type of therapy.
Which of the following should a nurse include in his/her teaching plan about corticosteroid therapy?
Incease intake of folic acid and B12 to prevent neurological side effects such as paresthesias of the hands and feet.
Monitor glucose with finger sticks to check for hypoglycemia.
The medications should be taken on a empty stomach in the morning to avoid nausea if taken with food.
Increase sodium intake to prevent hypotension due to edema.
Increase calcium intake to at least with vitamin D, to help to prevent steroid induced osteoporosis.
Increase calcium intake to at least with vitamin D, to help to prevent steroid induced osteoporosis.
Corticosteroids may lead to bone loss, especially after long term treatment (over 3 months). Calcium and vitamin D supplementation can help prevent these side effects. The client should also be advised to start a low impact exercise regimine if possible, and if necessary take a bisphosphonate drug.
Example Question #432 : Conditions And Treatments
You are caring for a patient who is started on clindamycin, ketorolac, prednisone, lisinopril, and simvastatin. After receiving multiple doses of each of these medications, you notice that the patient's blood glucose is . Which of these medications is known to cause hyperglycemia?
Ketorolac
Simvastatin
Prednisone
Lisinopril
Clindamycin
Prednisone
The correct answer is prednisone. Of all the medications listed, prednisone is the only medication that is known to cause hyperglycemia.
Prednisone has a number of side effects including hyperglycemia, acne, headache, restlessness, insomnia, nausea, vomiting, and weight gain, among others.
Clindamycin's side effects include diarrhea (including Clostridium difficile), and less commonly nausea, vomiting, and abdominal pain, among others, but not hyperglycemia.
Ketorolac's side effects include renal toxicity, tinnitus, heartburn, diarrhea, and abdominal pain, among others, but not hyperglycemia.
Lisinopril's side effects include hypotension, lightheadedness, angioedema, and barky cough, among others, but not hyperglycemia.
Simvastatin's side effects include muscle pains/aches, muscle weakness, and less frequently confusion, and electrolyte disturbances, but not hyperglycemia.
Example Question #432 : Conditions And Treatments
You are the nurse taking care of a patient with type two diabetes mellitus. The patient is hospitalized for pneumonia and switched from his home medication, metformin, to sliding-scale insulin, while inpatient. You explain to the patient that the specific reason is which of the following?
To prevent depression while hospitalized
To prevent stroke while hospitalized
To prevent lactic acidosis while hospitalized
To prevent headache while hospitalized
To prevent myocardial infarction while hospitalized
To prevent lactic acidosis while hospitalized
The correct answer is "to prevent lactic acidosis while hospitalized." This is the correct answer because a known side effect of metformin use is development of lactic acidosis (a form of metabolic acidosis). Patients who are hospitalized, especially if hospitalized for infections, like pneumonia, are independently at an elevated risk of developing a lactic acidosis. As such, to minimize the risk of lactic acidosis, a modifiable risk factor, metformin use, is frequently temporarily discontinued while inpatient. Patients on metformin are frequently switched to sliding-scale insulin as inpatients, as this allows for adequate glycemic monitoring, titration, and control. Once they are stable for discharge and the cause of their hospitalization is addressed and treated, most can be safely discharged home on metformin without issue.
While numerous measures are carried out while patients are hospitalized to prevent myocardial infarction, stroke, headache, and depression, the switching of metformin to sliding-scale insulin is not performed specifically for any of those reasons.
Example Question #432 : Conditions And Treatments
Which of the following is true of type I diabetes?
Patients are typically overweight adults
Patients develop insulin resistance
Patients typically present in diabetic ketoacidosis
Patients do not require treatment with insulin
Patients typically present in diabetic ketoacidosis
Type I diabetes is an autoimmune process that typically presents in young children in the form of DKA (diabetic ketoacidosis). This potentially life threatening condition is treated with IV insulin. Type II diabetes is insulin resistance, and is found in older adults (typically those who are overweight).
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