A nurse is admitting a client who is experiencing an Addisonian crisis. Which of the following should the nurse anticipate an order for?

IV hydrocortisone

Ketoconazole and insulin

Lactated Ringer's IV infusion

Furosemide slow IV push

Answer and Explanation

The Correct Answer is A

A. IV hydrocortisone: In an Addisonian crisis, there is an acute adrenal insufficiency which requires immediate treatment with IV hydrocortisone to replace the deficient glucocorticoids. This helps to rapidly correct the hormone imbalance and stabilize the patient.
B. Ketoconazole and insulin: Ketoconazole is an antifungal medication used to treat Cushing syndrome, not Addisonian crisis. Insulin is used for managing blood glucose levels and is not directly related to the treatment of an Addisonian crisis.
C. Lactated Ringer's IV infusion: While fluid replacement may be necessary in an Addisonian crisis, the immediate priority is to address the adrenal insufficiency with hydrocortisone. Lactated Ringer's may be used to support fluid balance but is not a substitute for glucocorticoid therapy.
D. Furosemide slow IV push: Furosemide is a diuretic used to manage fluid retention and is not indicated for treating Addisonian crisis. The primary treatment for Addisonian crisis is to address the adrenal hormone deficiency with hydrocortisone.

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Correct Answer is ["B","C","G"]

Explanation

A. Administer propylthiouracil (PTU): PTU is used for treating hyperthyroidism by inhibiting thyroid hormone production. The client's lab results show low Free T4 and elevated TSH, indicating hypothyroidism, not hyperthyroidism. Therefore, PTU is not appropriate for this condition.
B. Provide warm blankets: The client is experiencing hypothermia (temperature 35.6°C or 96.1°F) and lethargy. Providing warm blankets helps in managing low body temperature and preventing further complications. This intervention is necessary to stabilize the client's body temperature.
C. Place the client on a cardiac monitor: The client has bradycardia (heart rate 49/min) and a slow respiratory rate (10/min), which are signs of possible cardiac involvement due to hypothyroidism. Cardiac monitoring is essential to detect and manage any potential arrhythmias or cardiac issues that may arise.
D. Place the client on a high-calorie diet: A high-calorie diet is usually recommended for managing hyperthyroidism due to increased metabolism. However, this client has hypothyroidism, characterized by reduced metabolism and low energy levels, so this intervention is not appropriate.
E. Administer propranolol: Propranolol is used to manage symptoms of hyperthyroidism, such as tachycardia and tremors. Given the client's symptoms and lab results indicating hypothyroidism, propranolol is not indicated for this condition.
F. Administer acetaminophen: Acetaminophen is used to reduce fever, but the client is hypothermic rather than febrile. Administering acetaminophen would not address the client's current issue of low body temperature.
G. Administer levothyroxine: The client has low Free T4 and elevated TSH, indicating hypothyroidism. Levothyroxine is the appropriate medication to manage hypothyroidism by supplementing thyroid hormone levels. This intervention is necessary to treat the underlying thyroid condition.
H. Prepare the client for a subtotal thyroidectomy: A subtotal thyroidectomy is a surgical option considered for severe thyroid disorders, such as thyroid cancer or uncontrollable hyperthyroidism. This client's presentation suggests hypothyroidism rather than a condition requiring surgical intervention.

A. B-type natriuretic peptide (BNP) B. Troponin I C. Blood urea nitrogen (BUN) D. Platelet levels

Correct Answer is A

Explanation

A. B-type natriuretic peptide (BNP): BNP levels are elevated in heart failure due to increased pressure and stretch in the heart's chambers. It is a key marker used to diagnose and assess the severity of heart failure.
B. Troponin I: This marker is used to diagnose myocardial infarction (heart attack) rather than heart failure. Elevated troponin levels indicate damage to the heart muscle.
C. Blood urea nitrogen (BUN): BUN levels can be elevated in heart failure due to decreased renal perfusion, but it is not as specific for diagnosing heart failure as BNP.
D. Platelet levels: Platelet levels are not directly related to the diagnosis of heart failure. They are more relevant for assessing clotting disorders and other conditions.

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A nurse is admitting a client who is experiencing an Addisonian crisis. Which of the following should the nurse anticipate an order for?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client Exhibits Select the 3 interventions that the nurse should anticipate for this client.

Correct Answer is ["B","C","G"]

Explanation

A client seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be the most useful for diagnosing heart failure?

Correct Answer is A

Explanation

The patient is returning to the unit after undergoing a bilateral adrenalectomy. Which clinical manifestation would indicate that the client is experiencing an Addisonian crisis?

A nurse is caring for a client after a subtotal thyroidectomy. Which of the following manifestations would lead the nurse to suspect that the procedure caused damage to the client's parathyroid glands?

A nurse is preparing to administer total parental nutrition (TPN) 1800 mL to infuse over 24 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A nurse is providing education to a client who has a new diagnosis of Addison's disease. The nurse determines that additional teaching is needed when the client makes which of the following statements?

A client in a primary care provider's office has a new diagnosis of hypothyroidism. The nurse understands that the client should be screened for which of the following conditions common in people who have hypothyroidism?

Which pharmacologic therapy does the nurse anticipate administering to a client who is experiencing acute thyrotoxicosis?

A client is experiencing tachycardia and tremors. Lab values show elevated Free T4 and low thyroid stimulating hormone (TSH). Which diagnostic study will help the practitioner differentiate Graves' disease from other forms of hyperthyroidism?