A nurse is assessing a client who has a sliding hiatal hernia.
Which of the following findings should the nurse expect?

Choice A rationale

Drowsiness is a symptom of hypothyroidism, not hyperthyroidism (thyrotoxicosis). Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism. An overdose or excessive dose of this medication would lead to symptoms of hyperthyroidism, which is the opposite of drowsiness. Instead, clients would likely experience increased energy levels, anxiety, or insomnia.

Choice B rationale

Weight gain is a classic symptom of hypothyroidism, not thyrotoxicosis. When the body's metabolism slows down due to insufficient thyroid hormone, the client may gain weight. A client experiencing thyrotoxicosis from an excessive dose of levothyroxine would typically exhibit a hypermetabolic state, which often leads to unintended weight loss despite an increased appetite.

Choice C rationale

A fever is a sign of an accelerated metabolic rate, which is a key feature of thyrotoxicosis. When thyroid hormone levels become excessively high, the body's basal metabolic rate increases significantly, causing an increase in body temperature. This can manifest as a low-grade fever or even a significant fever in severe cases, requiring immediate medical attention.

Choice D rationale

Bradycardia, or a slow heart rate, is a symptom of hypothyroidism. The heart rate slows down as the body's overall metabolic processes decrease. Thyrotoxicosis is characterized by a rapid heart rate, known as tachycardia. This is due to the excessive stimulation of the cardiovascular system by high levels of thyroid hormone. A normal heart rate is typically between 60 and 100 beats per minute. .

Choice A rationale

Activating the fire alarm is a critical step in the RACE sequence (Rescue, Alarm, Contain, Extinguish). However, the immediate priority is to ensure the safety of people. Therefore, alerting others to the fire comes after the initial rescue of individuals in immediate danger. This action is necessary for a coordinated emergency response.

Choice B rationale

Closing doors and windows on the unit is an important step in containing the fire and preventing the spread of smoke and flames. This action follows the evacuation of individuals in immediate danger and is part of the "Contain" step of the RACE protocol. Containment helps to protect other areas of the facility.

Choice C rationale

Obtaining and using a fire extinguisher is a valid action, but only after clients in immediate danger have been evacuated and the fire alarm has been activated. The "Extinguish" step is only to be performed if the fire is small and contained and the person is trained to use the extinguisher, and it does not pose a risk to the person.

Choice D rationale

The primary responsibility of a nurse during a fire is to protect the clients. The acronym RACE guides this response: Rescue, Alarm, Contain, and Extinguish. The first and most critical step is to remove clients from the immediate danger area, which takes precedence over all other actions. *.