A nurse is assessing a client who has myxedema coma. Which of the following findings should the nurse expect?
Heat intolerance
Facial edema
Tachycardia
Diarrhea
The Correct Answer is B
Choice A reason : Heat intolerance is not a symptom associated with myxedema coma. Instead, patients with myxedema coma typically present with cold intolerance due to decreased metabolic rate and reduced heat production as a result of hypothyroidism¹.
Choice B reason : Facial edema, particularly around the eyes, is a characteristic finding in myxedema coma. This condition results from severe hypothyroidism, which can cause mucopolysaccharide deposition in the skin, leading to non-pitting edema¹.
Choice C reason : Tachycardia is not expected in myxedema coma; rather, bradycardia is more common due to the reduced metabolic demands of the body in the hypothyroid state¹.
Choice D reason : Diarrhea is not typically a symptom of myxedema coma. Patients are more likely to experience constipation due to slowed gastrointestinal motility in the context of hypothyroidism¹.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason : Elevating the head of the bed to 20 degrees can help reduce intracranial pressure by promoting venous drainage from the brain. It is a recommended practice unless contraindicated by other conditions³.
Choice B reason : Cleansing the eyes with normal saline every 4 hours is a standard care procedure to maintain eye hygiene and prevent infection, especially when the blink reflex may be compromised in an unconscious patient³.
Choice C reason : Lubricating the skin with baby oil is a common practice to prevent dryness and maintain skin integrity. It is not contraindicated unless the patient has specific allergies or skin conditions that require different care³.
Choice D reason : Suctioning the oropharynx routinely is contraindicated as it can stimulate the vagus nerve and potentially increase intracranial pressure. Suctioning should be performed cautiously and only when necessary³.
Correct Answer is A
Explanation
Choice A reason : Anginal pain is commonly triggered by physical exertion or emotional stress, which increases the heart's demand for oxygen. When the narrowed coronary arteries cannot supply enough oxygen-rich blood to the heart muscle, angina occurs³⁷.
Choice B reason : While sitting up may help relieve discomfort for some conditions, anginal pain is typically relieved by resting or taking prescribed medication such as nitroglycerin, which helps to widen the blood vessels and improve blood flow to the heart muscle³⁶.
Choice C reason : This statement is incorrect. Anginal pain does not persist with rest and organic nitrates; these are actually the measures taken to alleviate the pain. Resting decreases the heart's demand for oxygen, and nitrates are effective in relieving anginal pain³.
Choice D reason : Typically, anginal pain does not last longer than a few minutes. If chest pain persists for more than 20 minutes, it may indicate a more serious condition, such as a heart attack, and immediate medical attention is required³.
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