A nurse is assessing a patient admitted with hyperthyroidism.
The patient reports a weight loss of 5.4 kg (12 lb) in the last 2 months, increased appetite, increased perspiration, fatigue, menstrual irregularity, and restlessness.Which of the following actions should the nurse take to prevent a thyroid crisis?

Provide a quiet, low-stimulus environment

Keep the patient NPO

Administer aspirin as prescribed for any sign of hyperthermia.

Observe the patient carefully for signs of hypocalcemia.

Answer and Explanation

The Correct Answer is A

Choice A rationale
Providing a quiet, low-stimulus environment is one of the key interventions for a patient with hyperthyroidism who is at risk of a thyroid crisis. Hyperthyroidism is characterized by an overproduction of thyroid hormones, which can accelerate the body’s metabolism causing symptoms such as rapid heart rate, increased appetite, increased perspiration, fatigue, menstrual irregularity, and restlessness. A thyroid crisis, also known as a thyroid storm, is a severe, life-threatening condition characterized by extreme symptoms of hyperthyroidism. A quiet, low-stimulus environment can help reduce anxiety and agitation, which can exacerbate symptoms and potentially trigger a thyroid crisis.
Choice B rationale
Keeping the patient NPO (nothing by mouth) is not typically necessary in the management of hyperthyroidism unless the patient is preparing for a procedure such as thyroid surgery. In

fact, because of the increased metabolic rate in hyperthyroidism, patients often have an increased appetite and may require additional caloric intake.
Choice C rationale
Administering aspirin for any sign of hyperthermia is not recommended in hyperthyroidism. Aspirin can actually increase the level of free thyroid hormones in the blood by displacing them from their binding proteins, potentially worsening the hyperthyroid state.
Choice D rationale
While it is important to observe patients with hyperthyroidism for signs of various complications, hypocalcemia is not typically associated with hyperthyroidism. Hypocalcemia, or low calcium levels in the blood, is more commonly associated with hypoparathyroidism or vitamin D deficiency.

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Correct Answer is D

Explanation

Choice A rationale
An increase in intraocular pressure is not a cause of diabetic retinopathy. Diabetic retinopathy is caused by damage to the blood vessels in the retina due to high blood sugar levels.
Choice B rationale
While regular eye exams are important for patients with diabetes mellitus, having an eye exam every 2 years may not be sufficient for detecting and managing diabetic retinopathy. More frequent eye exams may be recommended depending on the patient’s condition.
Choice C rationale
Clouding of the lens is not a manifestation of diabetic retinopathy. This is a symptom of cataracts, not diabetic retinopathy. Diabetic retinopathy affects the blood vessels in the retina, not the lens of the eye.
Choice D rationale
Seeing spots, also known as floaters, is a common symptom of diabetic retinopathy. This occurs when blood and other fluids leak into the vitreous, the clear, jelly-like substance that fills the inside of the eye.

A. You can lay down 30 minutes after eating if that will help you feel better. B. It’s important for you to practice good oral hygiene with this disorder. C. A glass of wine per day might help with reducing your stress and improve your GERD. D. Adding more citrus foods in your diet might help with easing the manifestations.

Correct Answer is B

Explanation

Choice A rationale
Laying down 30 minutes after eating can actually worsen GERD symptoms. This is because the position can make it easier for stomach acid to back up into the esophagus.
Choice B rationale
Practicing good oral hygiene is important for everyone, but it doesn’t directly prevent GERD. However, it can help prevent complications of GERD such as tooth decay caused by stomach acid.
Choice C rationale
While moderate alcohol consumption may reduce stress, it can actually worsen GERD. Alcohol can relax the lower esophageal sphincter, allowing stomach acid to reflux into the esophagus. It can also increase stomach acid production.
Choice D rationale

Citrus foods are generally not recommended for people with GERD. They are acidic and can trigger GERD symptoms. Instead, non-citrus fruits like bananas, apples, and pears are better choices.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is educating a patient with diabetes mellitus about diabetic retinopathy. Which of the following statements should the nurse make to the patient?

Correct Answer is D

Explanation

A nurse is caring for a patient who continues to have issues with GERD (gastroesophageal reflux disease). Which of the following statements provides the best preventative health care education for this patient?

Correct Answer is B

Explanation

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