A nurse is caring for a client who is being evaluated for acromegaly. Which of the following manifestations should the nurse expect to find during assessment? (Select all that apply.)

Hepatomegaly

Moon face

Coarse facia features

Enlarged distal extreme

Loss of color discrimination

Answer and Explanation

Correct Answer : A,C,D,E

A: Hepatomegaly is a common manifestation of acromegaly, as excess growth hormone can cause organ enlargement.

B: Moon face is associated with Cushing's syndrome, not acromegaly. In acromegaly, facial changes are characterized by bony enlargement and coarsening of features, not the rounded face seen in Cushing's syndrome.

C: Coarse facial features are a classic sign of acromegaly due to the overgrowth of facial bones and soft tissue, leading to prominent brows, a larger nose, and a protruding jaw.

D: Enlarged distal extremities, such as hands and feet, are typical in acromegaly because of excessive growth hormone, which affects the growth plates in the bones and causes an increase in size and thickness.

E: This can occur due to optic nerve involvement, which is associated with pituitary tumors that can cause acromegaly. Vision changes, including loss of color discrimination, may be noted as a result of pressure on the optic chiasm.

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Correct Answer is C

Explanation

A. Checking the pedal pulses is important for assessing circulation, but it may not directly address the cause of the muscle spasms. In this case, addressing the electrolyte imbalance is a higher priority.

B. Requesting a relaxant might provide temporary relief for muscle spasms, but it does not address the potential underlying cause. It's important to identify and treat the root issue.

C. Correct. Severe muscle spasms in a client post-thyroidectomy could indicate hypocalcemia, as the parathyroid glands, which regulate calcium levels, can be affected during the surgery. Verifying the most recent calcium level will help determine if this is the cause.

D. Administering an oral potassium supplement addresses a different electrolyte imbalance (hypokalemia), which is not typically associated with muscle spasms following a thyroidectomy. Calcium levels are more relevant in this context.

A. "Withhold your usual daily dose of insulin." B. "Drink 240 to 360 milliliters of calorie-free liquids every 8 hours." C. "Test your blood glucose level every 8 hours." D. "Check your urine for ketones when blood glucose levels are greater than 240 mg/dL."

Correct Answer is D

Explanation

A. Incorrect. Withholding insulin during illness is not recommended. Clients with type 1 diabetes should continue to take their prescribed insulin even when they are ill. Insulin is necessary to regulate blood glucose levels, and illness can increase the body's demand for insulin.

B. Incorrect. Drinking calorie-free liquids is important to prevent dehydration during illness, but specific fluid amounts should be individualized based on the client's needs and healthcare provider's recommendations. The given volume is not a universally applicable guideline.

C. Incorrect. Testing blood glucose levels every 8 hours may not be frequent enough during illness. Blood glucose should be monitored more frequently to closely track changes in response to illness and adjust insulin doses accordingly.

D. Correct. Checking urine for ketones when blood glucose levels exceed 240 mg/dL is an important guideline during illness. Elevated blood glucose levels can lead to the production of ketones, and checking for ketones in the urine helps identify the early signs of diabetic ketoacidosis (DKA). If ketones are present, the client should follow a specific plan of action as outlined by their healthcare provider, which may include adjusting insulin doses or seeking medical attention.

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A nurse is caring for a client who is being evaluated for acromegaly. Which of the following manifestations should the nurse expect to find during assessment? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is 1 day postoperative following a thyroidectomy and reports severe muscle spasms of the lower extremities. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?

Correct Answer is D

Explanation

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