At the beginning of the shift, a nurse receives report on the following four patients. Which patient should the nurse place priority on assessing first?
A 40-year-old patient with Cushing syndrome and gynecomastia.
A 58-year-old patient with Addison's disease who is exhibiting confusion.
A 45-year-old patient with Graves' disease and exophthalmos.
A 47-year-old patient with hypothyroidism who is asking for a warm blanket.
A 47-year-old patient with hypothyroidism who is asking for a warm blanket.
The Correct Answer is B
A. A 40-year-old patient with Cushing syndrome and gynecomastia: While Cushing syndrome requires ongoing management and monitoring, gynecomastia alone is not an urgent concern compared to the symptoms described in option B.
B. A 58-year-old patient with Addison's disease who is exhibiting confusion: Addison's disease can lead to adrenal insufficiency, and confusion could indicate an adrenal crisis or severe electrolyte imbalance. This is a critical situation requiring immediate assessment to prevent severe complications.
C. A 45-year-old patient with Graves' disease and exophthalmos: Graves' disease with exophthalmos is significant but does not typically represent an immediate life-threatening condition compared to the symptoms associated with Addison's disease.
D. A 47-year-old patient with hypothyroidism who is asking for a warm blanket: This patient’s request for a warm blanket suggests they might be experiencing symptoms related to hypothyroidism, such as feeling cold. However, this is less urgent compared to the confusion and potential crisis in option B.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
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.
Correct Answer is ["75"]
Explanation
Step 1: Determine the total infusion time in hours
• There are 24 hours in a day.
Step 2: Calculate the infusion rate
• Infusion rate (mL/hr) = Total volume (mL) / Infusion time (hr)
• Infusion rate = 1800 mL / 24 hr = 75 mL/hr
Therefore, the nurse should set the IV pump to deliver 75 mL/hr.
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