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 B
Explanation
A. Weight gain and lethargy: These symptoms are more commonly associated with hypothyroidism or insufficient thyroid hormone levels, not with excess levothyroxine.
B. Nervousness and tachycardia: Excessive levothyroxine can lead to symptoms of hyperthyroidism, such as increased heart rate (tachycardia) and nervousness. These symptoms are consistent with an overdose of levothyroxine.
C. Facial puffiness and constipation: These symptoms are indicative of hypothyroidism, not hyperthyroidism. They would not be expected with an excess of levothyroxine.
D. Hypotension and intolerance to cold: These are symptoms of hypothyroidism and would not typically occur with an excess of levothyroxine. Excess levothyroxine usually causes symptoms of hyperthyroidism.
Correct Answer is A
Explanation
A. B-type natriuretic peptide (BNP): BNP levels are elevated in heart failure due to increased pressure and stretch in the heart's chambers. It is a key marker used to diagnose and assess the severity of heart failure.
B. Troponin I: This marker is used to diagnose myocardial infarction (heart attack) rather than heart failure. Elevated troponin levels indicate damage to the heart muscle.
C. Blood urea nitrogen (BUN): BUN levels can be elevated in heart failure due to decreased renal perfusion, but it is not as specific for diagnosing heart failure as BNP.
D. Platelet levels: Platelet levels are not directly related to the diagnosis of heart failure. They are more relevant for assessing clotting disorders and other conditions.
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