A nurse is caring for a client who reports increased anxiety, nervousness, heat intolerance, and unintentional weight loss. Blood testing reveals decreased thyroid-stimulating hormone (TSH), elevated thyroxine (T4), and elevated triiodothyronine (T3). Which of the following vital sign abnormalities does the nurse anticipate?

Decreased body temperature

Tachycardia

Hypotension

Slow respiratory rate

Answer and Explanation

The Correct Answer is B

Choice A reason: Decreased Body Temperature

Decreased body temperature is not typically associated with hyperthyroidism. In fact, hyperthyroidism often causes an increase in body temperature due to the accelerated metabolic rate. Patients with hyperthyroidism may experience heat intolerance and excessive sweating, but not a decrease in body temperature.

Choice B reason: Tachycardia

Tachycardia, or an abnormally fast heart rate, is a common symptom of hyperthyroidism. The elevated levels of thyroid hormones (T4 and T3) increase the body’s metabolism, leading to an increased heart rate. This can result in palpitations and a feeling of a racing heart, which are characteristic signs of hyperthyroidism. Therefore, tachycardia is the most likely vital sign abnormality in this scenario.

Choice C reason: Hypotension

Hypotension, or low blood pressure, is not typically associated with hyperthyroidism. Instead, hyperthyroidism can sometimes cause an increase in blood pressure due to the heightened metabolic activity and increased cardiac output4. Therefore, hypotension is not a characteristic finding in patients with elevated thyroid hormone levels.

Choice D reason: Slow Respiratory Rate

A slow respiratory rate is not commonly seen in hyperthyroidism. The condition usually leads to an increased respiratory rate due to the body’s heightened metabolic demands. Patients with hyperthyroidism may experience shortness of breath and rapid breathing, but not a slow respiratory rate.

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Correct Answer is C

Explanation

Choice A reason:

A serum potassium level of 5.0 mEq/L is within the normal range (3.5-5.0 mEq/L). While it is on the higher end of normal, it does not require immediate intervention in the context of SIADH. Potassium levels are crucial for cardiac and muscle function, but this value does not indicate a critical imbalance.

Choice B reason:

A serum calcium level of 8.0 mg/dL is slightly below the normal range (8.5-10.2 mg/dL). Mild hypocalcemia can occur in various conditions, but it is not typically associated with SIADH and does not require immediate intervention unless symptomatic or significantly lower.

Choice C reason:

A serum sodium level of 125 mEq/L indicates hyponatremia, which is a hallmark of SIADH. Hyponatremia can lead to severe neurological symptoms, including seizures, confusion, and coma, especially if it develops rapidly. Immediate intervention is required to correct the sodium imbalance and prevent serious complications.

Choice D reason:

A blood urea nitrogen (BUN) level of 24 mg/dL is within the upper normal range (7-20 mg/dL). While slightly elevated, it is not critically high and does not require immediate intervention in the context of SIADH. BUN levels can be influenced by various factors, including hydration status and renal function.

A. Keeping supplies on hand to treat hypoglycemic episodes is important. B. Increasing exercise can help with hypoglycemia. C. Clients with hypoglycemia cannot participate in religious/cultural fasting. D. Clients will usually have obvious manifestations of hypoglycemia.

Correct Answer is A

Explanation

Choice A reason:

Keeping supplies on hand to treat hypoglycemic episodes is crucial for clients with type 1 diabetes mellitus. Hypoglycemia, or low blood sugar, can occur suddenly and needs immediate treatment to prevent severe complications such as loss of consciousness or seizures. Supplies such as glucose tablets, juice, or candy can quickly raise blood sugar levels. The American Diabetes Association recommends that individuals with diabetes always carry a source of fast-acting carbohydrate to treat hypoglycemia. This proactive approach ensures that clients can manage their condition effectively and reduce the risk of severe hypoglycemic events.

Choice B reason:

Increasing exercise can help with hypoglycemia is not an appropriate statement. While regular exercise is beneficial for managing diabetes overall, it can actually increase the risk of hypoglycemia, especially if not properly managed. Exercise increases insulin sensitivity, which can lower blood glucose levels. Therefore, clients need to monitor their blood sugar levels before, during, and after exercise and adjust their carbohydrate intake or insulin dosage accordingly. Advising increased exercise without proper guidance on managing blood sugar levels can be dangerous for clients with type 1 diabetes.

Choice C reason:

Clients with hypoglycemia cannot participate in religious/cultural fasting is not entirely accurate. While fasting can pose challenges for individuals with diabetes, it is not impossible. Clients can participate in fasting with careful planning and medical supervision. They need to monitor their blood sugar levels more frequently and adjust their medication and food intake accordingly. Healthcare providers can work with clients to develop a plan that allows them to observe their religious or cultural practices safely. Therefore, a blanket statement that clients cannot participate in fasting is not appropriate.

Choice D reason:

Clients will usually have obvious manifestations of hypoglycemia is not always true. Hypoglycemia can present with a variety of symptoms, and not all clients will experience obvious signs. Common symptoms include shakiness, sweating, confusion, and irritability, but some individuals may have hypoglycemia unawareness, where they do not recognize the symptoms until their blood sugar levels are very low. This condition can be particularly dangerous as it increases the risk of severe hypoglycemia. Therefore, it is important for clients to regularly monitor their blood sugar levels rather than relying solely on symptoms.

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Naxlex Comprehensive Predictor Exams

The nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is critically ill. Which of the following lab findings requires immediate intervention?

Correct Answer is C

Explanation

A nurse is providing education to a client who has type 1 diabetes mellitus and has been experiencing hypoglycemic episodes. Which of the following statements by the nurse is appropriate?

Correct Answer is A

Explanation

A nurse is preparing to administer medications to a client who has pericarditis. Which of the following medications should the nurse anticipate to his client? (Select All that Apply)

A nurse is planning care for a client who has worsening heart failure and is experiencing arrhythmias. Which of the following procedures should the nurse anticipate the client will require to regulate the rhythm?

A nurse is preparing to administer medications to a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following medications should the nurse question?

A nurse is teaching a group of clients about risk factors for developing atrial flutter. Which of the following clients should the nurse understand is at highest risk for developing atrial flutter?

A nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings are manifestations of hyponatremia? (Select All that Apply)

A nurse is assessing a client who has peripheral artery disease for potential safety concerns. Which of the following client statements should the nurse report to the provider?

A nurse is preparing to administer medications to a client who has pericarditis. Which of the following medications should the nurse anticipate administering to this client? (Select All that Apply.)

A nurse is providing education to a client who has hypoglycemia. Which of the following information should the nurse include about the regulation of blood glucose levels?