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Complete NCLEX Study Materials
66. The nurse is caring for a client who is scheduled for an adrenalectomy. The nurse plans to administer which medication in the preoperative period to prevent Addison's crisis?
a) prednisone (deltasone)orally
b) fludrocortisone (Florinef) subcutaneously
c) spironolactone (Aldactone) intramuscularly
d) methiprednisolone sodium succinate (Solu-Medrol) intravenously
67. The nurse is preparing a client with Graves' disease to receive radioactive iodine therapy. The nurse tells the client which of the following about the therapy?
a) following the initial dose, subsequent treatments must continue lifelong
b) the radioactive iodine is designed to destroy the entire thyroid gland with just one dose
c) it takes 6 to 8 weeks after treatment to experience relief from the symptoms of the disease
d) the high levels of radioactivity prohibit contact with family for 4 weeks after initial treatment
68. The nurse is preparing to care for a client returning from the operating room following a subtotal thyroidectomy. The nurse anticipates the need for which of the following items to be placed at the bedside?
a) hypothermia blanket
b) emergency tracheostomy kit
c) magnesium sulfate in a ready-to-inject vial
d) ampule of saturated solution of potassium iodide (SSKI)
69. The nurse is admitting a client with a diagnosis of myxedema to the hospital. The nurse performs which of the following that will provide data related to this diagnosis?
a) inspects facial features
b) auscultates lung sounds
c) percusses the thyroid gland
d) palpates the adrenal glands
70. A nurse is preparing postoperative discharge instructions for a client who had one adrenal gland removed. The nurse includes which of the following in the instructions?
a) the reason for maintaining a diabetic diet
b) teaching proper application of an ostomy pouch
c) instructions about early signs of a wound infection
d) the need for lifelong replacement of all adrenal hormones
Endocrine System Questions and Answers and Rationale
66) D
- A glucocorticoid preparation will be administered intravenously or intramuscularly in the immediate preoperative period to a client scheduled for an adrenalectomy. Methylprednisolone sodium succinate protects the client from developing acute adrenal insufficiency (Addison's crisis) that occurs as a result of the adrenalectomy. Aldactone is a potassium-sparing diuretic. Prednisone is an oral corticosteroid. Fludrocortisone is a mineralocorticoid.
67) C
- Following treatment with radioactive iodine therapy, a decrease in thyroid hormone level should be noted, which would help alleviate symptoms. Relief of symptoms does not occur until 6 to 8 weeks after initial treatment. This form of therapy is not designed to destroy the entire gland; rather, some of the cells that synthesize thyroid hormone will be destroyed by the local radiation. The nurse needs to reassure the client and family that unless the dosage is extremely high, clients are not required to observe radiation precautions. The rationale for this is that the radioactivity quickly dissipates. Occasionally, a client may require a second or third dose, but treatments are not lifelong.
68) B
- Respiratory distress can occur following thyroidectomy as a result of swelling in the tracheal area. The nurse would ensure that an emergency tracheostomy kit is available. Surgery on the thyroid does not alter the heat control mechanism of the body. Magnesium sulfate would not be indicated because the incidence of hypomagnesemia is not a common problem post-thyroidectomy. SSKI is typically administered preoperatively to block thyroid hormone synthesis and release, as well as to place the client in a euthyroid state.
69) A
- Inspection of facial features will reveal the characteristic coarse features, presence of edema around the eyes and face, and the blank expression that are characteristic of myxedema. The assessment techniques in options B, C, and D will not reveal information related to the diagnosis of myxedema.
70) C
- A client who had a unilateral adrenalectomy will be placed on corticosteroids temporarily to avoid a cortisol deficiency. These medications will be gradually weaned in the postoperative period until they are discontinued. Also, because of the anti-inflammatory properties of corticosteroids produced by the adrenals, clients who undergo an adrenalectomy are at increased risk of developing wound infections. Because of this increased risk of infection, it is important for the client to know measures to prevent infection, early signs of infection, and what to do if an infection seems to be present. The client does not need to maintain a diabetic diet, and the client will not have an ostomy following this surgery.After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:
Endocrine System Questions and Answers (1-7)
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Endocrine System Questions and Answers (71-75)
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