a 45 year old woman presents with fatigue weight gain and constipation laboratory tests reveal low tsh and high free t4 levels what is the most likely
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1. A 45-year-old woman presents with fatigue, weight gain, and constipation. Laboratory tests reveal low TSH and high free T4 levels. What is the most likely diagnosis?

Correct answer: B

Rationale: The presentation of low TSH and high free T4 levels is characteristic of hyperthyroidism, which is consistent with the symptoms of fatigue, weight gain, and constipation described in the case. In hyperthyroidism, the thyroid gland produces an excess of thyroid hormone leading to a hypermetabolic state, which can manifest with these symptoms.

2. The client is prescribed clozapine (Clozaril), and the nurse plans to educate them about its purpose. Which statement should the nurse provide?

Correct answer: B

Rationale: Clozapine (Clozaril) is an antipsychotic medication that is known to improve cognitive function and thought clarity in individuals with schizophrenia. It primarily helps in managing symptoms related to thought processes rather than focusing on community function, coping with symptoms, or grooming and hygiene.

3. A client with chronic renal failure is prescribed epoetin alfa (Epogen). Which outcome indicates that the medication is effective?

Correct answer: C

Rationale: Epoetin alfa is a medication that stimulates red blood cell production. Therefore, in a client with chronic renal failure, an effective outcome of epoetin alfa therapy would be an improvement in hemoglobin levels. This indicates that the medication is working as intended by addressing anemia, a common complication of chronic renal failure. Increased urine output (choice A) is not directly related to the action of epoetin alfa. Decreased blood pressure (choice B) is not a primary expected outcome of epoetin alfa therapy. Stable potassium levels (choice D) are important but not a direct indicator of the effectiveness of epoetin alfa in this context.

4. A client diagnosed with dementia is disoriented, wandering, has a decreased appetite, and is having trouble sleeping. What is the priority nursing problem for this client?

Correct answer: D

Rationale: The correct answer is 'Risk for injury.' In a client with dementia who is disoriented, wandering, and experiencing sleep disturbances, the priority nursing problem is the risk for injury. Disorientation and wandering behavior can lead to accidents, falls, or other harmful situations, making it crucial for the nurse to address the safety concerns first to prevent any potential harm to the client.

5. Following a CVA, the nurse assesses that a client has developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?

Correct answer: A

Rationale: In a client with dysphagia and gastrointestinal symptoms such as hypoactive bowel sounds and a firm, distended abdomen, continuous tube feeding might exacerbate the symptoms. This can lead to complications and should be questioned by the nurse.

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