HESI RN
HESI RN Nursing Leadership and Management Exam 6
1. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should Nurse Hans recognize as an adverse drug effect?
- A. Dysuria
- B. Leg cramps
- C. Tachycardia
- D. Blurred vision
Correct answer: C
Rationale: Tachycardia is a potential adverse effect of levothyroxine, indicating overmedication. Dysuria (painful urination) is not typically associated with levothyroxine. Leg cramps are not a common adverse effect of levothyroxine. Blurred vision is not a typical adverse effect of levothyroxine; instead, it may be a sign of other eye-related conditions or medication side effects.
2. A client with Graves' disease is prescribed propranolol. The nurse understands that the purpose of this medication is to:
- A. Treat the underlying cause of the disease
- B. Reduce thyroid hormone production
- C. Alleviate symptoms such as tachycardia and tremors
- D. Increase energy levels
Correct answer: C
Rationale: The correct answer is C: Alleviate symptoms such as tachycardia and tremors. Propranolol is a beta-blocker that helps manage symptoms like tachycardia (fast heart rate) and tremors in patients with Graves' disease. Choice A is incorrect because propranolol does not address the underlying cause of Graves' disease, which is autoimmune in nature. Choice B is incorrect because propranolol does not directly reduce thyroid hormone production; it mainly targets the symptoms. Choice D is incorrect because while propranolol may help with symptoms like tachycardia, it is not intended to increase energy levels.
3. The client with DM is being instructed by the nurse about the importance of controlling blood glucose levels. The nurse should emphasize that uncontrolled blood glucose can lead to:
- A. Increased risk of heart disease and stroke.
- B. Improved wound healing.
- C. Reduced need for medication.
- D. Decreased risk of infection.
Correct answer: A
Rationale: The correct answer is A: Increased risk of heart disease and stroke. Uncontrolled blood glucose levels in clients with diabetes mellitus (DM) can lead to cardiovascular complications, such as heart disease and stroke. High blood glucose levels can damage blood vessels over time, increasing the risk of atherosclerosis and cardiovascular events. Choices B, C, and D are incorrect because uncontrolled blood glucose levels do not improve wound healing, reduce the need for medication, or decrease the risk of infection. In fact, uncontrolled blood glucose levels can impair wound healing, require more medications to manage symptoms, and increase the risk of infections due to compromised immune function.
4. Which nursing diagnosis takes the highest priority for a female client with hyperthyroidism?
- A. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess
- B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing
- C. Body image disturbance related to weight gain and edema
- D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
Correct answer: D
Rationale: The correct answer is D: Imbalanced nutrition: Less than body requirements related to thyroid hormone excess. In hyperthyroidism, increased metabolic rate leads to increased nutritional needs, causing weight loss and muscle wasting. Therefore, addressing imbalanced nutrition due to excessive thyroid hormone is a priority. Choice A is incorrect as hyperthyroidism typically leads to weight loss, not weight gain. Choice B is less of a priority as skin issues are secondary to the metabolic disturbances caused by hyperthyroidism. Choice C, body image disturbance, is important but addressing the client's nutritional needs should take precedence to prevent further complications.
5. The nurse is teaching a client with newly diagnosed hyperthyroidism about the management of the condition. Which of the following statements by the client indicates a need for further teaching?
- A. I should take my medication every day as prescribed.
- B. I need to avoid foods high in iodine.
- C. I can skip my medication on days when I feel fine.
- D. I should monitor my pulse regularly.
Correct answer: C
Rationale: Clients with hyperthyroidism should take their medication consistently and not skip doses, even if they feel well.
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