the nurse is assessing a client who has just undergone a thyroidectomy which assessment finding is most concerning
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Nursing Elites

HESI LPN

Adult Health 1 Exam 1

1. The healthcare provider is assessing a client who has just undergone a thyroidectomy. Which assessment finding is most concerning?

Correct answer: C

Rationale: Tingling around the mouth is the most concerning finding as it may indicate hypocalcemia, a potential complication after thyroidectomy. Hoarseness of the voice is common due to surgical manipulation, slight swelling at the incision site is expected postoperatively, and mild fever can be a normal inflammatory response. Hypocalcemia after thyroidectomy can lead to serious complications and should be addressed promptly to prevent further issues.

2. The nurse plans to administer the rubella vaccine to a postpartum client whose titer is < 1:8 and who is breastfeeding. What information should the nurse provide this client?

Correct answer: D

Rationale: Educating about the waiting period helps prevent possible rubella infection in a subsequent early pregnancy.

3. The nurse is caring for a client with chronic liver disease. Which lab value is most concerning?

Correct answer: D

Rationale: The correct answer is D, prolonged PT/INR. In a client with chronic liver disease, a prolonged PT/INR is the most concerning lab value. This indicates impaired liver function, leading to a higher risk of bleeding. Elevated AST and ALT (choice A) are indicators of liver damage but do not directly assess the risk of bleeding. Decreased albumin level (choice B) reflects impaired liver function but is not as directly related to bleeding risk as a prolonged PT/INR. Elevated bilirubin level (choice C) is a sign of liver dysfunction, specifically related to bile metabolism, and while important, it is not as directly associated with bleeding risk as a prolonged PT/INR in the context of chronic liver disease.

4. A client with a diagnosis of rheumatoid arthritis is prescribed methotrexate. What is the primary action of this medication?

Correct answer: B

Rationale: The correct answer is B: Methotrexate is an immunosuppressant that works by suppressing the immune system, thereby reducing inflammation in rheumatoid arthritis. Methotrexate does not directly increase joint lubrication (Choice A) as its primary action is on the immune system. Choices C and D are incorrect since methotrexate does not enhance bone density or stimulate cartilage regeneration. It is crucial for healthcare providers to understand the mechanism of action of medications to provide safe and effective care to patients.

5. The healthcare provider is assessing a client who has just undergone a thoracentesis. Which finding should be reported immediately?

Correct answer: D

Rationale: Shortness of breath should be reported immediately as it may indicate a pneumothorax, a potential complication of thoracentesis. Diminished breath sounds on the affected side, pain at the procedure site, and blood-tinged sputum are common findings post-thoracentesis and do not necessarily indicate immediate complications like a pneumothorax.

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