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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?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Thyroiditis
- D. Thyroid cancer
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. A client with a history of gout is experiencing an acute attack. Which medication should the nurse expect the healthcare provider to prescribe?
- A. Aspirin.
- B. Allopurinol (Zyloprim).
- C. Colchicine.
- D. Probenecid (Benemid).
Correct answer: C
Rationale: During an acute gout attack, the healthcare provider is likely to prescribe colchicine. Colchicine is commonly used to treat acute gout attacks because it works by reducing inflammation and alleviating pain associated with the condition. It is important to note that aspirin is not recommended for gout treatment and may even exacerbate the symptoms. Allopurinol and probenecid are medications used for long-term management of gout by reducing uric acid levels in the blood, but they are not typically prescribed during an acute attack. Therefore, colchicine is the most appropriate medication for managing an acute gout attack.
3. A healthcare professional is assessing a client with severe dehydration. Which finding indicates a need for immediate intervention?
- A. Heart rate of 110 beats per minute.
- B. Blood pressure of 90/60 mm Hg.
- C. Urine output of 20 ml/hour.
- D. Dry mucous membranes.
Correct answer: C
Rationale: A urine output of 20 ml/hour indicates severe dehydration and impaired renal function. This finding suggests a critical state where the kidneys are conserving water, leading to reduced urine output. Immediate intervention is required to restore fluid balance and prevent further complications associated with severe dehydration. Choice A, a heart rate of 110 beats per minute, may indicate dehydration but is not as severe as the critically low urine output. Choice B, a blood pressure of 90/60 mm Hg, can be seen in dehydration but is not as concerning as the extremely low urine output. Choice D, dry mucous membranes, is a common sign of dehydration but does not require immediate intervention compared to the severely reduced urine output.
4. A client with hepatic encephalopathy is being treated with lactulose. What is an expected outcome of this treatment?
- A. Reduction in blood ammonia levels
- B. Improvement in liver enzyme levels
- C. Decrease in bilirubin levels
- D. Increase in urine output
Correct answer: A
Rationale: Lactulose is used to treat hepatic encephalopathy by reducing blood ammonia levels through promoting its excretion via the intestines. Elevated ammonia levels contribute to the development of encephalopathy symptoms, so by lowering them, the client's neurological status can improve.
5. A patient with anemia is prescribed ferrous sulfate. What advice should the nurse give regarding the administration of this medication?
- A. Take with dairy products to increase absorption.
- B. Take on an empty stomach for best absorption.
- C. Avoid vitamin C while taking this medication.
- D. Take before bedtime.
Correct answer: B
Rationale: The correct advice for the administration of ferrous sulfate is to take it on an empty stomach for best absorption. This enhances the absorption of iron. If gastrointestinal upset occurs, the medication can be taken with food. Taking ferrous sulfate with dairy products is not recommended as calcium can inhibit iron absorption. Taking it before bedtime is also not recommended. Vitamin C can actually help with the absorption of iron and is often recommended to be taken alongside iron supplements to enhance absorption. Therefore, avoiding vitamin C while taking ferrous sulfate is not correct.
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