A nurse is assessing a client who has hyperthyroidism. The nurse should expect the client to report which of the following manifestations?
Constipation
Sensitivity to cold
Weight gain of 4.5 kg (10 lbs) in 3 weeks
Frequent mood changes
The Correct Answer is D
Choice A Reason:
Constipation is not typically associated with hyperthyroidism. Hyperthyroidism usually speeds up the body’s metabolism, leading to symptoms like increased bowel movements or diarrhea rather than constipation.
Choice B Reason:
Sensitivity to cold is more commonly associated with hypothyroidism, where the body’s metabolism slows down. In hyperthyroidism, patients often experience heat intolerance due to an increased metabolic rate.
Choice C Reason:
Weight gain of 4.5 kg (10 lbs) in 3 weeks is also more indicative of hypothyroidism. Hyperthyroidism generally causes weight loss despite an increased appetite because of the accelerated metabolism.
Choice D Reason:
Frequent mood changes are a common symptom of hyperthyroidism. The excess thyroid hormones can affect the nervous system, leading to symptoms such as anxiety, irritability, and mood swings.
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Correct Answer is B
Explanation
Choice A reason: Turn the client every 4 hours:
Regularly turning the client can help prevent pressure ulcers and improve overall circulation, but it is not the most effective measure specifically for preventing ventilator-associated pneumonia (VAP). While repositioning can help with lung expansion and secretion clearance, oral care is more directly related to reducing VAP risk.
Choice B reason: Brush the client’s teeth with a suction toothbrush every 12 hours:
Oral care is crucial in preventing VAP. Bacteria from the mouth can easily travel to the lungs, especially in intubated patients. Using a suction toothbrush helps remove dental plaque and secretions, reducing the bacterial load and the risk of infection. This practice is a key component of VAP prevention bundles.
Choice C reason: Provide humidity by maintaining moisture within the ventilator tubing:
While maintaining humidity is important to prevent drying of the respiratory mucosa and to help with secretion clearance, it does not directly reduce the risk of VAP. Proper humidification is necessary for patient comfort and respiratory function but is not a primary VAP prevention strategy.
Choice D reason: Position the head of the client’s bed in the flat position:
Positioning the head of the bed flat can increase the risk of aspiration, which is a significant risk factor for VAP. The head of the bed should be elevated to 30-45 degrees to reduce the risk of aspiration and promote better lung expansion.
Correct Answer is B
Explanation
Choice A reason:
Intense pruritus: While itching (pruritus) can be a symptom of skin conditions, it is not a definitive sign of malignancy in nevi. Pruritus can be associated with benign conditions such as eczema or allergic reactions. However, if a mole starts to itch, it should be monitored closely, but it is not as strong an indicator of malignancy as irregular borders.
Choice B reason:
Irregular borders: This is a significant sign of potential malignancy in nevi. Melanomas often have uneven, notched, or scalloped borders, unlike benign moles, which typically have smooth, even borders. The irregularity in the border is due to the uncontrolled growth of melanocytes, which can spread unevenly.
Choice C reason:
Uniform pigmentation: Uniform pigmentation is generally a sign of a benign mole. Malignant moles often have multiple colors or an uneven distribution of color, which can include shades of brown, black, red, white, or blue. A mole with uniform color is less likely to be malignant.
Choice D reason:
Purulent drainage: While purulent drainage (pus) indicates an infection, it is not a typical sign of malignancy in nevi. Infections can occur in any skin lesion, but they do not specifically indicate cancer. Malignant moles are more likely to change in size, shape, or color rather than produce pus.