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Transcript of Evolve Endocrine NCLEX-PN 2 - flashcardbook.com · preparing a teaching plan for the client with...
Evolve Endocrine NCLEX-PN 2The nurse caring for a
client scheduled for a
transsphenoidal
hypophysectomy to
remove a tumor in the
pituitary gland assists in
developing a plan of care
for the client. The nurse
suggests including which
specific information in the
preoperative teaching
plan?
Toothbrushing will not be permitted for at least 2 weeks following
surgery.
The nurse has provided
diabetic teaching with the
family of a client newly
diagnosed with diabetes.
The nurse determines that
the family understands the
reason for having
glucagon on hand for
emergency home use if
the family indicates that
the purpose of the
medication is to treat
which condition?
Hypoglycemia frominsulin overdose
A comatose client with an
admitting diagnosis of
diabetic ketoacidosis
(DKA) has a blood glucose
value of 368 mg/dL,
arterial pH of 7.2, arterial
Fruity breath order
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bicarbonate of 14 mEq/L,
and is positive for serum
ketones. The diagnosis is
supported by which noted
data?
After receiving furosemide
(Lasix) 40 mg slow
intravenous push for chest
pain related to shortness
of breath and generalized
edema, the client responds
poorly. The client has no
relief of the chest pain,
shortness of breath, or
edema and only minimal
urine output (less than 40
mL of urine). The health
care provider is notified,
and after reviewing the
chart, suspects the client
has syndrome of
inappropriate antidiuretic
hormone (SIADH). Which
findings would lead to this
specific diagnosis? Refer
to chart.
Minimal responsiveness to furosemide (Lasix) and small cell lung
cancer
The nurse is discussing
foot care with a diabetic
client and the spouse. The
nurse includes which
instruction during this
informational session?
The toenails should be cut straight across
The nurse has collected Temperature
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data on a client with
diabetes mellitus. Findings
include a fasting blood
glucose of 130 mg/dL,
temperature 101° F, pulse
of 88 beats per minute,
respirations of 22 breaths
per minute, and a blood
pressure of 118/78 mm
Hg. Which finding would
be of concern to the
nurse?
The nurse is collecting
data on a client with
hyperparathyroidism.
Which question would elicit
accurate information about
this condition from the
client?
"Are you experiencing pain in your joints?"
The nurse is collecting
data from a client who is
being admitted to the
hospital for a diagnostic
workup for primary
hyperparathyroidism. The
nurse understands that
which client complaint
would be characteristic of
this disorder?
Polyuria
When the nurse is
reinforcing instructions to a
client who has been newly
diagnosed with type 1
"I will notify my health care provider if my blood glucose level is
consistently greater than 250 mg/dL
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diabetes mellitus, which
statement by the client
would indicate that
teaching has been
effective?
The nurse is assisting with
preparing a teaching plan
for the client with diabetes
mellitus regarding proper
foot care. Which
instruction should be
included in the plan of
care?
Apply a moisturizing lotion to dry feet, but n to between the toes.
The nurse is caring for a
client with type 1 diabetes
mellitus who is
hyperglycemic. Which
problem should the nurse
consider first, when
planning care for this
client?
Signs of dehydration
The nurse reinforces
teaching with a client with
diabetes mellitus regarding
differentiating between
hypoglycemia and
ketoacidosis. The client
demonstrates an
understanding of the
teaching by stating that
glucose will be taken if
which symptom develops?
Shakiness
A client with diabetes "Are you rotating the injection site?"
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mellitus who takes insulin
is seen in the health care
clinic. The client tells the
nurse that after giving the
injection, the insulin seems
to leak through the skin.
The nurse can
appropriately determine
the problem by asking the
client which?
The nurse is monitoring a
client with Graves' disease
for signs of thyrotoxic crisis
(thyroid storm). Which
signs and symptoms noted
in the client should alert
the nurse to the presence
of this crisis? Select all
that apply.
Fever, Sweating, Agitation
A hospitalized client is
newly diagnosed with
diabetes mellitus. The
client must take both NPH
and Regular insulin for
glucose control. The nurse
develops a teaching plan
to help the client meet
which outcome as a first
step in managing the
disease?
Adjust insulin according to capillary blood glucose levels.
Which client is at risk for
developing thyrotoxicosis?
A client with Graves' disease who is having surgery
The wife of a client with Check his blood glucose level.
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diabetes mellitus who
takes insulin calls the
nurse in a health care
provider's office about her
husband. She states that
her husband is sleepy and
that his skin is warm and
flushed. She adds that his
breathing is faster than
normal and his pulse rate
seems fast. Which action
should the nurse tell the
wife to do first
A client with type 2
diabetes mellitus has a
blood glucose of more
than 600 mg/dL and is
complaining of polydipsia,
polyuria, weight loss, and
weakness. The nurse
reviews the health care
provider's documentation
and would expect to note
which diagnosis?
Hyperglycemic hyperosmolar state (HHS)
Which signs/symptoms
should the nurse expect to
note when collecting data
on a client with Addison's
disease?
Hypotension and vomiting
The nurse participating in
a free health screening at
the local mall obtains a
random blood glucose
Call the health care provider to have the value rechecked as soon as
possible.
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level of 200 mg/dL on an
otherwise healthy client.
The nurse tells the client to
do which as a next step?
The nurse notes that a
client with type 1 diabetes
mellitus has lipodystrophy
on both upper thighs.
Which further information
should the nurse obtain
from the client during data
collection?
Plan for injection rotation
Which measure should the
nurse anticipate being
included in the plan of care
for a client who has been
diagnosed with Graves'
disease?
A restful environment
The nurse is collecting
data on a client admitted to
the hospital with a
diagnosis of myxedema.
Which data collection
technique would provide
data necessary to support
the admitting diagnosis?
Inspection of facial features
A client recently diagnosed
with diabetes mellitus
requiring insulin tells the
clinic nurse that he is
traveling by air throughout
the next week. The client
asks the nurse for any
Keep snacks in carry-on luggage to prevent hypoglycemia during the
flight.
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suggestions about
managing the disorder
while traveling. Which
action should the nurse tell
the client to do?
A client who is managing
diabetes mellitus with
insulin injections asks the
nurse for information about
any necessary changes in
her diet to avoid
hyperinsulinism. Which
diet would be appropriate
for the client?
Small frequent meals with protein, fat, and carbohydrates at each
meal
The nurse is caring for a
postoperative
parathyroidectomy client.
Which would require the
nurse's immediate
attention?
Laryngeal stridor
A client with myxedema
has changes in intellectual
function such as impaired
memory, decreased
attention span, and
lethargy. The client's
husband is upset and
shares his concerns with
the nurse. Which
statement by the nurse is
helpful to the client's
husband?
"It's seems that you are concerned about your wife's conditions, but
the symptoms may improve with continued therapy."
A client scheduled for a Fear about impending surgery
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thyroidectomy says to the
nurse, "I am so scared to
get cut in my neck." Based
on the client's statement,
the nurse determines that
the client is experiencing
which problem?
The nurse is collecting
data regarding a client
after a thyroidectomy and
notes that the client has
developed hoarseness and
a weak voice. Which
nursing action is
appropriate?
Reassure the client that this is usually a temporary condition.
The nurse is caring for a
client with a diagnosis of
hypoparathyroidism. The
nurse reviews the client's
laboratory results and
notes that the calcium
level is extremely low. The
nurse should expect to
note which sign/symptom
on data collection?
Positive Trousseau's sign
A client is admitted with a
diagnosis of
pheochromocytoma. The
nurse should monitor
which parameter to detect
the most common sign of
pheochromocytoma?
Blood pressure elevation
Following Check the urine specific gravity
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hypophysectomy, a client
complains of being very
thirsty and having to
urinate frequently. Which
is the initial nursing action?
The nurse provides dietary
instructions to a client with
diabetes mellitus regarding
the prescribed diabetic
diet. Which statement
made by the client
indicates the need for
further teaching
" I need to buy special dietetic foods."
During data collection on a
postoperative client who
has undergone
hypophysectomy, the
client complains of thirst
and frequent urination.
Knowing the expected
complication of this
surgery, the nurse should
check which parameter
next
Urine specific gravity
The nurse is caring for a
client with Addison's
disease. The nurse checks
the client's vital signs and
determines that the client
has orthostatic
hypotension. The nurse
determines that this finding
relates to which factor?
A decreased secretion of aldosterone
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A client newly diagnosed
with diabetes mellitus is
having difficulty learning
the technique of blood
glucose measurement.
The nurse should teach
the client to do which
action to perform the
procedure properly?
Let the arm hang dependently and milk the digit
The nurse is preparing to
reinforce instructions to a
client with Addison's
disease regarding diet
therapy. The nurse
understands that which
diet should be prescribed
for this client?
High-sodium, high-carbohydrate diet
The nurse has just
supervised a newly
diagnosed diabetes
mellitus client self-inject
NPH insulin at 7:30 .
The nurse reviews the time
frames for peak insulin
action with the client,
telling the client to be
especially watchful for a
hypoglycemic reaction
between which time
frame?
1:30pm and 7:30pm
The nurse educator is
asking the nursing student
to recall the
Dry skin, constipation, cold intolerance
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signs/symptoms of
hypothyroidism. The nurse
educator determines that
the student understands
this disorder if which are
included in the student's
response? Select all that
apply.
The nurse is caring for a
child with a diagnosis of
diabetes insipidus. The
nurse anticipates that the
health care provider will
prescribe which
medications?
Desmopressin Acetate (DDAVP)
A client with type 1
diabetes mellitus takes
NPH insulin every morning
and checks the blood
glucose level four times
per day. The client tells the
nurse that yesterday the
late afternoon blood
glucose was 60 mg/dL and
that she "felt funny." Which
statement by the client
indicates an understanding
of this occurrence?
"I forgot to take my usual mid afternoon snack yesterday."
The nurse is reinforcing
discharge teaching with a
client who has Cushing's
syndrome. Which
statement by the client
"I can eat foods that contain potassium"
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indicates that the
instructions related to
dietary management were
understood?
A health care provider has
prescribed propylthiouracil
(PTU) for a client with
hyperthyroidism, and the
nurse assists in developing
a plan of care for the
client. Which nursing
measure would be
included in the plan
regarding this medication?
Signs and symptoms of hypothroidism
The nurse is caring for a
client experiencing thyroid
storm. Which should be a
priority concern for this
client?
Potential for cardiac disturbances
The nurse is reinforcing
discharge instructions to a
client who had a unilateral
adrenalectomy. Which
information should be a
component of the
instructions?
Instructions about early signs of a wound infection
The nurse is collecting
data from a client newly
diagnosed with diabetes
mellitus regarding the
client's learning readiness.
Which client behavior
indicates to the nurse that
The client complains of fatigue whenever the nurse plans a teaching
session.
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the client is not ready to
learn?
The nurse in an outpatient
diabetes clinic is assisting
in caring for a client on
insulin pump therapy.
Which statement by the
client indicates that a need
for teaching regarding
insulin pump therapy?
"Now that I have this pump, I don't have to worry about insulin
reactions or ketoacidosis occurring again."
A client is brought to the
emergency department in
an unresponsive state, and
a diagnosis of
hyperglycemic
hyperosmolar state (HHS)
is made. The nurse who is
assisting with care for the
client obtains which item in
preparation for the
treatment of this
syndrome?
Intravenous (IV) infusion of normal saline
The nurse is instructing a
client with Addison's
disease about a newly
prescribed medication,
fludrocortisone acetate
(Florinef). Which statement
by the client indicates a
need for further teaching?
"I will be glad to gain weight."
An older client with a
history of
hyperparathyroidism and
The possibility of injury
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severe osteoporosis is
hospitalized. The nurse
caring for the client plans
to address which problem
first
The nurse has reinforced
instructions about
measuring blood glucose
levels to a client newly
diagnosed with diabetes
mellitus. The nurse
determines that the client
understands the procedure
when making which most
accurate statement?
"I should check my blood glucose level before eating each meal,
regardless of how much I eat."
The nurse is reviewing a
health care provider's
prescriptions for a client
with newly diagnosed,
untreated hypothyroidism.
Which medication
prescribed for the client
should the nurse question
and verify?
Morphine sulfate
A client is admitted to the
hospital with a diagnosis of
diabetic ketoacidosis
(DKA). The initial serum
glucose level was 950
mg/dL. Intravenous (IV)
insulin was started along
with rehydration with IV
normal saline. The serum
IV infusion containing 5% dextrose
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glucose level is now 240
mg/dL. The nurse who is
assisting in caring for the
client obtains which item,
anticipating a health care
provider's prescription?
The nurse is caring for a
client with
pheochromocytoma. The
client is scheduled for an
adrenalectomy. During the
preoperative period, the
priority nursing action
should be to monitor which
criterion?
Vital signs
The nurse has reinforced
instructions to the client
with hyperparathyroidism
regarding home care
measures related to
exercise. Which statement
by the client indicates a
need for further teaching?
Select all that apply.
" I need to limit playing football to only the weekends."
"I should exercise in the evening to encourage a good sleep pattern."
The nurse is collecting
data on a client with a
diagnosis of
hypothyroidism. Which of
these behaviors, if present
in the client's history,
should the nurse
determine as being likely
related to the symptoms of
Depression
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this disorder?
The nurse is caring for a
client diagnosed with
hyperparathyroidism who
is prescribed furosemide
(Lasix). The nurse
reinforces dietary
instructions to the client.
Which is an appropriate
instruction?
Drink at least 2 to 3 L of fluid daily.
Glucagon hydrochloride
injection would most likely
be prescribed for which
disorder?
Type 1 diabetes mellitus
A client with diabetes
mellitus is scheduled to
have a fasting blood
glucose level determined
in the morning. The nurse
tells the client not to eat or
drink after midnight. When
the client asks for further
information, the nurse
clarifies by stating that
which should be
acceptable to take before
the test?
Water
The nurse is reviewing the
postoperative prescriptions
for a client who had a
transsphenoidal
hypophysectomy. Which
health care provider's
Apply a loose dressing if any clear drainage is noted
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prescription noted on the
record indicates the need
for clarification?
The nurse caring for a
client who has had a
subtotal thyroidectomy
reviews the plan of care
and determines which
problem is the priority for
this client in the immediate
postoperative period?
Bleeding
The nurse is caring for a
client newly diagnosed
with diabetes mellitus. The
client asks the nurse
whether eating at a
restaurant will affect the
diabetic control and
whether this is allowed.
Which nursing response is
appropriate?
"You should order a half-portion meal and have fresh fruit for
dessert."
(AKA stop being a fat a** and put the pie down)
The nurse enters the room
of a client with type 1
diabetes mellitus and finds
the client difficult to
arouse. The client's skin is
warm and flushed, and the
pulse and respiratory rate
are elevated from the
client's baseline. Which
action should the nurse
implement?
Check the client's capillary blood glucose
A client with type 1 "I should not exercise in the later afternoon."
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diabetes mellitus calls the
nurse to report recurrent
episodes of hypoglycemia.
Which statement by the
client indicates a correct
understanding of Humulin
N insulin and exercise?
The nurse is assigned to
assist in caring for a client
admitted to the emergency
department with diabetic
ketoacidosis (DKA). Which
is the priority nursing
action for this client who is
in the acute phase?
Administer IV regular insulin
When caring for a client
diagnosed with
pheochromocytoma, which
information should the
nurse know when assisting
with planning care?
Excessive catecholamines are released.
A client with type 1
diabetes mellitus is to
begin an exercise
program, and the nurse is
reinforcing instructions to
the client regarding the
program. Which should the
nurse include in the
instructions?
Take a blood glucose test before exercising.
The nurse working on an
endocrine nursing unit
understands that which
Clients who have hyperparathyroidism should be protected against
falls.
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correct concept is used in
planning care?
The nurse is planning to
instruct a client with
diabetes mellitus who has
hypertension about "sick
day management." Which
beverage does the nurse
avoid putting on a list of
easily consumed
carbohydrate-containing
beverages for use when
the client cannot tolerate
food orally?
Mineral water
A client with a pituitary
tumor will undergo
transsphenoidal
hypophysectomy. The
nurse reinforces which
information in the
preoperative teaching plan
for the client?
Blowing the nose following surgery is prohibited.
The nurse is caring for a
client with
pheochromocytoma.
Which data are indicative
of a potential complication
associated with this
disorder?
Congestion heard on auscultation of the lungs
The nurse should expect
to note which interventions
in the plan of care for a
client with hypothyroidism?
Instruct the client about thyroid replacement therapy.
Encourage the client to consume fluids and high-fiber foods in the
diet
Instruct the client to contact the health care provider if episodes of
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Select all that apply. chest pain occur.
The nurse is preparing to
discharge a client who has
had a parathyroidectomy.
When reinforcing
instructions to the client
about the prescribed oral
calcium supplement, which
information should the
nurse include?
Take the calcium 30 to 60 minutes following a meal
The nurse is caring for a
postoperative
adrenalectomy client.
Which finding does the
nurse specifically monitor
for in this client?
Signs and symptoms of hypovolemia
A client with diabetes
mellitus is being
discharged following
treatment for
hyperglycemic
hyperosmolar state (HHS)
precipitated by acute
illness. The client states to
the nurse, "I will call the
doctor next time I can't eat
for more than a day or so."
The nurse plans care,
understanding that which
statement accurately
reflects this client's level of
knowledge?
The client needs immediate education before discharge
The nurse is caring for a Graham crackers and warm milk
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client with
pheochromocytoma. The
client asks for a snack and
something warm to drink.
Which is the appropriate
choice for this client to
meet nutritional needs?
A client has just been
admitted with a diagnosis
of myxedema coma. If all
of the following
interventions were
prescribed, the nurse
should place highest
priority on completing
which action first?
Administering oxygen
The nursing instructor asks
a student to describe the
pathophysiology that
occurs in Cushing's
disease. Which statement
by the student indicates an
accurate understanding of
this disorder?
"Cushing's disease is characterized by an over secretion of
glucocorticoid hormones."
The nurse has reinforced
dietary instructions to a
client with a diagnosis of
hypoparathyroidism. The
nurse instructs the client to
include which item in the
diet?
Vegetables
A client with diabetes
mellitus visits the health
Prednisone
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care clinic. The client
previously had been well
controlled with glyburide
(DiaBeta), but recently, the
fasting blood glucose has
been running 180 to 200
mg/dL. Which medication,
if added to the client's
regimen, may be
contributing to the
hyperglycemia?
Which nursing action
would be appropriate to
implement when a client
has a diagnosis of
pheochromocytoma?
Monitor the client's blood pressure
The nurse has reinforced
home care measures to a
client diagnosed with
diabetes mellitus regarding
exercise and insulin
administration. Which
statement by the client
indicates a need for further
teaching?"
"I should perform my exercise at peak insulin time."
A client with a diagnosis of
diabetic ketoacidosis
(DKA) is being treated in
the emergency
department. Which finding
should the nurse expect to
note as confirming this
diagnosis?
Elevated blood glucose and low plasma bicarbonate
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A client has an endocrine
system dysfunction of the
pancreas. The nurse
anticipates that the client
will exhibit impaired
secretion of which
substance?
Insulin
While collecting data on a
client being prepared for
an adrenalectomy, the
nurse obtains a
temperature reading of
100.8° F. The nurse
analyzes this temperature
reading as which?
A finding that meeds to be reported immediately
The nurse is caring for a
client with hypothyroidism
who is overweight. Which
food items should the
nurse suggest to include in
the plan?
Skim milk, apples, whole-grain bread, and cereal
The nurse is assigned to
care for a client at home
who has a diagnosis of
type 1 diabetes mellitus.
When the nurse arrives to
care for the client, the
client tells the nurse that
she has been vomiting and
has diarrhea. Which
additional statement by the
client indicates a need for
further teaching?
"I need to stop my insulin."
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Which nursing measure
would be effective in
preventing complications
in a client with Addison's
disease?
Monitoring the blood glucose
The anticipated intended
effect of fludrocortisone
acetate (Florinef) for the
treatment of Addison's
disease is which?
Promote electrolyte balance
A client has a blood
glucose level drawn for
suspected hyperglycemia.
After interviewing the
client, the nurse
determines that the client
ate lunch approximately 2
hours before the blood
specimen was drawn. The
laboratory reports the
blood glucose to be 180
mg/dL, and the nurse
analyzes this result as
indicative of which
interpretation?
Elevated from the normal value
In planning nutrition for the
client with
hypoparathyroidism, which
diet would be appropriate?
High in calcium and low phosphorous
The nurse is assisting in
preparing a care plan for a
client with diabetes
mellitus who has
Dehydration
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hyperglycemia. The nurse
should focus on which
potential problem for this
client?
A client with Graves'
disease has exophthalmos
and is experiencing
photophobia. Which
intervention would best
assist the client with this
problem?
Obtaining dark glasses for the client
The nurse is providing
instructions to a client
newly diagnosed with
diabetes mellitus. The
nurse gives the client a list
of the signs of
hyperglycemia. Which
specific signs of this
complication should be
included on the list?
Increased thirst
Which client complaint
should alert the nurse to a
possible hypoglycemic
reaction?
Tremors and double vision
A preoperative client is
scheduled for
adrenalectomy to remove
a pheochromocytoma. The
nurse should most closely
monitor which assessment
in the preoperative period?
Vital signs
A client who has been Rotate the insulin injections sites systematically.
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newly diagnosed with
diabetes mellitus has been
stabilized with daily insulin
injections. Which teaching
information should the
nurse reinforce upon
discharge?
A client who returned to
the nursing unit 8 hours
ago after hypophysectomy
has clear drainage
saturating the nasal
dressing. The nurse
should take which action?
Test the drainage for glucose
A client is brought to the
emergency department
with suspected diabetic
ketoacidosis (DKA). Which
finding should the nurse
note as being consistent
with this diagnosis?
H
High serum glucose level and low serum bicarbonate level.
The nurse is caring for a
client after a thyroidectomy
and monitoring for signs of
thyroid storm. The nurse
determines that which
sign/symptom is indicative
that a thyroid storm may
be occurring?
Blood pressure of 80/60 mmHg
A client who returned to
the nursing unit 8 hours
ago after hypophysectomy
Test the drainage for glucose
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has clear drainage
saturating the nasal
dressing. The nurse
should take which action?
A client is brought to the
emergency department
with suspected diabetic
ketoacidosis (DKA). Which
finding should the nurse
note as being consistent
with this diagnosis?
High serum glucose level and low serum bicarbonate level
The nurse is caring for a
client after a thyroidectomy
and monitoring for signs of
thyroid storm. The nurse
determines that which
sign/symptom is indicative
that a thyroid storm may
be occurring?
Blood pressure of 80/60 mmHg
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