ATI RN
ATI Med Surg Woolery Q5 Questions
Question 1 of 5
A nurse is providing dietary teaching for a client who has Graves' disease. Which of the following statements made by the client indicates a need for further teaching by the nurse?
Correct Answer: D
Rationale: Six full meals (
D) is excessive; smaller, frequent, high-calorie meals are better for Graves' disease. Protein and carbohydrates (
A), avoiding caffeine (
B), and high-fiber diet (
C) are appropriate.
Extract:
Nurses Notes
0900:
Client is a 78-year-old female who was brought to the hospital via ambulance. The client's neighbor called 911 after checking on the client and finding the client confused and complaining of weakness. The neighbor states that the client has had "a thyroid problem" for years, and that the client mentioned recently that she hadn't picked up her medications due to an inability afford them. The client is lethargic, oriented to person and year, but uncertain of place and situation. S1 & S2 heard on auscultation of heart. Lungs clear in all lobes. Breathing is slow and shallow. Initial lab results show low Free T4 and elevated TSH. Provider notified, awaiting orders.
Vital Signs
0900:
Temperature: 35.6° C (96.1° F)
Heart rate: 49/min
Respiratory rate: 10/min
Blood pressure: 102/53 mm Hg
Oxygen saturation: 94% on room air
Question 2 of 5
Select the 3 interventions that the nurse should anticipate for this client.
Correct Answer: B,C,G
Rationale: The client's symptoms and lab results (low Free T4, elevated TSH) indicate hypothyroidism. PTU (
A) is for hyperthyroidism, not hypothyroidism. Warm blankets (
B) address hypothermia (35.6°
C). Cardiac monitoring (
C) is needed due to bradycardia (heart rate 49/min). A high-calorie diet (
D) is for hyperthyroidism, not hypothyroidism. Propranolol (E) manages hyperthyroid symptoms like tachycardia, not applicable here. Acetaminophen (F) is for fever, not hypothermia. Levothyroxine (G) treats hypothyroidism by replacing thyroid hormone.
Extract:
Question 3 of 5
A client with a history of hypothyroidism has accidentally been taking double her prescribed dose of levothyroxine. Which assessment findings would the nurse expect due to an excess of this medication?
Correct Answer: B
Rationale: Excess levothyroxine causes hyperthyroid symptoms like nervousness and tachycardia (
B). Weight gain and lethargy (
A) indicate hypothyroidism. Facial puffiness and constipation (
C) are hypothyroid symptoms. Hypotension and cold intolerance (
D) are associated with hypothyroidism, not excess levothyroxine.
Question 4 of 5
A client is experiencing tachycardia and tremors. Lab values show elevated Free T4 and low thyroid stimulating hormone (TSH). Which diagnostic study will help the practitioner differentiate Graves' disease from other forms of hyperthyroidism?
Correct Answer: B
Rationale: RAIU test (
B) differentiates Graves' disease (high uptake) from other hyperthyroidism causes. Levothyroxine test (
A) is irrelevant. ACTH test (
C) assesses adrenal function. Thyroidectomy (
D) is a treatment, not a diagnostic test.
Question 5 of 5
The patient is returning to the unit after undergoing a bilateral adrenalectomy. Which clinical manifestation would indicate that the client is experiencing an Addisonian crisis?
Correct Answer: C
Rationale: Low blood pressure (92/50) (
C) indicates Addisonian crisis due to adrenal insufficiency. Surgical pain (
A) is expected. Hyperglycemia (
B) is unrelated. High sodium (
D) is incorrect; hyponatremia is typical.