A 43-year-old female client who has had a thyroidectomy due to Grave's disease is prescribed a thyroid replacement hormone. Which signs and symptoms are associated with thyroid hormone toxicity and should be reported promptly to the health care provider?

Correct Answer: B

Rationale: The signs and symptoms of thyroid hormone toxicity, especially when the dosage is excessive, include tachycardia (rapid heart rate) and chest pain. These symptoms are indicative of hyperthyroidism, where the body receives an excessive amount of thyroid hormone. It is crucial to report these symptoms promptly to the healthcare provider to adjust the medication dosage and prevent potential complications.

Correct Answer: B

Rationale: In this scenario, option B is the correct answer. The practical nurse (PN) should review with the client that their sexual partner(s) should also be treated when diagnosed with vaginal trichomoniasis and prescribed oral metronidazole. This is crucial to prevent re-infection and ensure the complete eradication of the parasite from both individuals. Option A is incorrect because while it is important to advise clients on potential side effects of medications, avoiding direct sunlight exposure and using sunscreen with SPF100 is not specifically relevant to the treatment of vaginal trichomoniasis with metronidazole. Option C is incorrect as advising against the use of vinegar or commercial product douches is a general guideline for vaginal health but not directly related to the treatment of trichomoniasis with metronidazole. Option D is incorrect as there is no need to eliminate dairy products from the diet during the treatment of vaginal trichomoniasis with metronidazole. In an educational context, it is important for practical nurses to understand the comprehensive care required for clients diagnosed with sexually transmitted infections like trichomoniasis. Educating clients on treatment protocols, including partner notification and treatment, is essential in preventing the spread of infection and promoting overall health and well-being.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B: 3:30 to 7:30 PM. NPH insulin is an intermediate-acting insulin that typically peaks around 4-12 hours after administration. Administering NPH insulin before breakfast means that its peak effect would coincide with the afternoon and early evening hours, putting the client at an increased risk for a hypoglycemic reaction during that time frame. Option A (8:30 to 11:30 AM) is incorrect because this timeframe falls shortly after the client's breakfast when the insulin's effect would not yet peak. Option C (9:30 PM to midnight) is incorrect as this timeframe is much later than when the NPH insulin would typically peak. Option D (1:00 to 5:00 AM) is also incorrect as it is too early for the peak action of NPH insulin. Educationally, this question highlights the importance of understanding the onset and peak times of different types of insulin to prevent hypoglycemic episodes in patients. Nurses should be aware of the timing of insulin administration in relation to meals to ensure optimal blood glucose control and to prevent complications such as hypoglycemia. It underscores the need for precise timing and monitoring of insulin therapy to ensure patient safety and well-being.

Correct Answer: C

Rationale: The correct insulin type for the nurse to mix into the intravenous fluids is regular insulin. In the scenario of diabetic ketoacidosis (DKA), rapid reduction of blood glucose levels is crucial. Regular insulin has a fast onset of action, making it suitable for intravenous administration to address the high blood sugar levels seen in DKA. Isophane, Glargine, and Detemir are not appropriate choices for intravenous administration in this emergency situation as they are intermediate-acting or long-acting insulins.

Correct Answer: D

Rationale: The correct answer is D. Nitroglycerine sublingual tablets need to be replaced every 3 to 5 months, not every year, making statement A incorrect. While nitroglycerine can cause a headache, it is important to continue taking the prescribed nitroglycerine if the client has angina, making statement B accurate. Nitroglycerine tablets do not cause addiction, so statement C is correct. Dizziness and weakness are associated with the hypotensive effect of nitroglycerine; therefore, if the client feels dizzy when taking them, they should sit down or lie down until they feel better. Taking nitroglycerine tablets before an activity known to cause angina can help prevent angina attacks.