A client with a cold is taking the antitussive benzonatate (Tessalon). Which assessment data indicates to the nurse that the medication is effective?

Correct Answer: B

Rationale: The correct answer is B: Denies having coughing spells. Benzonatate is an antitussive medication that suppresses cough reflex. If the client denies having coughing spells, it indicates that the medication is effectively suppressing the cough. This is the most direct indicator of the medication's effectiveness. A: Reports reduced nasal discharge - This is not directly related to the effectiveness of benzonatate in suppressing cough. C: Able to sleep through the night - While improved sleep may result from reduced coughing, it is not as specific an indicator of antitussive effectiveness as denying coughing spells. D: Expectorating bronchial secretions - This indicates productive coughing, which is not the intended effect of benzonatate.

Correct Answer: D

Rationale: The correct answer is D: Tachycardia, mental status change, and low urine output. In the early stages of shock, the body compensates by increasing heart rate (tachycardia) to maintain perfusion. Mental status change can indicate decreased cerebral perfusion. Low urine output is a sign of decreased renal perfusion. A: Warm skin, hypertension, and constricted pupils are not indicative of shock. In shock, skin becomes cool and clammy, blood pressure drops, and pupils dilate. B: Bradycardia, hypotension, and respiratory acidosis are not early signs of shock. Bradycardia and hypotension occur in the late stages of shock. Respiratory acidosis is a complication of shock, not an early symptom. C: Mottled skin, tachypnea, and hyperactive bowel sounds are signs of shock but not early indicators. Mottled skin appears in the late stages of shock, tach

Correct Answer: A

Rationale: The most likely diagnosis is A: Hypothyroidism. High TSH and low free T4 levels indicate primary hypothyroidism. Elevated TSH is a compensatory response by the pituitary gland to stimulate the thyroid to produce more thyroid hormones, but the thyroid gland is unable to do so effectively, resulting in low free T4 levels. Fatigue, weight gain, and constipation are classic symptoms of hypothyroidism. - B: Hyperthyroidism is characterized by low TSH and high free T4 levels, opposite of the lab results presented. - C: Thyroiditis may initially present with high or low thyroid hormone levels, but the combination of high TSH and low free T4 levels is more indicative of hypothyroidism. - D: Thyroid cancer typically does not cause abnormal thyroid hormone levels; it is more commonly associated with thyroid nodules or masses.

Correct Answer: C

Rationale: The most likely diagnosis in this case is pancreatic cancer (Choice C) based on the constellation of symptoms including weight loss, jaundice, palpable mass in the right upper quadrant, and elevated bilirubin and alkaline phosphatase levels. These findings are indicative of a pancreatic head mass causing obstruction of the common bile duct, leading to jaundice and elevated liver enzymes. Gallstones (Choice A) typically present with colicky pain, not a palpable mass. Hepatitis (Choice B) would present with different liver enzyme patterns and usually lacks a palpable mass. Primary biliary cirrhosis (Choice D) typically presents with pruritus and fatigue, not a palpable mass and jaundice.

Correct Answer: A

Rationale: The correct answer is A: Hypothyroidism. The patient's symptoms of fatigue, weight gain, and cold intolerance are classic signs of hypothyroidism. Elevated TSH and low free T4 levels indicate primary hypothyroidism. TSH is high due to the pituitary gland trying to stimulate the thyroid gland to produce more thyroid hormones, but the thyroid gland is unable to do so. Hyperthyroidism (choice B) would present with opposite symptoms and lab values. Thyroiditis (choice C) typically presents with transient hyperthyroidism followed by hypothyroidism. Thyroid cancer (choice D) is less common and typically does not present with these typical hypothyroid symptoms and lab findings.