A nursing health history of a client suspected of having Cushing syndrome must include assessment of

Correct Answer: C

Rationale: In assessing a client suspected of having Cushing syndrome, it is crucial to include an evaluation of changes in body structure and weight. This is because Cushing syndrome is characterized by the excessive production of cortisol, leading to symptoms such as central obesity, muscle wasting, and thin skin. Changes in body structure and weight are key indicators of the metabolic disturbances associated with Cushing syndrome. Option A, increased pigmentation, is more commonly associated with Addison's disease, where there is an increase in melanocyte-stimulating hormone. Option B, decreased urinary output, is not a typical symptom of Cushing syndrome but may be seen in conditions like kidney failure. Option D, increased thickening and coarsening of skin, is more indicative of conditions like acromegaly, caused by excess growth hormone. Educationally, understanding the specific signs and symptoms of endocrine disorders like Cushing syndrome is essential for nurses to provide comprehensive care. By knowing the distinctive features of each condition, nurses can accurately assess, diagnose, and plan appropriate interventions for their patients. This knowledge enhances patient outcomes and improves the quality of care provided.

Correct Answer: B

Rationale: The correct answer is B) Provide a general explanation to the client. This option is the most appropriate nursing intervention for preparing a client for a CT scan because it involves clear communication with the client, which is essential in ensuring their cooperation and understanding of the procedure. By providing a general explanation, the nurse can alleviate the client's anxiety, inform them about what to expect during the scan, and address any concerns they may have. This helps in promoting a positive patient experience and ensuring the client is well-prepared both mentally and physically for the procedure. Option A) Consult the physician for special preparation is incorrect because while it is important to collaborate with the physician in the care of the client, the nurse is typically responsible for directly preparing the client for the procedure. Option C) Informing the client to temporarily eliminate salt from the diet is incorrect as it is not a standard preparation for a CT scan unless specifically ordered by the physician for a particular medical condition. Option D) Instructing the client to fast is also incorrect as fasting is not typically required for a CT scan unless specified by the healthcare provider for certain types of scans that involve contrast dye. In an educational context, it is crucial for nursing students to understand the significance of effective communication in preparing clients for diagnostic procedures. By providing clear explanations, nurses can build trust with their patients, promote patient education, and ensure optimal outcomes for the client's healthcare journey. This rationale emphasizes the importance of patient-centered care and the role of the nurse in facilitating a positive patient experience through effective communication and education.

Correct Answer: C

Rationale: Rationale: The correct answer is C) Altered level of consciousness. Thyrotoxic crisis, also known as thyroid storm, is a life-threatening condition characterized by severe manifestations of hyperthyroidism. Altered level of consciousness is a hallmark sign of thyrotoxic crisis due to the profound effects of excess thyroid hormones on the central nervous system. Patients may present with agitation, delirium, confusion, or even progress to coma. Option A) Chest pain is not a typical sign of thyrotoxic crisis. While individuals with hyperthyroidism may experience palpitations or tachycardia, chest pain is more commonly associated with cardiac conditions. Option B) Bradycardia is the opposite of what is seen in thyrotoxic crisis, where patients typically exhibit tachycardia and other signs of sympathetic overactivity. Option D) Hypothermia is also not a typical feature of thyrotoxic crisis. Instead, patients with thyrotoxicosis often have heat intolerance and may present with fever or hyperthermia due to increased metabolic activity. Educational Context: Nurses play a crucial role in educating patients about the signs and symptoms of thyroid disorders, including the potentially life-threatening thyrotoxic crisis. Recognizing the early warning signs of thyrotoxic crisis is essential for prompt intervention and preventing complications. By understanding the distinct clinical manifestations of thyrotoxic crisis, nurses can provide competent care and ensure positive patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct task to delegate to the nursing assistant is option D) Remind patient to check glucose level prior to each meal. Delegating this task to the nursing assistant is appropriate as it involves a reminder, which is within the scope of the assistant's role and does not require specialized nursing knowledge or skills. Option A) Arrange consult with the dietitian for the patient involves coordinating with another healthcare professional and requires an understanding of the patient's specific dietary needs, which is beyond the nursing assistant's scope of practice. Option B) Verify patient's insulin injection technique requires specialized knowledge and training to ensure correct administration of medication, making it inappropriate to delegate to a nursing assistant. Option C) Teach patient to use a glucometer for monitoring glucose at home involves patient education and training, which should be done by a registered nurse or diabetes educator who has the expertise to provide comprehensive instruction on using medical devices. Educationally, understanding the scope of practice for different healthcare team members is crucial in providing safe and effective patient care. Delegating tasks appropriately ensures that each team member works within their competency level, leading to better overall patient outcomes. Nurses should be knowledgeable about delegation principles to optimize teamwork and enhance patient care delivery.