After a thyroidectomy, Mr. M begins to show signs of tetany. The nurse should suspect a deficiency of which of the following?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Parathyroid hormone. After a thyroidectomy, there is a risk of inadvertently damaging or removing the parathyroid glands, which are responsible for regulating calcium levels in the body. Tetany, which is characterized by muscle spasms and twitching due to low calcium levels, is a common sign of hypoparathyroidism following thyroid surgery. Choice A) Insulin is not related to calcium regulation but to glucose metabolism, so it is not the correct answer in this context. Choice C) Thyroid hormone is also not directly involved in calcium regulation but rather in metabolism and growth. Choice D) Corticosteroids are not associated with tetany; they are involved in stress response and immune function. In an educational context, it is crucial for healthcare professionals to understand the interconnectedness of the endocrine system and the potential complications that can arise post-thyroidectomy. Recognizing the signs of hypoparathyroidism, such as tetany, is essential for prompt intervention and preventing further complications related to calcium imbalance. This knowledge can improve patient outcomes and safety in the postoperative period.

Correct Answer: C

Rationale: In the context of a client with diabetes insipidus, the correct advice is to emphasize compliance with drug therapy (Option C). This is because diabetes insipidus is a condition characterized by the inability of the body to properly regulate fluid balance due to insufficient antidiuretic hormone (ADH) production or response. Medications like desmopressin are commonly used to manage this condition by replacing the deficient ADH. Option A, remaining in air-conditioned areas during hot and humid weather, may help reduce fluid loss to some extent by minimizing excessive sweating, but it does not address the underlying cause of the condition or provide a comprehensive solution like drug therapy does. Option B, avoiding any activity, is not a practical or healthy recommendation as physical activity is important for overall health and well-being. Complete avoidance of activity is not necessary for managing diabetes insipidus. Option D, avoiding a high-protein diet, is unrelated to managing fluid loss in diabetes insipidus. Protein intake does not significantly impact fluid balance in the same way that the presence or absence of ADH does. In an educational context, understanding the rationale behind the correct answer helps healthcare providers and patients make informed decisions about managing diabetes insipidus effectively. Emphasizing compliance with drug therapy is crucial in controlling symptoms and improving the client's quality of life by addressing the root cause of the condition. It also highlights the importance of individualized treatment plans and the role of healthcare professionals in guiding patients towards optimal management strategies.

Correct Answer: D

Rationale: In a patient with Cushing's disease, excessive cortisol levels can lead to fluid retention and increased susceptibility to infections. Crackles heard bilaterally in the lower lobes of the lungs suggest the presence of pulmonary edema, a potential complication of Cushing's due to fluid overload, which can progress rapidly to respiratory distress. Therefore, notifying the physician immediately is crucial for timely intervention to prevent respiratory compromise. Option A, purple striae on the abdomen and thighs, is a common physical manifestation of Cushing's disease due to the weakening of the skin's connective tissue, but it does not require immediate physician notification as it is a chronic finding. Option B, a 1-pound weight gain since the previous day, while potentially concerning in the context of fluid retention, is not as urgent as the presence of crackles indicating acute respiratory distress. Option C, the error option, is obviously incorrect. This question provides an opportunity for learners to understand the acute complications of Cushing's disease and the importance of recognizing and responding promptly to signs of respiratory distress in patients with endocrine disorders. It reinforces the concept of prioritizing assessments based on the urgency of the patient's condition, a critical skill in clinical practice.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) The RN encourages the patient to drink orange juice. This response requires immediate intervention because the patient is showing signs of diabetic ketoacidosis (DKA), a serious complication of diabetes. Encouraging the patient to drink orange juice is not appropriate as DKA is characterized by hyperglycemia, dehydration, and metabolic acidosis. Option A is incorrect because checking the patient's fingerstick glucose may be important for monitoring blood sugar levels but is not the most urgent task given the patient's presentation. Option C is also incorrect as checking the patient's order for sliding scale insulin is not the immediate priority in this critical situation. Option D, assessing the patient's vital signs every 15 minutes, is important but does not address the immediate need to correct the patient's metabolic imbalance. From an educational perspective, this question highlights the importance of recognizing and responding to critical situations promptly in patients with diabetes. It emphasizes the significance of understanding the signs and symptoms of DKA and the appropriate interventions required in such cases. Educating healthcare providers on the prioritization of care in emergencies like DKA is crucial for patient safety and optimal outcomes.