1. The nurse is administering a saturated solution of potassium iodide (SSKI). The
nurse should:
1. Pour the solution over ice chips.
2. Mix the solution with an antacid.
3. Dilute the solution with water, milk, or fruit juice and have the client drink it
with a straw.
4. Disguise the solution in a pureed fruit or vegetable.
- Correct Answer - 3. SSKI should be diluted well in milk, water, juice, or a
carbonated beverage before administration to help disguise the strong, bitter taste.
Also, this drug is irritating to mucosa if taken undiluted. The client should sip the
diluted preparation through a drinking straw to help prevent staining of the teeth.
Pouring the solution over ice chips will not sufficiently dilute the SSKI or cover the
taste. Antacids are not used to dilute or cover the taste of SSKI. Mixing in a puree
would put the SSKI in contact with the teeth.
CN: Pharmacological and parenteral therapies; CL: Apply
2. Following a subtotal thyroidectomy, the nurse asks the client to speak
immediately upon regaining consciousness. The nurse does this to monitor for signs
of which of the following?
1. Internal hemorrhage.
,2. Decreasing level of consciousness.
3. Laryngeal nerve damage.
4. Upper airway obstruction.
- Correct Answer - 3. Laryngeal nerve damage is a potential complication of thyroid
surgery because of the proximity of the thyroid gland to the recurrent laryngeal
nerve. Asking the client to speak helps assess for signs of laryngeal nerve damage.
Persistent or worsening hoarseness and weak voice are signs of laryngeal nerve
damage and should be reported to the physician immediately. Internal hemorrhage is
detected by changes in vital signs. The client's level of consciousness can be
partially assessed by asking her to speak, but that is not the primary reason for doing
so in this situation. Upper airway obstruction is detected by color and respiratory rate
and pattern.
CN: Reduction of risk potential; CL: Analyze
3. A client who has undergone a subtotal thyroidectomy is subject to
complications in the first 48 hours after surgery. The nurse should obtain and keep at
the bedside equipment to:
1. Begin total parenteral nutrition.
2. Start a cutdown infusion.
3. Administer tube feedings.
4. Perform a tracheotomy. - Correct Answer - 4. Equipment for an emergency
tracheotomy should be kept in the room, in case
tracheal edema and airway occlusion occur. Laryngeal nerve damage can result in
vocal cord spasm and respiratory obstruction. A tracheostomy set, oxygen and
suction equipment, and a suture removal set (for respiratory distress from
hemorrhage) make up the emergency equipment that should be readily available.
Total parenteral nutrition is not anticipated for the client undergoing thyroidectomy.
Intravenous infusion via a cutdown is not an expected possible treatment after
thyroidectomy. Tube feedings are not anticipated emergency care.
,CN: Reduction of risk potential; CL: Synthesize
4. One day following a subtotal thyroidectomy, a client begins to have tingling in
the fingers and toes. The nurse should first:
1. Encourage the client to flex and extend the fingers and toes.
2. Notify the physician.
3. Assess the client for thrombophlebitis.
4. Ask the client to speak. - Correct Answer - 2. Tetany may occur after
thyroidectomy if the parathyroid glands are
accidentally injured or removed during surgery. This would cause a disturbance
inserum calcium levels. An early sign of tetany is numbness and tingling of the
fingers or toes and in the circumoral region. Tetany may occur from 1 to 7 days
postoperatively.
Late signs and symptoms of tetany include seizures, contraction of the glottis, and
respiratory obstruction. The nurse should notify the physician. Exercising the joints in
the fingers and toes will not relieve the tetany. The client is not exhibiting signs of
thrombophlebitis. There is no indication of nerve damage that would cause the client
not to be able to speak.
CN: Physiological adaptation; CL: Synthesize
5. Which of the following medications should be available to provide emergency
treatment if a client develops tetany after a subtotal thyroidectomy?
1. Sodium phosphate.
2. Calcium gluconate.
3. Echothiophate iodide.
, 4. Sodium bicarbonate. - Correct Answer - 2. The client with tetany is suffering from
hypocalcemia, which is treated by administering an IV preparation of calcium, such
as calcium gluconate or calcium chloride. Oral calcium is then necessary until normal
parathyroid function returns. Sodium phosphate is a laxative. Echothiophate iodide is
an eye preparation used as a miotic for an antiglaucoma effect. Sodium bicarbonate
is a potent systemic antacid.
CN: Pharmacological and parenteral therapies; CL: Apply
6. A 60-year-old female is diagnosed with hypothyroidism. The nurse should
assess the client for which of the following?
1. Tachycardia.
2. Weight gain.
3. Diarrhea.
4. Nausea. - Correct Answer - 2. Typical signs and symptoms of hypothyroidism
include weight gain, fatigue, decreased energy, apathy, brittle nails, dry skin, cold
intolerance, hair loss, constipation, and numbness and tingling in the fingers.
Tachycardia is a sign of hyperthyroidism, not hypothyroidism. Diarrhea and nausea
are not symptoms of hypothyroidism.
CN: Physiological adaptation; CL: Analyze
7. The nurse should assess a client with hypothyroidism for which of the
following?
1. Corneal abrasion due to inability to close the eyelids.
2. Weight loss due to hypermetabolism.
3. Fluid loss due to diarrhea.
4. Decreased activity due to fatigue. - Correct Answer - 4. A major problem for the
person with hypothyroidism is fatigue. Other signs and symptoms include lethargy,
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