Page 2608 - Saunders Comprehensive Review For NCLEX-RN

919. Answer: 4

Rationale: Laboratory determinations of the serum thyroid-stimulating hormone
(TSH) level are an important means of evaluation. Successful therapy causes
elevated TSH levels to decline. These levels begin their decline within hours of the
onset of therapy and continue to decrease as plasma levels of thyroid hormone build
up. If an adequate dosage is administered, TSH levels remain suppressed for the
duration of therapy. Although energy levels may increase and the client’s mood may
improve following effective treatment, these are not noted until normal thyroid
hormone levels are achieved with medication therapy. An increase in the blood
glucose level is not associated with this condition.
Test-Taking Strategy: Focus on the subject, therapeutic effects of this medication.
Note the words expected outcome. Relate the diagnosis of hypothyroidism with
thyroid hormone levels in the correct option.
Level of Cognitive Ability: Evaluation
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Evaluation
Content Area: Pharmacology: Endocrine Medications: Thyroid hormones
Health Problem: Adult Health: Endocrine: Thyroid disorders
Priority Concepts: Cellular Regulation; Evidence
Reference: Lewis et al. (2017), pp. 1168-1169.

920. Answer: 2, 4, 5, 6

Rationale: Risk factors for breast cancer include nulliparity or first child born after
age 30 years; early menarche; late menopause; family history of breast cancer; high-
dose radiation exposure to the chest; and previous cancer of the breast, uterus, or
ovaries. In addition, specific inherited mutations in BReast CAncer (BRCA)1 and
BRCA2 increase the risk of female breast cancer; these mutations are also associated
with an increased risk for ovarian cancer.
Test-Taking Strategy: Focus on the subject, the risk factors associated with breast
cancer. Thinking about the physiology associated with the reproductive system and
the most common causes of cancer will assist in answering the question.
Level of Cognitive Ability: Analyzing
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Oncology
Health Problem: Adult Health: Cancer: Breast
Priority Concepts: Cellular Regulation; Client Education
Reference: Ignatavicius, Workman, Rebar (2018), p. 1442.

921. Answer: 1

Rationale: An inflammatory reaction such as acute pancreatitis can cause paralytic
ileus, the most common form of nonmechanical obstruction. Inability to pass flatus is
a clinical manifestation of paralytic ileus. Loss of sphincter control is not a sign of
paralytic ileus. Pain is associated with paralytic ileus, but the pain usually manifests

2608