Page 2614 - Saunders Comprehensive Review For NCLEX-RN

the incorrect client statement. Remember that rest is needed for the liver to heal.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Adult Health: Gastrointestinal
Health Problem: Adult Health: Gastrointestinal: GI Accessory organs
Priority Concepts: Client Education; Infection
Reference: Ignatavicius, Workman, Rebar (2018), pp. 1182-1183.

933. Answer: 3, 4, 6

Rationale: The clinical manifestations of hypothyroidism are the result of
decreased metabolism from low levels of thyroid hormone. Interventions are aimed
at replacement of the hormone and providing measures to support the signs and
symptoms related to decreased metabolism. The client often has cold intolerance and
requires a warm environment. The nurse encourages the client to consume a well-
balanced diet that is low in fat for weight reduction and high in fluids and high-fiber
foods to prevent constipation. Iodine preparations may be used to treat
hyperthyroidism. Iodine preparations decrease blood flow through the thyroid
gland and reduce the production and release of thyroid hormone; they are not used
to treat hypothyroidism. The client is instructed to notify the PHCP if chest pain
occurs because it could be an indication of overreplacement of thyroid hormone.
Test-Taking Strategy: Focus on the subject, hypothyroidism. Recalling the
manifestations of this disorder and that in this disorder the client has a decreased
metabolic rate will assist in determining the appropriate interventions.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Adult Health: Endocrine
Health Problem: Adult Health: Endocrine: Thyroid disorders
Priority Concepts: Caregiving; Thermoregulation
Reference: Lewis et al. (2017), pp. 1168-1169.

934. Answer: 1

Rationale: Plugging a tracheostomy tube is usually done by inserting the
tracheostomy plug (decannulation stopper) into the opening of the outer cannula.
This closes off the tracheostomy, and airflow and respiration occur normally through
the nose and mouth. When plugging a cuffed tracheostomy tube, the cuff must be
deflated. If it remains inflated, ventilation cannot occur, and respiratory arrest could
result. A tracheostomy plug could not be placed in a tracheostomy if an inner
cannula was in place. The ability to swallow or speak is unrelated to weaning and
plugging the tube.
Test-Taking Strategy: Focus on the subject, care of the client with a tracheostomy,
and note the word required in the question. Think about the structure and function of
a tracheostomy tube. Recalling that an inflated cuff would cause airway obstruction
will assist in directing you to the option that addresses a priority physiological need.

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