Ch. 55 Thyroid and Parathyroid Gland Conditions Flashcards
Which statement made by the client alerts the nurse to the possibility of hypothyroidism?
A. “My grandmother had thyroid problems.”
B. “I seem to feel the heat more than other people.”
C. “Food just doesn’t taste good without a lot of salt.”
D. “I am always tired, even when I get 10 or 12 hours of sleep.”
D. “I am always tired, even when I get 10 or 12 hours of sleep.”
Which changing trends in a client’s serum laboratory values indicates to the nurse that thyroid hormone replacement therapy of hypothyroidism is effective?
A. Rising thyroid hormone (TH) levels; declining thyroid-stimulating hormone (TSH) levels
B. Declining thyroid hormone (TH) levels; rising thyroid-stimulating hormone (TSH) levels
C. Rising thyroglobulin (Tg) levels; declining thyrotropin receptor antibody (TRAb) levels)
D. Declining thyroglobulin (Tg) levels; rising thyrotropin receptor antibody (TRAb) levels
A. Rising thyroid hormone (TH) levels; declining thyroid-stimulating hormone (TSH) levels
The nurse is caring for a client with severe hypothyroidism. When the client is difficult to around and has a heart rate of 48 beats/minute, which action will the nurse take first?
A. Assess blood pressure
B. Apply oxygen by mask
C. Contact the health care provider
D. Activate the Rapid Response Team
B. Apply oxygen by mask
A client with hypothyroidism is prescribed thyroid hormone replacement therapy (HRT). Which precaution will the nurse communicate?
A. “Avoid over-the-counter medications unless prescribed by your provider.”
B. “Increase the amount of fiber in your diet to prevent the side effects of constipation.”
C. “Stop this drug immediately if you discover you are pregnant.”
D. “If you miss a dose, double your next day’s dose.”
A. “Avoid over-the-counter medications unless prescribed by your provider.”
For which new-onset symptom associated with thyroid hormone replacement therapy will the nurse teach a client to report to the primary health care provider?
A. Anorexia
B. Runny nose
C. Hand tremors
D. Calf muscle cramping
C. Hand tremors
A client with Graves disease has a goiter. Which teaching will the nurse provide when the client says, “Why do I have this thing”?
A. The low circulating levels of thyroid hormones stimulate the feedback system and trigger the anterior pituitary gland to secrete more thyroid-stimulating hormone, which increases the numbers and size of glandular cells in the thyroid gland.
B. The autoantibodies stimulate the inflammatory and immune responses to increase the number of white blood cells circulating in the thyroid gland, which increases tissue size without increasing the number of glandular cells.
C. The autoantibodies stimulate blood vessel growth and blood storage within the thyroid gland, increasing its overall size.
D. The excessive autoantibodies bind to the thyroid-stimulating hormone receptor sites, which increases the number and size of glandular cells in the thyroid gland.
D. The excessive autoantibodies bind to the thyroid-stimulating hormone receptor sites, which increases the number and size of glandular cells in the thyroid gland.
Which action does the postanesthesia care unit (PACU) nurse perform when caring for a client who has just arrived after a total thyroidectomy?
A. Assessing the wound dressing for bleeding
B. Administering morphine for pain
C. Monitoring oxygen saturation
D. Maintaining the neck position
C. Monitoring oxygen saturation
The nurse reviews the vital signs for a client diagnosed with Graves disease and notes that the client’s temperature is 99.6 F. After notifying the primary health care provider, what is the nurse’s next action?
A. Administer aspirin
B. Activate the Rapid Response Team
C. Observe for the presence of chills
D. Assess cardiac status
D. Assess cardiac status
Which statement made by a client who is undergoing therapy with radioactive iodine (RAI) for Graves disease indicates a lack of understanding about the disorder and its treatment?
A. “It will be great to lose my ‘bug-eyed’ appearance.”
B. “If this treatment works, maybe I will stop sweating all the time.”
C. “I hope I don’t gain too much weight when my thyroid function is normal.”
D. “Luckily, I have my own bathroom, so I won’t be exposing the rest of my family to radiation.”
A. “It will be great to lose my ‘bug-eyed’ appearance.”
With which client will the nurse be aware of an increased risk for hypoparathyroidism?
A. Client with pregnancy-induced hypertension
B. Client who had radiation therapy for Graves disease
C. Client starting on insulin therapy for type 2 diabetes mellitus
D. Client with heart failure after myocardial infarction
B. Client who had radiation therapy for Graves disease
Which trends in serum electrolyte values will the nurse expect to find in a client who has untreated hypoparathyroidism?
A. Above normal calcium levels; above normal phosphorus levels
B. Above normal calcium levels; below normal phosphorus levels
C. Below normal calcium levels; below normal phosphorus levels
D. Below normal calcium levels; above normal phosphorus levels
D. Below normal calcium levels; above normal phosphorus levels
Which assessment finding in a client who had a parathyroidectomy yesterday indicates to the nurse that immediate action is needed?
A. Apical pulse of 78 beats/min
B. Bilateral leg muscle twitching
C. Hypoactive bowel sounds
D. Dry mouth
B. Bilateral leg muscle twitching
Which assessment findings will the nurse expect to find in a client who has just been diagnosed with hypothyroidism? Select all that apply.
A. Pulse rate below 60 beats/min
B. Agitation and inability to sleep
C. Nonpitting edema of hands and feet
D. Decreased deep tendon reflexes
E. Warm, moist skin
A, C, D
The nurse is planning to teach a community group about hyperthyroidism. Which teaching will the nurse include? Select all that apply.
A. Has a sudden onset of symptoms
B. Most common form is Graves disease
C. Can be diagnosed by the presence of a goiter
D. Produces symptoms of a hypermetabolic state
E. Is much more common among women than among men
B, D, E
Which items are most important for the nurse to ensure are in the room when a client returns from having thyroidectomy? Select all that apply.
A. Calcium gluconate
B. Emergency tracheotomy kit
C. Hypertonic saline
D. Oxygen
E. Suction
A, B, D, E
