Mod 13- Thyroid and Parathyroid Agents

Question 1

The thyroid hormone regulates the rate of _________________, which is the rate at which energy is burned.

Answer 1

metabolism

Question 2

2

Children who do not have a thyroid gland or have a nonfunctioning gland develop ___________

Answer 2

cretinism- a condition characterized by physical deformity and learning disabilities that is caused by congenital thyroid deficiency

Question 3

A lack of sufficient levels of thyroid hormones needed to maintain normal metabolism is defined as __________________.

Answer 3

hypothyroidism

Question 4

T/F: Bisphosphonates are used to treat hypocalcemia by increasing the uptake of calcium from the bone.

Answer 4

FALSE
Bisphosphonates are a group of medicines that slow down or prevent bone loss, strengthening bones. Bisphosphonates inhibit osteoclasts which are responsible for breaking down and reabsorbing minerals such as calcium from bone (the process is known as bone resorption).

Question 5

T/F: The parathyroid glands are four small groups of glandular tissue located on the back of the thyroid gland.

Answer 5

TRUE

Question 6

T/F: Levothyroxine is used as replacement therapy for hypothyroidism.

Answer 6

TRUE

Question 7

T/F: Calcitriol (Rocaltrol) is used in the management of hypercalcemia to help decrease calcium.

Answer 7

FALSE
Calcitriol is a form of vitamin D3. Vitamin D helps your body absorb calcium from the stomach. Calcitriol is used to treat hyperparathyroidism (overactive parathyroid glands) and metabolic bone disease in people who have chronic kidney failure and are not receiving dialysis

Question 8

T/F: Parathyroid hormone (PTH) is the most important regulator of serum calcium levels in the body.

Answer 8

TRUE

Question 9

The thyroid gland needs _________ to produce the thyroid hormones that regulate body metabolism.

Answer 9

iodine

Question 10

The most common cause of hyperthyroidism in adults is ___________ disease.

Answer 10

Graves’

Question 11

In which of the following ways does the thyroid gland use iodin

Answer 11

To produce Thyroid hormones
Correct

The thyroid gland uses iodine to produce the thyroid hormones that regulate body metabolism. Control of the thyroid gland involves an intricate balance among TRH, TSH, and circulating levels of thyroid hormone.

Question 12

The client is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the client to exhibit?

Answer 12

Complaints of extreme fatigue & hair loss
Correct
A decrease in thyroid hormone causes decreased metabolism, which leads to fatigue and hair loss.

Question 13

The client diagnosed with hypothyroidism is prescribed the thyroid hormone levothyroxine. Which assessment data indicate the medication has been effective?

Answer 13

The client’s temp is WNL

Question 14

Which statement made by the client makes the nurse suspect the client is experiencing hyperthyroidism?

Answer 14

All my collars are getting tighter
Correct
The thyroid gland (in the neck) en-larges as a result of the increased need for thyroid hormone production; an enlarged gland is called a goiter.

Question 15

These drugs should have their dosage lowered in patients with moderate renal impairment and should not be given at all in patients with severe renal impairment or renal failure

Answer 15

biphosphonates

Question 16

When may vaccines be contraindicated?

Answer 16

When a pt has received a blood transfusion in the last month
Correct
Vaccines are contraindicated in patients who are receiving immune globulin or who have received blood or blood products within the last 3 months because a serious immune reaction could occur.

Question 17

A client admitted to the hospital with hyperthyroidism treated with propylthiouracil suddenly develops a skin rash. Which action would the nurse implement first?

Answer 17

Notify the primary health care provider.
Explanation:
Whenever a client develops a skin rash after taking propylthiouracil, the nurse must notify the primary health care provider immediately because it may be an adverse reaction.

Question 18

What organ provides the control over the amount of calcium in the blood?

Answer 18

parathyroid glands

Question 19

Which vitamin supplements should the nurse recommend while a postmenopausal client is taking alendronate (Fosamax)?

Answer 19

Vitamin D and calcium
Explanation:
Fosamax is a bisphosphonate medication. An intake of 1500 mg calcium and 400 to 800 units of vitamin D are recommended daily while taking bisphosphonates.

Question 20

The nurse is concerned that a client has taken too much vitamin D. What symptoms will the client exhibit who has vitamin D excess? (Select all that apply.)

Answer 20

Muscle pain
 Polydipsia
 Irritability
  Explanation:
Excess amounts of vitamin D may cause headache, somnolence, weakness, irritability, hypertension, cardiac arrhythmias, kidney stones, polydipsia, polyuria, and bone and muscle pain.

Question 21

A primary health care provider has prescribed levothyroxine to a client with hypothyroidism. Which information would the nurse include in the teaching plan to promote an optimal response to the drug therapy?

Answer 21

Administer the drug early in the morning before breakfast.
Explanation:
The nurse should instruct the client to administer the drug early in the morning before breakfast to promote an optimal response to the drug therapy since an empty stomach increases the absorption of the oral preparation

Question 22

Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to:

Answer 22

stand or sit upright for at least 30 minutes after taking alendronate.
Explanation:
To decrease gastrointestinal distress, the patient should stand or sit upright for at least 30 minutes after taking the drug

Question 23

The community health nurse is preparing to administer a prescribed dose of levothyroxine to a client. What is the nurse’s priority assessment?

Answer 23

heart rate and rhythm
Explanation:
The effects of hypothyroidism and thyroid medications are varied, due to the broad effects of thyroid hormones. However, cardiac function is among the most frequent and serious. For this reason, cardiac assessment is a priority.

Question 24

A female client with a six-month-old infant has been prescribed propylthiouracil (PTU). What is the most important question the nurse should ask this client?

Answer 24

“Are you breastfeeding your child?”
Explanation:
Mothers taking PTU should not breastfeed their children (pregnancy category D). For the safety of the infant, the nurse should ask the client if she’s breastfeeding.

Question 25

While reviewing the medication history of a client receiving alendronate, the nurse notes that the client also takes a multivitamin. Which instruction would be most appropriate?

Answer 25

“Separate taking the two drugs by about a half hour.”
Explanation:
Alendronate can interact with a multivitamin, decreasing the absorption of the bisphosphonate. Therefore, the drugs should be separated by at least a half hour. The multivitamin does not need to be stopped.

Question 26

When describing thyroid function, the nurse would emphasize the need for intake of:

Answer 26

iodine

Question 27

Serum levels of calcium must be maintained in a narrow range within the body. What is the normal range of serum calcium?

Answer 27

9 and 11 mg/dL
Explanation:
Calcium is an electrolyte that is used in many of the body’s metabolic processes. These processes include membrane transport systems, conduction of nerve impulses, muscle contraction, and blood clotting. To achieve all of these effects, serum levels of calcium must be maintained between 9 and 11 mg/dL.

Question 28

A home care nurse is caring for a 70-year-old female client who has been diagnosed with osteoporosis. When developing a plan of care for this client, the nurse should include measures to prevent what complication of the disease?

Answer 28

Bone fracture

Question 29

A nurse is providing education to a client who will soon begin taking levothyroxine for the first time. Which teaching point should the nurse include in this education session?

Answer 29

“You’ll most likely take this drug for the rest of your life.”

Question 30

A client, diagnosed with hypothyroidism, is currently taking an opioid for knee pain. This client is at increased risk for developing which adverse reaction?

Answer 30

Myxedema coma
Explanation:
People with hypothyroidism are especially likely to experience respiratory depression and myxedema coma with opioid analgesics and other sedating drugs. P

Question 31

The nurse is teaching a patient who is prescribed calcitriol about the drug. Which patient statement indicates that the teaching was successful?

Answer 31

“I need to have my calcium levels checked periodically.”

Question 32

A client’s low ionized calcium levels have necessitated an infusion of an IV calcium preparation. During the administration of this medication, the nurse should prioritize what assessment?

Answer 32

Cardiac monitoring
Explanation:
Calcium imbalances can result in alterations in heart rate and rhythm; cardiac monitoring is thus necessary.

Question 33

Which statement reflects the relationship between calcium and phosphate?

Answer 33

When there is an increase in calcium, the phosphate is decreased.

When there is an increase in calcium, the phosphate is decreased.
Explanation:
An inverse relationship exists between calcium and phosphate. When serum calcium levels increase, serum phosphate levels decrease. When the serum calcium level decreases, serum phosphate levels increase. Calcium and phosphorus are learned together as they are closely related. These mineral nutrients occur in the same food, and absorbed together.

Question 34

The nurse elicits a positive Chvostek sign when tapping on the facial nerve. What action by the nurse is a priority after this assessment is complete?

Answer 34

Assess the client’s calcium level for hypocalcemia.
Explanation:
Hypocalcemia is indicated by a positive Chvostek sign and the nurse should assess the calcium level for the deficit and prepare to administer calcium

Question 35

What question is important for the nurse to ask a client who is scheduled to receive a first dose of radioactive iodine for hyperthyroidism?

Answer 35

“Do you have any trouble swallowing?”

Question 36

What is the best position for the client after the administration of a bisphosphonate medication?

Answer 36

High Fowler’s

Question 37

The nurse is providing client education prior to administering propylthiouracil. During teaching, the nurse should inform the client about the need for what form of follow-up?

Answer 37

Routine liver function testing
Explanation:
The FDA has issued a black box warning for propylthiouracil stating that severe liver injury resulting in death or acute liver failure may occur within 6 months of treatment. All clients should receive instructions about the signs and symptoms of acute liver failure. Routine liver function testing to assess for liver failure is important.

Question 38

The nurse should teach clients who are taking thyroid hormones to take the medication:

Answer 38

on an empty stomach.

Question 39

A client presents at the clinic reporting weight loss despite an increased appetite. For which condition should this client be assessed?

Answer 39

Hyperthyroidism
Explanation:
Hyperthyroidism is manifested by increased appetite and metabolism. Without treatment, it may be difficult for hyperthyroid individuals to consume enough calories to prevent weight loss.

Question 40

The nurse is discussing the use of corticosteroids with a group of nursing students and tells that students that both men and women who take corticosteroids are at risk for what side effect?

Answer 40

Osteoporosis
Explanation:
Both men and women who take corticosteroids are at risk for osteoporosis.

Question 41

A hospital client’s current medication administration record specifies oral administration of propylthiouracil (PTU) every 8 hours. What sign or symptom may have originally prompted the care provider to prescribe this drug?

Answer 41

persistent tachycardia
Explanation:
Propylthiouracil (PTU) is used for the treatment of hyperthyroidism; one of the characteristic symptoms of this disease is tachycardia.

Question 42

An adult female client has undergone diagnostic testing and been diagnosed with hypothyroidism. The client has been prescribed levothyroxine and the nurse is providing education. What should the nurse teach the client? Select all that apply.

Answer 42

Take the medication in the morning, at the same time each day.
Expect your heart rate and blood pressure to increase.
Anticipate an increase in energy levels and decreased drowsiness.

Question 43

The nurse should monitor a client for which effect of a drug interaction in a client taking thyroid hormones and a beta blocker?

Answer 43

Tachycardia
Explanation:
Beta blockers and thyroid hormones interact, leading to decreased effectiveness of the beta blocker (i.e., cardiac drug, adrenergic blocker).

Question 44

A nurse is caring for a patient undergoing thyroid hormone replacement therapy. What should the nurse inform this patient regarding administration of the drug?

Answer 44

Take the drug before breakfast.

Question 45

What is the most common cause of subclinical hyperthyroidism?

Answer 45

excess thyroid hormone therapy

Question 46

The nurse is caring for a client with osteoporosis. Which electrolyte will the nurse assess to determine the action of exogenous calcitonin in this client?

Answer 46

calcium

Question 47

A middle-aged client is proactive with personal health maintenance and reports taking 2400 international units of vitamin D daily, stating, “More is better when it comes to vitamins.” The nurse should provide health teaching to the client associated with a risk for which disorder?

Answer 47

Hypercalcemia
Explanation:
It is important to take vitamin D supplements cautiously and not overuse them; excessive amounts can cause serious problems, including hypercalcemia. Tetany is associated with hypocalcemia.

Question 48

A client is prescribed calcitriol. Which instruction would be most important for the nurse to include in the teaching plan?

Answer 48

“Have your calcium levels checked periodically.”