Deck 36: Care of Patients with Pituitary, Thyroid, Parathyroid, and Adrenal Disorders

Question 1

The patient with Addison disease is receiving IV fluids for rehydration.The nurse should carefully monitor the patient for which potential problem?

A) Hypotension
B) Hyperglycemia
C) Hypokalemia
D) Hypernatremia

Answer 1

Hypotension

Question 2

The nurse is caring for a patient with a goiter.The nurse correctly uses which technique to administer potassium iodide solution?

A) Pour the solution over ice to increase palatability.
B) Dilute the solution and administer it through a straw.
C) Administer the solution on an empty stomach.
D) Mix the solution with an antacid to reduce gastric irritation.

Answer 2

Dilute the solution and administer it through a straw.

Question 3

A nurse is teaching a patient with Addison disease who has a prescription for corticosteroids.Which statement is most important for the nurse to include in the teaching plan?

A) Take the medication every day.
B) Take the medication on an empty stomach.
C) Stop the medication if gastrointestinal symptoms appear.
D) Double the medication during stressful events.

Answer 3

Take the medication every day.

Question 4

The nurse is caring for a patient scheduled for a thyroidectomy.Which instruction should be included in the preoperative care?

A) Avoid salt for 2 weeks prior to surgery.
B) Preoperative medications will include drugs to increase the vascularity of the gland.
C) Keep a food diary for 2 weeks prior to surgery.
D) Preoperative medications will be given 2 weeks before surgery to reduce the vascularity of the gland.

Question 5

The nurse is caring for patient who is 8 hours postoperative after a total thyroidectomy.The patient complains of muscle cramps,and the nurse assesses a positive Chvostek sign.The nurse correctly interprets that these findings indicate which complication?

A) Imminent convulsions
B) Hypoparathyroidism
C) Hyperkalemia
D) Thyroid storm

Question 6

The nurse is educating a patient who has a new prescription for methimazole (Tapazole).Which instruction is most important for the nurse to include?

A) "Double the next medication dose if the previous dose is forgotten."
B) "Take the medication on a strict schedule."
C) "Ask the pharmacist for a less expensive generic substitute."
D) "The medication is approved for use in pregnant women."

Question 7

The husband of a patient with Grave disease confides that he is frustrated with his wife's emotional outbursts and wide mood swings.How should the nurse respond?

A) "I understand how you feel."
B) "Antithyroid drugs usually help regulate mood swings after a few weeks."
C) "I'm afraid this behavior will continue. How are you coping with it now?"
D) "Have you told her how you feel?"

Question 8

The nurse is caring for a patient who reports abruptly discontinuing his prescribed levothyroxine.The nurse should carefully monitor the patient for which complication?

A) Seizures
B) Extreme diarrhea
C) Sudden hypertension
D) Respiratory distress

Question 9

A patient with central diabetes insipidus (DI)likely has which occurrence as part of his health history?

A) Brain surgery to remove a tumor
B) A kidney disorder
C) Water addiction
D) A thyroid disorder

Question 10

Which statement accurately describes a subtotal thyroidectomy?

A) It allows the patient to take minimum amounts of antithyroid drugs.
B) It allows continued production and release of thyroid hormones from the remainder of the gland.
C) It reduces exophthalmos.
D) It poses less postoperative risk than a total thyroidectomy.

Question 11

The patient with hyperthyroidism is undergoing ablation therapy with radioactive iodine.Which precaution is most important for the nurse to employ?

A) Take radioactive precautions with syringes and bedpans.
B) Use Standard Precautions only.
C) Enforce isolation for 3 days.
D) Wear a mask and eye protectors when caring for patient.

Question 12

A patient who had a hypophysectomy 3 days ago begins to have 3000 mL of urine output every shift and complains of thirst and a dry mouth.Which problem does the nurse suspect?

A) Overreaction to diuretics
B) Diabetes insipidus (DI)
C) Diabetes mellitus
D) Glucose intolerance

Question 13

Pituitary adenoma antagonizes insulin.This benign tumor results in which imbalance?

A) Hyperinsulinism
B) Hyperglycemia
C) Hypopituitarism
D) Hypoglycemia

Question 14

The nurse planning the postoperative instructions for the patient who will undergo a hypophysectomy.Which information is most important for the nurse to include?

A) A drip pad will be placed under your nose.
B) Avoid brushing your teeth.
C) Avoid raising your arms above your head.
D) Breathe through your mouth.
E) Avoid blowing your nose.

Question 15

The nurse is performing preoperative thyroidectomy instruction for a patient with Graves' disease.The patient begins to cry and says,"I am so nervous and can't listen to you.Just get out!" What should the nurse do next?

A) Give the patient written preoperative instructions.
B) Inform the charge nurse or surgeon of the patient's behavior.
C) Remind the patient the preoperative information is important.
D) Ask the family member to explain the preoperative instructions.

Question 16

Which manifestations occur with a benign pituitary adenoma?

A) Gigantism in children
B) Acromegaly in adults
C) Muscle weakness
D) Excessive hair growth
E) Joint pain

Question 17

The nurse is preparing a patient to undergo a dexamethasone suppression test.Which action is most appropriate?

A) Instruct the patient to be NPO 6 hours before the test.
B) Instruct the patient that urine levels will be assessed after a 24-hour collection period.
C) Administer a steroid the morning of the test.
D) Instruct the patient that a blood specimen will be collected in the morning.

Question 18

The nurse is educating a patient with a simple goiter.Which statement indicates that the patient needs additional instruction?

A) "The lump on my throat is my enlarged thyroid."
B) "Treatment stops enlargement of the goiter."
C) "I am aware this goiter could develop into cancer."
D) "I'm glad my treatment will make this thing go away."

Question 19

The nurse is reviewing the health history of a patient.Which behavior is linked to increased probability of developing Grave disease?

A) Smoking
B) Long-term use of oral contraceptives
C) Excessive alcohol consumption
D) Use of St. John wort

Question 20

The nurse is aware that the severe dehydration associated with diabetes insipidus (DI)can lead which serious electrolyte imbalance?

A) Hypercalcemia
B) Hypernatremia
C) Hypocalcemia
D) Hyperkalemia

Question 21

A tumor of the pituitary has caused the syndrome of inappropriate secretion of antidiuretic hormone (SIADH).Which interventions should the nurse plan?

A) Assist with activities of daily living.
B) Record accurate urine.
C) Weigh the patient daily.
D) Assess for changes in level of consciousness.
E) Assess stools for occult blood.

Question 22

The nurse traces the closed loop of thyroid secretion.Place the events in appropriate order.

Step 6

A)Hypothalamus is activated.
B)Pituitary releases thyroid-stimulating hormone (TSH).
C)Drop in norepinephrine level.
D)Thyroid releases thyroid hormone.
E)Satisfaction of norepinephrine level signals hypothalamus in negative feedback.
F)Thyrotropin-releasing hormone (TRH) is secreted.

Question 23

The nurse's major contribution to the care of a patient with Cushing syndrome is that of __________ and __________.

Question 24

On the first postoperative day following a total thyroidectomy,which finding(s)would lead the nurse to suspect that the patient may be developing a thyroid storm?

A) Temperature of 101.8° F
B) Pulse of 58 beats/min
C) Brief attention span
D) Apprehension and restlessness
E) Respiratory rate of 12 breaths/min

Question 25

The nurse traces the closed loop of thyroid secretion.Place the events in appropriate order.

Step 4

A)Hypothalamus is activated.
B)Pituitary releases thyroid-stimulating hormone (TSH).
C)Drop in norepinephrine level.
D)Thyroid releases thyroid hormone.
E)Satisfaction of norepinephrine level signals hypothalamus in negative feedback.
F)Thyrotropin-releasing hormone (TRH) is secreted.

Question 26

The nurse traces the closed loop of thyroid secretion.Place the events in appropriate order.

Step 5

A)Hypothalamus is activated.
B)Pituitary releases thyroid-stimulating hormone (TSH).
C)Drop in norepinephrine level.
D)Thyroid releases thyroid hormone.
E)Satisfaction of norepinephrine level signals hypothalamus in negative feedback.
F)Thyrotropin-releasing hormone (TRH) is secreted.

Question 27

The nurse associates the pathophysiology to the signs of the condition it causes in the adult.Match the hormonal change to the symptom it would produce.

Hyponatremia,edema

A)Decreased growth hormone
B).Increased thyroid hormone
C)Decreased follicle-stimulating hormone
D)Decreased thyroid hormone
E)Increased antidiuretic hormone

Question 28

The nurse is planning care for a patient with diabetes insipidus (DI).Which outcomes are important for the nurse to include?

A) Maintain fluid therapy.
B) Conserve energy.
C) Supporting dietary choices to reduce diarrhea.
D) Assess for bradycardia.
E) Encouraging exercise to reduce weight.

Question 29

The nurse associates the pathophysiology to the signs of the condition it causes in the adult.Match the hormonal change to the symptom it would produce.

Pathologic fractures

A)Decreased growth hormone
B).Increased thyroid hormone
C)Decreased follicle-stimulating hormone
D)Decreased thyroid hormone
E)Increased antidiuretic hormone

Question 30

The nurse associates the pathophysiology to the signs of the condition it causes in the adult.Match the hormonal change to the symptom it would produce.

Weight gain,fatigue,and lethargy

A)Decreased growth hormone
B).Increased thyroid hormone
C)Decreased follicle-stimulating hormone
D)Decreased thyroid hormone
E)Increased antidiuretic hormone

Question 31

The nurse associates the pathophysiology to the signs of the condition it causes in the adult.Match the hormonal change to the symptom it would produce.

Menstrual irregularities

A)Decreased growth hormone
B).Increased thyroid hormone
C)Decreased follicle-stimulating hormone
D)Decreased thyroid hormone
E)Increased antidiuretic hormone

Question 32

The nurse associates the pathophysiology to the signs of the condition it causes in the adult.Match the hormonal change to the symptom it would produce.

High metabolism rate

A)Decreased growth hormone
B).Increased thyroid hormone
C)Decreased follicle-stimulating hormone
D)Decreased thyroid hormone
E)Increased antidiuretic hormone

Question 33

Which interventions are indicated for the immediate postoperative care of a person after a thyroidectomy?

A) Placing the patient in semi-Fowler position.
B) Supporting the head with sandbags.
C) Assess vital signs hourly.
D) Assess the patient's ability to swallow.
E) Assess for bleeding.

Question 34

Which classic signs and symptoms are manifestations of hyperthyroidism?

A) Tremulousness
B) Bradycardia
C) Exertional dyspnea
D) Scanty menstruation
E) Increased thirst and urination

Question 35

The nurse traces the closed loop of thyroid secretion.Place the events in appropriate order.

Step 3

A)Hypothalamus is activated.
B)Pituitary releases thyroid-stimulating hormone (TSH).
C)Drop in norepinephrine level.
D)Thyroid releases thyroid hormone.
E)Satisfaction of norepinephrine level signals hypothalamus in negative feedback.
F)Thyrotropin-releasing hormone (TRH) is secreted.

Question 36

The nurse traces the closed loop of thyroid secretion.Place the events in appropriate order.

Step 2

A)Hypothalamus is activated.
B)Pituitary releases thyroid-stimulating hormone (TSH).
C)Drop in norepinephrine level.
D)Thyroid releases thyroid hormone.
E)Satisfaction of norepinephrine level signals hypothalamus in negative feedback.
F)Thyrotropin-releasing hormone (TRH) is secreted.

Question 37

The nurse is evaluating the laboratory results of a patient suspected of having hyperparathyroidism.Which finding(s)would be consistent with this condition?

A) Anorexia
B) Decreased serum phosphate levels
C) Diarrhea
D) Agitation
E) Increased serum calcium levels

Question 38

The nurse traces the closed loop of thyroid secretion.Place the events in appropriate order.

Step 1

A)Hypothalamus is activated.
B)Pituitary releases thyroid-stimulating hormone (TSH).
C)Drop in norepinephrine level.
D)Thyroid releases thyroid hormone.
E)Satisfaction of norepinephrine level signals hypothalamus in negative feedback.
F)Thyrotropin-releasing hormone (TRH) is secreted.