Deck 45: Thyroid and Parathyroid Disorders

Question 1

When the patient starts taking a saturated solution of potassium iodide (SSKI),the nurse should instruct the patient to:

A) Sip medication through a straw to prevent tooth staining.
B) Double the dose if a dose is missed.
C) Expect excessive salivation.
D) Take before meals.

Answer 1

Sip medication through a straw to prevent tooth staining.

Question 2

The nurse will include in the presurgical teaching of a patient scheduled for a subtotal thyroidectomy that the patient will have to:

A) Lie flat on her back for 24 hours to prevent undue strain on the suture line.
B) Be able to verbalize the signs and symptoms of thyroid crisis.
C) Demonstrate how to deep breathe and support her head during position changes.
D) Have a tube into her trachea to assist in breathing.

Answer 2

Demonstrate how to deep breathe and support her head during position changes.

Question 3

An older patient with hypothyroidism asks why her daily dose of thyroid hormone,which she has taken for 15 years,has been reduced.The nurse's best response would be that the decreased dose is related to:

A) Improved efficacy of the thyroid preparation
B) Age-related reduction in metabolic rate
C) Drug-related hypertrophy of the thyroid
D) Changes in your diet and activity level

Answer 3

Age-related reduction in metabolic rate

Question 4

To address the nursing diagnosis,"Risk for impaired skin integrity,related to dry skin" in the patient with hypothyroidism,the nurse would:

A) Increase the frequency of bathing to get rid of dry skin.
B) Apply lotions and creams to help maintain moisture.
C) Increase activities to stimulate circulation in the skin.
D) Take antihistamines to prevent itching.

Question 5

The patient asks about his laboratory test,which showed a high level of thyroid-stimulating hormone (TSH)and a low level of T?.You explain that:

A) "It means that you have an inconsistency in your thyroid tests, and you will need more testing."
B) "I am sorry. You will have to ask your physician about your laboratory results. We are not allowed to discuss them."
C) "The TSH is sending a message to your thyroid gland to increase production, but your thyroid isn't producing enough hormone."
D) "That means that you will have to go on hormone therapy for the rest of your life."

Question 6

An appropriate nursing diagnosis for the patient recently diagnosed with hyperthyroidism would be:

A) Hypothermia, related to increased metabolic processes
B) Constipation, related to increased hormonal stimulation
C) Disturbed body image, related to weight gain
D) Disturbed sleep pattern, related to metabolic disturbance

Question 7

To assess for hemorrhage in a post thyroidectomy patient the nurse should:

A) Assess upper chest for the patient positioned in high Fowler position.
B) Turn the patient to the side to check; the patient must be kept flat in the bed.
C) Lift up the neck dressing to assess for excessive bleeding.
D) Examine behind patient's neck and upper back to assess for hemorrhage.

Question 8

The nurse would anticipate that the patient with hyperparathyroidism would exhibit a history of:

A) Fatigue, hyperactive reflexes, muscle cramps, and twitching
B) Poor muscle tone, bone pain, urinary calculi, and fractures
C) Hunger, thirst, and urinary retention
D) Tachycardia, air hunger, and nervousness

Question 9

The patient with a hyperthyroid complains of fatigue but still cannot get to sleep.The nurse suggests:

A) Taking "cat naps" during the day.
B) Adhering to a bedtime ritual.
C) Drinking a cup of cocoa before bedtime.
D) Performing mild prebedtime exercises.

Question 10

The nurse clarifies the pathophysiologic changes of Graves disease by saying:

A) "Your thyroid gland is not producing enough hormones; consequently, you will need replacement therapy."
B) "Your thyroid gland is overactive, but there are ways to treat it-through medicine or surgery."
C) "It's an autoimmune disorder that has no satisfactory treatment."
D) "Graves disease is a temporary disorder that will gradually subside."

Question 11

The nurse taking the blood pressure of a patient who had a total thyroidectomy 2 days earlier notes that the patient's hand goes into a carpopedal spasm; the nurse recognizes this movement as an indication of:

A) Hyperkalemia, called the Allen sign
B) Hypernatremia, called the Hogan sign
C) Hypocalcemia, called the Trousseau sign
D) Hypokalemia, called the Chvostek sign

Question 12

The patient,newly diagnosed with hypothyroidism,is anxious to begin her drug regimen.The nurse's instructions relative to hormone replacement include:

A) "Be certain that no dose is skipped."
B) "Be sure and take these drugs just before bedtime."
C) "Know the signs and symptoms of hyperthyroidism."
D) "You will be able to notice the benefits of thyroid replacement therapy right away."

Question 13

The patient has been given an antithyroid drug called propylthiouracil.Appropriate nursing implementations include:

A) Using special radioactive precautions for her urine for the first 24 hours.
B) Monitoring her vital signs and withholding the medications if her pulse is >100 beats/min.
C) Teaching her to watch for and report any signs and symptoms of hypothyroidism or infections.
D) Keeping her on a low-calorie, low-protein diet.

Question 14

Significant instructions to a patient scheduled for a thyroid scan (¹²³I)should include the need for:

A) Providing of a special container to collect urine for the next 24 hours.
B) Wearing a protective apron to shield him or her from radiation for the next 24 hours.
C) Requesting that visitors keep a distance of at least 6 feet away for the next 24 hours.
D) Washing their hands with soap and water after every voiding for the next 24 hours.

Question 15

On returning from surgery after undergoing a thyroidectomy,the patient is alarmed about the large tracheostomy tray on the bedside table.When she asks why it is there,the nurse's most reassuring response would be:

A) "We have it there as a precautionary measure in the unlikely event that you have difficulty breathing."
B) "If you start bleeding, we'll be able to take care of it right here at the bedside."
C) "We have to keep it there in case of an emergency and the physician needs it."
D) "It's hospital policy to have it available for persons who are likely to have respiratory arrest."

Question 16

In initiating the Chvostek sign,the nurse will:

A) Ask the patient to grimace, and note if the facial response is symmetrical.
B) Inflate a blood pressure cuff to the systolic level, and watch for a carpopedal spasm.
C) Tap the face over the facial nerve, and watch for a spasm of the facial muscle.
D) Check the pupillary response to light, and determine whether the pupil accommodates and reacts.

Question 17

Food such as soybeans,turnips and rutabagas can have an effect on persons with a thyroid disorder by:

A) Suppressing thyroid hormone
B) Decreasing the hypothermia of the person with hypothyroidism
C) Supplementing the diet of a person with hypothyroidism
D) Counteracting the effect of iodide therapy

Question 18

The physician ordered T? and T? tests for a young woman complaining of fatigue,weight gain,muscle aches and pains,and constipation.These laboratory tests will help confirm the diagnosis of hypothyroidism when:

A) Both tests show decreases.
B) Both tests show increases.
C) The T3 test elevates, and the T4 test decreases.
D) The level of thyroxin rises then falls back to subnormal levels.

Question 19

The nurse assessing a patient 1 day after a subtotal thyroidectomy notes that the patient's color is poor,the pulse and respirations are rapid,and she feels warm to the touch.The patient says that she feels frightened.The nurse's initial implementation should be to:

A) Tell her that there is nothing to be afraid of, and to stay to calm her.
B) Ask her if she would like pain medication.
C) Call the charge nurse; these are signs of a thyroid storm.
D) Get a tracheostomy set at the bedside.

Question 20

The patient with exophthalmos is distressed about her appearance and asks when it will go away.The nurse's best and most informative response would be based on the knowledge that exophthalmos:

A) Is not reversible.
B) Can be disguised with sunglasses and makeup.
C) Usually subsides after medication for hyperthyroidism is started.
D) Can be minimized with plastic surgery to the eyelids.

Question 21

The patient being treated for hyperparathyroidism is to receive calcitonin (Calcimar).Before administering this drug,the patient should be:

A) Assessed for hydration status
B) Evaluated for cardiac dysrhythmia
C) Tested for sensitivity
D) X-rayed for the presence of urinary calculi

Question 22

An appropriate nursing diagnosis for a patient with hyperparathyroidism would be:

A) Impaired urinary elimination, related to urinary calculi
B) Decreased cardiac output, related to heart failure secondary to hypocalcemia
C) Risk for injury, related to hypocalcemia leading to muscle spasms and convulsions
D) Imbalanced nutrition: Greater than body requirements, related to increased appetite

Question 23

To meet the nutritional needs of a patient with Graves disease,the nurse recommends a diet of ____________________ to ____________________ calories.

Question 24

When the patient with hypoparathyroidism complains of fatigue and a lack of energy,the nurse is aware that:

A) Hypertension is the cause of the fatigue.
B) Hypocalcemia has caused decreased cardiac output.
C) Dyspnea has sapped the patient's energy.
D) Poor muscle tone makes any activity tiring.

Question 25

Congenital hypothyroidism,if left untreated,will result in _________________.

Question 26

The nurse caring for a patient with hyperthyroidism would include in the nursing care plan implementations for:

A) Decreasing weight
B) Provision of a cool environment
C) Eye care
D) Nutritional support
E) Prevention of diarrhea

Question 27

The nurse recommends the use of salt that is iodized because iodized salt:

A) Can prevent the development of goiter in adults and cretinism in infants.
B) Can help prevent hypothyroidism.
C) Is instrumental in preventing tumors of the parathyroid gland.
D) Works as an important component of thyroid replacement therapy.

Question 28

The home health care nurse is aware that hypothyroidism is frequently overlooked in older adults because:

A) Signs and symptoms are subtle.
B) Signs and symptoms are discounted as age-related changes.
C) Weight changes in the older adult are not pronounced.
D) Older adults are not susceptible to thyroid disorders.
E) Decrease in mental function is attributed to dementia.

Question 29

The patient who has hypothyroidism can live a full and normal life if he is:

A) Taught the importance of taking his antithyroid medication until it is no longer needed.
B) Able to exercise to burn extra calories and maintain a normal weight.
C) Taught to take care of his energy needs through adequate nutrition.
D) Treated with thyroid replacement therapy.

Question 30

The nurse makes a list of symptoms that the patient who is taking methimazole (Tapazole),a thionamide drug,should report.This list includes:

A) Becoming Pregnancy
B) Jaundice
C) Blood in the stool
D) Rash
E) Urine retention

Question 31

The nurse explains to the patient that the presurgical protocol of antithyroid drugs is given to:

A) Decrease the level of hormone in the blood before surgery.
B) Help reduce the risk of hemorrhage during surgery.
C) Decrease the threat of a thyroid storm.
D) Reduce exophthalmia.
E) Increase weight.