Question 1

A client has been diagnosed with hypothyroidism.Which medication is the nurse prepared to administer to treat the client's bradycardia?

Accepted Answer

The treatment for bradycardia from hypothyroidism is to treat the hypothyroidism using levothyroxine sodium.If the heart rate were so slow that it became an emergency,then atropine or epinephrine might be an option for short-term management.Inderal is a beta blocker and would be contraindicated for a client with bradycardia.

Question 2

Twelve hours after a total thyroidectomy,the client develops stridor.Which is the nurse's priority intervention?

Accepted Answer

Stridor on exhalation is a hallmark of respiratory distress,usually caused by obstruction resulting from edema.One emergency measure is to remove the surgical clips to relieve the pressure.This might be a physician function.The nurse should prepare to assist with emergency intubation or tracheostomy while notifying the provider or the Rapid Response Team.The other choices do not address the emergency situation.

Question 3

Which dietary modification does the nurse provide for a client with hyperthyroidism?

Accepted Answer

The client is hypermetabolic and has an increased need for calories,carbohydrates,and proteins.Proteins are especially important because the client is at risk for a negative nitrogen balance.The other modifications are inappropriate for a client with hyperthyroidism.

Question 4

Which is the best instruction for the nurse to give a client scheduled for a thyroid scan?

Accepted Answer

The radioactive iodine used in thyroid scans is of low intensity and has such a short half-life that the client is not considered to be a radiation hazard.Thus,no radiation precautions are necessary.The other statements are inaccurate.

Question 5

A client has hypothyroidism and has been started on levothyroxine (Synthroid).Which assessment finding leads the nurse to conclude that the treatment is effective?

Accepted Answer

Hypothyroidism decreases body functioning and can result in effects such as bradycardia,confusion,and constipation.If a client's heart rate is bradycardic while on thyroid hormone replacement,this is an indicator that the replacement may not be adequate.Conversely,a heart rate above 100 beats/min may indicate that the client is receiving too much of the thyroid hormone.The other assessment findings do not give any indication as to whether treatment is successful.

Question 6

A client has hypothyroidism.Which problem does the nurse address as a priority for this client?

Accepted Answer

Hypothyroidism causes many problems in psychosocial functioning.Depression is the most common reason for seeking medical attention.Memory and attention span may be impaired.The client's family may have great difficulty accepting and dealing with these changes.The client is often unmotivated to participate in self-care.Lapses in memory and attention require the nurse to ensure that the client's environment is safe.Heat intolerance is seen in hyperthyroidism.Body image problems and weight issues do not take priority over mental status and safety.

Question 7

A client has undergone a complete thyroidectomy.Which statement by the client indicates that further instruction is needed?

Accepted Answer

After the client undergoes a thyroidectomy,the client must be given thyroid replacement medication for life.He or she may also need calcium if the parathyroid is damaged during surgery and can receive pain medication postoperatively.

Question 8

A client has diabetes mellitus.Her daughter has recently been diagnosed with Graves' disease.The client asks the nurse if she is responsible for the fact that her daughter has Graves' disease.Which is the best response of the nurse?

Accepted Answer

An association between autoimmune diseases such as rheumatoid arthritis and diabetes mellitus has been noted.The predisposition is probably polygenic and the client's diabetes did not cause her daughter's Graves' disease.The other statements are inaccurate.

Question 9

The client is receiving methimazole (Tapazole).Which statement by the client indicates good understanding of teaching regarding this medication?

Accepted Answer

Methimazole can cause birth defects,and clients should not take it if they are pregnant.Liver problems can occur with propylthiouracil (PTU).The client does not need to take his or her pulse daily.Dyspnea and vertigo are not side effects of methimazole.

Question 10

A client has hyperparathyroidism.Which intervention is the priority for the nurse to add to the client's plan of care?

Accepted Answer

Hyperparathyroidism causes increased resorption of calcium from the bones,increasing the risk for pathologic fractures.Using a lift sheet when moving or positioning the client,instead of pulling on the client,reduces the risk of bone injury.Hyperparathyroidism can cause kidney stones,but not every client will need to have urine strained.The priority is preventing injury.Supporting the neck with movement and using a soft toothbrush are not needed for this client.

Question 11

A client scheduled for a partial thyroidectomy asks the nurse why she is being given an iodine preparation before surgery.Which is the nurse's best response?

Accepted Answer

Iodine preparations decrease the size and vascularity of the thyroid gland,reducing the risk for hemorrhage and the potential for thyroid storm during surgery.The other answers are not accurate.

Question 12

A client with hypothyroidism as a result of Hashimoto's thyroiditis asks the nurse how long she will have to take thyroid medication.Which is the nurse's best response?

Accepted Answer

Hashimoto's thyroiditis results in a permanent loss of thyroid function.The client will need lifelong thyroid replacement therapy.The other answers are incorrect.

Question 13

A client being treated for hypothyroidism has been admitted for pneumonia.Which activity does the nurse include as a priority in this client's care plan?

Accepted Answer

A client with hypothyroidism who develops another illness is at risk for myxedema coma.In this emergency situation,maintaining an airway is a priority.The nurse should ensure that suction is available in the client's room because it may be needed if myxedema coma develops.The other interventions are necessary for any client with pneumonia,but having suction available is a safety feature for this client.

Question 14

The nurse is assessing a client with Graves' disease and finds that the client's temperature has risen 1° F.Before notifying the health care provider,which action by the nurse takes priority?

Accepted Answer

A temperature increase of 1° F may indicate the development of thyroid storm,and the provider needs to be notified.Before notifying the provider,the nurse should take measures to reduce environmental stimuli that increase the risk of cardiac complications.The nurse can then call for an ECG.The apical-radial pulse deficit would not be necessary,and Tylenol is not needed because the temperature increase is due to thyroid activity.

Question 15

When taking the blood pressure of a client after a parathyroidectomy,the nurse notes that the client's hand has gone into flexion contractions.Which laboratory result does the nurse correlate with this condition?

Accepted Answer

Hypocalcemia destabilizes excitable membranes and can lead to muscle twitches,spasms,and tetany.This effect of hypocalcemia is enhanced in the presence of tissue hypoxia.The flexion contractions (Trousseau's sign)that occur during blood pressure measurement are indicative of hypocalcemia,not the other electrolyte imbalances,which include hypokalemia,hyperkalemia,and hyponatremia.

Question 16

On the second postoperative day after a subtotal thyroidectomy,the client tells the nurse that he feels numbness and tingling around his mouth.Which is the nurse's priority intervention?

Accepted Answer

Numbness and tingling around the mouth or in the fingers and toes are manifestations of hypocalcemia,which could progress to cause tetany and seizure activity.The nurse should assess the client further by testing for Chvostek's sign and Trousseau's sign.Then the nurse should notify the provider.The other choices do not address the emergency situation.

Question 17

Which client statement alerts the nurse to the possibility of hypothyroidism?

Accepted Answer

Clients with hypothyroidism usually feel tired or weak despite getting many hours of sleep.Thyroid problems are not inherited.Heat intolerance is indicative of hyperthyroidism.Loss of taste is not a manifestation of hyperthyroidism.

Question 18

The nurse is reviewing client medical histories.Which client is at greatest risk for hyperparathyroidism?

Accepted Answer

Clients who have chronic kidney disease do not completely activate vitamin D and poorly absorb calcium from the GI tract.They are chronically hypocalcemic,and this triggers overstimulation of the parathyroid glands.The other factors do not place a client at higher risk for hyperparathyroidism.

Question 19

A client presents with elevations in triiodothyronine (T₃)and thyroxine (T₄)and with normal thyroid-stimulating hormone (TSH)levels.Which is the nurse's priority intervention?

Accepted Answer

The client's laboratory findings suggest that the client is experiencing hyperthyroidism.The increased metabolic rate can cause an increase in the client's heart rate,and the client should be monitored for the development of dysrhythmias.Placing the client on a telemetry monitor might also be a precaution.Synthroid is given for hypothyroidism.Propranolol is a beta blocker often used to lower sympathetic nervous system activity in hyperthyroidism.Trousseau's sign is a test for hypocalcemia.

Question 20

A client with hyperthyroidism is taking lithium carbonate.Which finding indicates that the client is having side effects of this therapy?

Accepted Answer

Lithium antagonizes antidiuretic hormone and can cause symptoms of diabetes insipidus.The other choices are not specific to lithium.

Quiz 66: Care of Patients With Problems of the Thyroid and Parathyroid Glands

A client has been diagnosed with hypothyroidism.Which medication is the nurse prepared to administer to treat the client's bradycardia?

Twelve hours after a total thyroidectomy,the client develops stridor.Which is the nurse's priority intervention?

Which dietary modification does the nurse provide for a client with hyperthyroidism?

Which is the best instruction for the nurse to give a client scheduled for a thyroid scan?

A client has hypothyroidism and has been started on levothyroxine (Synthroid) .Which assessment finding leads the nurse to conclude that the treatment is effective?

A client has hypothyroidism.Which problem does the nurse address as a priority for this client?

A client has undergone a complete thyroidectomy.Which statement by the client indicates that further instruction is needed?

A client has diabetes mellitus.Her daughter has recently been diagnosed with Graves' disease.The client asks the nurse if she is responsible for the fact that her daughter has Graves' disease.Which is the best response of the nurse?

The client is receiving methimazole (Tapazole) .Which statement by the client indicates good understanding of teaching regarding this medication?

A client has hyperparathyroidism.Which intervention is the priority for the nurse to add to the client's plan of care?

A client scheduled for a partial thyroidectomy asks the nurse why she is being given an iodine preparation before surgery.Which is the nurse's best response?

A client with hypothyroidism as a result of Hashimoto's thyroiditis asks the nurse how long she will have to take thyroid medication.Which is the nurse's best response?

A client being treated for hypothyroidism has been admitted for pneumonia.Which activity does the nurse include as a priority in this client's care plan?

The nurse is assessing a client with Graves' disease and finds that the client's temperature has risen 1° F.Before notifying the health care provider,which action by the nurse takes priority?

When taking the blood pressure of a client after a parathyroidectomy,the nurse notes that the client's hand has gone into flexion contractions.Which laboratory result does the nurse correlate with this condition?

On the second postoperative day after a subtotal thyroidectomy,the client tells the nurse that he feels numbness and tingling around his mouth.Which is the nurse's priority intervention?

Which client statement alerts the nurse to the possibility of hypothyroidism?

The nurse is reviewing client medical histories.Which client is at greatest risk for hyperparathyroidism?

A client presents with elevations in triiodothyronine (T₃) and thyroxine (T₄) and with normal thyroid-stimulating hormone (TSH) levels.Which is the nurse's priority intervention?

A client with hyperthyroidism is taking lithium carbonate.Which finding indicates that the client is having side effects of this therapy?

Quiz 66: Care of Patients With Problems of the Thyroid and Parathyroid Glands

A client has been diagnosed with hypothyroidism.Which medication is the nurse prepared to administer to treat the client's bradycardia?

Twelve hours after a total thyroidectomy,the client develops stridor.Which is the nurse's priority intervention?

Which dietary modification does the nurse provide for a client with hyperthyroidism?

Which is the best instruction for the nurse to give a client scheduled for a thyroid scan?

A client has hypothyroidism and has been started on levothyroxine (Synthroid) .Which assessment finding leads the nurse to conclude that the treatment is effective?

A client has hypothyroidism.Which problem does the nurse address as a priority for this client?

A client has undergone a complete thyroidectomy.Which statement by the client indicates that further instruction is needed?

A client has diabetes mellitus.Her daughter has recently been diagnosed with Graves' disease.The client asks the nurse if she is responsible for the fact that her daughter has Graves' disease.Which is the best response of the nurse?

The client is receiving methimazole (Tapazole) .Which statement by the client indicates good understanding of teaching regarding this medication?

A client has hyperparathyroidism.Which intervention is the priority for the nurse to add to the client's plan of care?

A client scheduled for a partial thyroidectomy asks the nurse why she is being given an iodine preparation before surgery.Which is the nurse's best response?

A client with hypothyroidism as a result of Hashimoto's thyroiditis asks the nurse how long she will have to take thyroid medication.Which is the nurse's best response?

A client being treated for hypothyroidism has been admitted for pneumonia.Which activity does the nurse include as a priority in this client's care plan?

The nurse is assessing a client with Graves' disease and finds that the client's temperature has risen 1° F.Before notifying the health care provider,which action by the nurse takes priority?

When taking the blood pressure of a client after a parathyroidectomy,the nurse notes that the client's hand has gone into flexion contractions.Which laboratory result does the nurse correlate with this condition?

On the second postoperative day after a subtotal thyroidectomy,the client tells the nurse that he feels numbness and tingling around his mouth.Which is the nurse's priority intervention?

Which client statement alerts the nurse to the possibility of hypothyroidism?

The nurse is reviewing client medical histories.Which client is at greatest risk for hyperparathyroidism?

A client presents with elevations in triiodothyronine (T3) and thyroxine (T4) and with normal thyroid-stimulating hormone (TSH) levels.Which is the nurse's priority intervention?

A client with hyperthyroidism is taking lithium carbonate.Which finding indicates that the client is having side effects of this therapy?

A client presents with elevations in triiodothyronine (T₃) and thyroxine (T₄) and with normal thyroid-stimulating hormone (TSH) levels.Which is the nurse's priority intervention?