Question 1

Which of the following effects on the cardiovascular system would a patient with a hypofunction of the parathyroid gland most likely exhibit?

Accepted Answer

Hypofunction of the parathyroid gland can lead to hypocalcemia, which can cause decreased contractility of the heart muscle, leading to cardiovascular complications such as heart failure. Hypertension, increased cardiac output and dysrhythmias are not typically associated with hypofunction of the parathyroid gland.

Question 2

A 73-year-old woman is hospitalized with possible SIADH.She is confused and reports a headache,muscle cramps,and twitching.Initially,which of the following laboratory results would the nurse expect to find?

Accepted Answer

SIADH (syndrome of inappropriate antidiuretic hormone) is characterized by excessive production or activity of antidiuretic hormone (ADH). This leads to water retention, hyponatremia (low serum sodium levels), and diluted urine. So, the option with serum sodium of 124 mmol/L is expected, as a lower level of sodium in serum is seen in SIADH. Options A and B, hematocrit and blood urea nitrogen levels, are not specifically related to SIADH. Option D, serum chloride level, may not necessarily be decreased in SIADH.

Question 3

Which one of the following effects on the integumentary system would a patient with a hyperfunction of the parathyroid gland most likely exhibit?

Accepted Answer

D

Question 4

While a 68-year-old woman is hospitalized for a fractured femur,she is diagnosed with hypothyroidism.Which of the following medications ordered for the patient at the time of admission does the nurse recognize should not be administered without consulting the physician?

Accepted Answer

A sedative should not be administered without consulting the physician as it can worsen hypothyroidism symptoms and interact with thyroid hormone replacement medication. The other options (stool softener, analgesic, antibiotic) are not contraindicated in hypothyroidism and can be safely administered unless the patient has a specific allergy or adverse reaction.

Question 5

A patient seeks care at the clinic because of increasing speech difficulties and hoarseness,telling the nurse his tongue has gotten so big that he can hardly talk.The physician suspects acromegaly.During the nursing history,which of the following should the nurse specifically ask the patient whether he has experienced?

Accepted Answer

Acromegaly is a disorder caused by excessive growth hormone production, usually due to a benign pituitary tumor. One of the hallmark symptoms of acromegaly is enlargement of the hands and feet, often leading to an increase in shoe size. Asking about shoe size can help the nurse assess for this symptom and potentially aid in the diagnosis of acromegaly. While the other options may be relevant to a nursing history in other contexts, they are not specifically related to the suspected diagnosis of acromegaly.

Question 6

When teaching a patient newly diagnosed with Graves' disease about the disorder,the nurse explains which of the following?

Accepted Answer

Antithyroid medications, such as methimazole or propylthiouracil, are commonly used to reduce thyroid activity in Graves' disease. However, it may take several weeks for these medications to have an effect. Restriction of iodine intake is not typically recommended in Graves' disease as the condition is primarily caused by an overactive thyroid gland and not excess iodine intake. Exercise is generally encouraged in moderation as it can help with weight management and overall well-being. Surgery to remove the thyroid gland, known as a thyroidectomy, is generally used only in cases where medications and radioactive iodine therapy are not effective or when a goiter is causing significant compression or discomfort.

Question 7

While assessing a patient who has just arrived in the postanaesthesia recovery unit after a thyroidectomy,the nurse obtains the following data.Which information is most important to communicate to the surgeon?

Accepted Answer

Increasing swelling of the neck after a thyroidectomy is the most important information to communicate to the surgeon because it may indicate hemorrhage or hematoma formation, which can lead to airway compression and is a potentially life-threatening complication.

Question 8

During preoperative teaching for a patient scheduled for transsphenoidal hypophysectomy for treatment of a pituitary adenoma,what should the nurse instruct the patient that she will have to do?

Accepted Answer

After a transsphenoidal hypophysectomy, patients are advised not to brush their teeth for a period (often 10 days) to avoid stressing the surgical site, which is accessed through the nasal cavity. This helps prevent infection and allows the surgical area to heal properly.

Question 9

A few hours after returning to the surgical nursing unit,a patient who has undergone a subtotal thyroidectomy develops laryngeal stridor and a cramp in the right hand.What intervention would the nurse anticipate?

Accepted Answer

The symptoms described, laryngeal stridor and a cramp in the right hand, suggest hypocalcemia, which can occur after thyroidectomy due to accidental removal or damage to the parathyroid glands. Administration of intravenous calcium gluconate is the appropriate intervention to correct the hypocalcemia.

Question 10

Following a transsphenoidal resection of a pituitary tumour,the nurse suspects that the patient has developed diabetes insipidus on finding which of the following data?

Accepted Answer

A urine specific gravity of 1.001 indicates diluted urine, which is a common finding in diabetes insipidus. The other options do not necessarily suggest diabetes insipidus.

Question 11

When teaching a patient with chronic SIADH about long-term management of the disorder,the nurse determines that additional instruction is needed when the patient gives which of the following responses?

Accepted Answer

In chronic SIADH (Syndrome of Inappropriate Antidiuretic Hormone), the problem is not excess sodium but rather water retention leading to hyponatremia. A sodium-restricted diet is not typically required; instead, fluid restriction is a key management strategy.

Question 12

A patient with hyperthyroidism is treated with radioactive iodine at a clinic.Before the patient is discharged,what should the nurse instruct the patient about?

Accepted Answer

The answer of A patient with hyperthyroidism is treated with...

Question 13

A patient with symptoms of diabetes insipidus is admitted to the hospital for evaluation and treatment of the condition.What is an appropriate nursing diagnosis that the nurse would document for the patient based on an understanding of this condition?

Accepted Answer

Diabetes insipidus is characterized by polyuria (excessive urination) and polydipsia (excessive thirst), leading to frequent nocturnal awakenings for urination, which can disturb sleep patterns.

Question 14

The nurse identifies a nursing diagnosis of risk for injury: corneal ulceration related to inability to close the eyelids secondary to exophthalmos for a patient with Graves' disease.What is an appropriate nursing intervention to prevent this problem?

Accepted Answer

The answer of The nurse identifies a nursing diagnosis of...

Question 15

Which information obtained when caring for a patient who has just been admitted for evaluation of diabetes insipidus will be of greatest concern to the nurse?

Accepted Answer

Confusion and lethargy can be signs of brain dysfunction, which could be related to the cause of diabetes insipidus (such as head injury or tumor), and require immediate attention. A high urinary output and low urine specific gravity are expected findings in diabetes insipidus.

Question 16

A patient with an antidiuretic hormone (ADH)-secreting small cell cancer of the lung is treated to control the symptoms of syndrome of inappropriate ADH (SIADH).The nurse determines that treatment is effective on finding which of the following data?

Accepted Answer

In SIADH, excess ADH causes water retention and low urine output. Effective treatment would increase urinary output as the excess water is excreted.

Question 17

During the nursing assessment of a patient with Graves' disease,the nurse notes a bounding,rapid pulse and systolic hypertension.What is an additional manifestation of the disorder that the nurse would expect to find?

Accepted Answer

Graves' disease is an autoimmune disorder that results in hyperthyroidism. With increased thyroid hormone production, patients may experience symptoms such as tachycardia (bounding, rapid pulse), systolic hypertension, and chest pain. Constipation, decreased appetite, and muscle aches are not typically associated with Graves' disease.

Question 18

Which of the following is the first nursing action indicated when a patient returns to the surgical nursing unit after a thyroidectomy?

Accepted Answer

Assessing the patient's respiratory rate and effort is a priority after a thyroidectomy because the surgery can affect the patient's airway and breathing. Checking for hemorrhage, assessing speech, and monitoring for tingling in the fingers and toes are all important interventions but are not the first priority.

Question 19

After 5 years of experiencing depression,fatigue,and lethargy,an older adult woman is diagnosed with hypothyroidism,and levothyroxine (Synthroid)is prescribed.During initiation of thyroid replacement for the patient,it is most important for the nurse to assess which of the following functions?

Accepted Answer

During the initiation of thyroid replacement therapy, especially in older adults, it is crucial to monitor cardiovascular function due to the increased metabolic rate that can stress the heart, potentially leading to arrhythmias or exacerbation of existing heart conditions.

Question 20

A patient is suspected of having a pituitary tumour causing panhypopituitarism.During assessment of the patient,the nurse would expect to find which of the following changes?

Accepted Answer

Panhypopituitarism leads to decreased production of pituitary hormones, affecting secondary sex characteristics and libido due to reduced gonadotropins.

Quiz 51: Nursing Management: Endocrine Problems