Deck 43: Coordinating Care for Patients With Thyroid and Parathyroid Disorders

Question 1

The nurse is evaluating care provided to a patient with hypothyroidism. Which finding indicates that additional care is needed?
1)Warm skin
2)Heart rate 72
3)Blood pressure 118/68 mm Hg
4)Weight increase 2 kg over a month

Answer 1

4

Question 2

A patient spontaneously develops manifestations of hypoparathyroidism. The nurse correlates which data from the patient's history as the cause for this health problem?
1)Diabetes mellitus
2)Thyroid hypertrophy
3)Low intake of calcium-rich foods
4)Congenital absence of parathyroid glands

Answer 2

1

Question 3

A patient with hyperthyroidism is prescribed propylthiouracil (PTU). The nurse includes which formation about the mechanism of action of this medication in the teaching plan?
1)Diverts iodine pathways
2)Causes formation of thyroid antibodies
3)Decreases the vascularity of the thyroid gland
4)Blocks iodine from binding with thyroglobulin

Answer 3

1

Question 4

A patient with hypothyroidism asks why the neck has become so large. What should the nurse respond to this patient?
1)"The growth is cancer."
2)"The sluggish thyroid caused fat to be deposited around the neck."
3)"The growth is the body's attempt to wall off the infection in your thyroid."
4)"The gland got larger because it was trying to make more thyroid hormone."

Question 5

The nurse monitors for which clinical manifestations in the patient diagnosed with hypoparathyroidism?
1)Low heart rate
2)Muscle weakness
3)Respiratory rate 20 and shallow
4)Hand spasm

Question 6

A patient is recovering from a thyroidectomy. Which observation needs to be reported immediately to the healthcare provider?
1)Changes in voice tone
2)Hypoactive bowel sounds
3)Blood pressure 138/70 mm Hg
4)Incisional pain

Question 7

Which patient receiving levothyroxine requires close monitoring of vital signs during medication titration?
1)The patient with a history of anxiety
2)The patient with a history of depression
3)The patient with a history of cardiovascular disease
4)The patient with a history of inflammatory bowel disease

Question 8

A patient with thyroid cancer is receiving high-dose radiation to the thyroid gland. In assessing the patient, which clinical manifestations would be consistent with hypoparathyroidism?
1)Voice changes
2)Tetany
3)Absent deep tendon reflexes
4)Periorbital edema

Question 9

The nurse notes that a patient is diagnosed with Hashimoto's thyroiditis. What is the most likely cause of this patient's health problem?
1)Congenital
2)Iodine deficiency
3)Tyrosine deficiency
4)Autoimmune response

Question 10

A patient undergoes a total thyroidectomy, leaving one lobe of the parathyroid gland intact. Which laboratory value would provide the nurse the most accurate assessment of parathyroid function?
1)TSH
2)Ionized calcium
3)Serum calcium
4)Serum potassium

Question 11

A patient is diagnosed with secondary hyperparathyroidism. Which additional health problem does the nurse assess for in this patient's history?
1)Diabetes insipidus
2)Hyperaldosteronism
3)Chronic renal failure
4)Parathyroid adenoma

Question 12

The nurse monitors for which clinical manifestation in the patient diagnosed with hyperthyroidism?
1)Insomnia
2)Bradycardia
3)Cold intolerance
4)Decreased appetite

Question 13

The nurse recognizes which disorder as the most common cause of hyperthyroidism?
1)Cancer
2)Toxic medications
3)Radiation exposure
4)Autoimmune disorder

Question 14

What is the priority action by the nurse in providing care to a patient diagnosed with thyrotoxicosis?
1)Monitoring heart rate
2)Managing the airway
3)Assessing blood pressure
4)Administering intravenous fluids

Question 15

The nurse administers which medication to the patient diagnosed with hypoparathyroidism?
1)Lithium
2)Synthroid
3)Vitamin D
4)Propylthiouracil (PTU)

Question 16

The nurse correlates a husky voice in the patient with hypothyroidism to which assessment finding?
1)Chronic fatigue
2)Enlarged thyroid gland
3)Edema of the tongue and larynx
4)Dry mucous membranes from dehydration

Question 17

The nurse correlates which laboratory value to a patient diagnosed with hypoparathyroidism?
1)Serum phosphate 5.5 mg/dL
2)Serum magnesium 3.0 mg/dL
3)Serum potassium 3.2 mEq/L
4)Serum albumin 4.0 g/dL

Question 18

A patient with hyperthyroidism is placed on seizure precautions as a result of which observation?
1)Serum sodium 120 mEq/L
2)Serum glucose 200 mg/dL
3)Rapid heart rate
4)Increased T3 and T4 levels

Question 19

The nurse is preparing discharge instructions for a patient being treated medically for hyperthyroidism. What should the nurse emphasize to protect the patient's eyes?
1)Use artificial tears.
2)Wear sunglasses at all times.
3)Wear eye shields at all times.
4)Tape the eyes closed at bedtime.

Question 20

A patient with hypothyroidism is prescribed levothyroxine (Synthroid). At which time should the nurse schedule this medication to be administered?
1)0800 hours
2)1200 hours
3)1700 hours
4)2300 hours

Question 21

The nurse monitors for which clinical manifestations in the patient diagnosed with hyperthyroidism? Select all that apply.
1)Anorexia
2)Heart rate 150 bpm
3)Hyperactive bowel sounds
4)Thinning hair 5.10 pound weight loss over the last month

Question 22

The nurse monitors for which clinical manifestations in the patient diagnosed with myxedema? Select all that apply.
1)Coarse hair
2)Facial puffiness
3)Periorbital edema
4)Excessive perspiration
5)Medial eyebrow thinness

Question 23

The nurse correlates which laboratory values to the patient diagnosed with primary hypothyroidism? Select all that apply.
1)Decreased T3
2)Decreased T4
3)Decreased serum calcium
4)Decreased TSH
5)Decreased serum glucose

Question 24

The nurse monitors for which clinical manifestations in the patient with hypothyroidism? Select all that apply.
1)Fatigue
2)Weight gain
3)Increased sleep
4)Decreased energy
5)Increased appetite

Question 25

The nurse correlates flank pain to which disorder in the patient with hyperparathyroidism?
1)Renal calculi
2)Muscle spasms
3)Adrenal gland dysfunction
4)Elevated phosphorous level

Question 26

The nurse is evaluating teaching provided to a patient with hyperparathyroidism. Which statement by the patient indicates the need for further teaching?
1)"I should expect to have a poor appetite."
2)"I should eat raw vegetables and fruits every day."
3)"I should expect to have muscle cramping and pain."
4)"I should consume dairy products with breakfast and lunch."

Question 27

What actions does the nurse implement for the patient experiencing thyroid storm? Select all that apply.
1)Positioning on a cooling blanket
2)Administering intravenous fluids
3)Administering levothyroxine
4)Administering dexamethasone
5)Administering beta-adrenergic blockers

Question 28

A patient with hypothyroidism is recovering from orthopedic surgery. Which findings suggest that this patient is developing myxedema coma? Select all that apply.
1)Hypoxia
2)Slow heart rate
3)Low body temperature
4)Elevated blood pressure
5)PaCO₂ 32 mm Hg

Question 29

A patient with chronic renal failure is diagnosed with hyperparathyroidism. Which treatment approach is most effective in this patient?
1)Increased oral fluid intake
2)Oral thiazide diuretics twice a day
3)High-volume normal saline infusions
4)Discontinued calcium and vitamin D supplements

Question 30

The nurse correlates which clinical manifestations to the patient diagnosed with myxedema? Select all that apply.
1)Constipation
2)Weight loss
3)Dry, coarse skin
4)Decreased heart rate
5)Generalized nonpitting edema