Question 1

The nurse would monitor carefully the client concurrently taking levothyroxine (Synthroid)and:

Accepted Answer

Levothyroxine can increase the effects of warfarin, leading to an increased risk of bleeding. Therefore, the nurse should monitor closely for signs of bleeding and ensure that the client's INR levels are regularly checked. Aspirin and vitamin B supplementation may also interact with levothyroxine, but it is not typically as significant as the interaction with warfarin. Penicillin does not have a known significant interaction with levothyroxine.

Question 2

The nurse would anticipate elevated levels of circulating T3 and T4 in the client with:

Accepted Answer

Hypoalbuminemia can lead to elevated levels of circulating thyroid hormones because fewer thyroid hormones are bound to albumin, leaving more unbound and available to circulate in the bloodstream. Leukopenia, thrombocytopenia, and hemolytic anemia do not have a direct effect on thyroid hormone levels.

Question 3

In which instance would the nurse hold the dose of levothyroxine (Synthroid)?

Accepted Answer

Levothyroxine can cause symptoms of hyperthyroidism if overdosed, including palpitations. If a client complains of palpitations, it may indicate that the dose is too high, and the nurse should hold the dose and consult with the healthcare provider.

Question 4

The nurse is concerned that a client is developing myxedema coma after assessing which symptoms? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

Myxedema coma is a severe form of hypothyroidism. The symptoms of myxedema coma include puffy face and eyes due to fluid accumulation, hypoglycemia, and hypoventilation. Tachycardia and hyperthermia are not usually seen in myxedema coma.

Question 5

To detect malignancy of a thyroid nodule,the nurse would prepare the client for:

Accepted Answer

A needle biopsy is the most specific diagnostic test for detecting malignancy of a thyroid nodule. It involves using a fine needle to remove cells from the nodule and examining them under a microscope for the presence of cancer cells. Thyroid scanning, ultrasound, and x-ray may be useful in evaluating the size, location, and function of the thyroid gland, but they are not as conclusive in detecting malignancy as a biopsy.

Question 6

The nurse knows the most visible signs of Graves disease are goiter and exophthalmos.Exophthalmos is:

Accepted Answer

Exophthalmos is defined as outward bulging of the eyes, which is a common characteristic of Graves disease. Choices A and B are not related to Graves disease, and while choice C is related, it is not a visible sign.

Question 7

The nurse,learning that a client's thyroid hormone is elevated,recognizes that one of the strongest stimuli for an increase in thyroid hormone production is:

Accepted Answer

Exposure to cold is one of the strongest stimuli for an increase in thyroid hormone production, leading to increased metabolic activity and heat production to maintain body temperature. This is part of the body's regulatory mechanism to maintain homeostasis.

Question 8

The nurse is instructing a client taking levothyroxine (Synthroid)that full therapeutic benefits will be seen:

Accepted Answer

Full therapeutic benefits of levothyroxine (Synthroid) will typically be seen in 1-3 weeks, as this is the time it takes for the medication to reach a steady state in the body and produce its intended effects. It is important to continue taking the medication as prescribed during this time and not to adjust dosages without consulting a healthcare provider.

Question 9

The nurse instructs a client with hypothyroidism about medications that accelerate the metabolism of levothyroxine,including:

Accepted Answer

Phenytoin is known to accelerate the metabolism of levothyroxine by increasing hepatic enzyme activity, leading to a decrease in serum levothyroxine levels. Warfarin, digoxin, and calcium do not have this effect on levothyroxine metabolism.

Question 10

For which client would the nurse use of levothyroxine (Synthroid)?

Accepted Answer

The answer of For which client would the nurse use...

Question 11

A client is diagnosed with primary hypothyroidism.Which laboratory tests were used to aid in this diagnosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The diagnosis of primary hypothyroidism is based on elevated TSH levels and reduced serum T4. Therefore, measurement of serum T4 and TSH levels are frequently used to confirm the diagnosis. Serum calcium, serum potassium, and serum iodine levels are not useful for diagnosing primary hypothyroidism.

Question 12

Which laboratory value will the nurse monitor to determine the progression of a thyroid disease in a client?

Accepted Answer

TSH (thyroid-stimulating hormone) is the most sensitive indicator of thyroid function and is often the first laboratory value to change in a thyroid disease. An increase in TSH indicates hypothyroidism, whereas a decrease in TSH indicates hyperthyroidism. T3 and T4 are also important indicators of thyroid function, but changes in these values may occur later in the progression of thyroid disease. Iodine is not a reliable indicator of thyroid disease progression.

Question 13

How would the nurse explain the pathophysiologic etiology of cretinism to a client's family?

Accepted Answer

Cretinism is caused by congenital hypofunction of the thyroid gland, leading to insufficient production of thyroid hormones. This can result in physical, mental, and developmental impairments if left untreated.

Question 14

The nurse would anticipate the client with hypothyroidism to exhibit which symptom?

Accepted Answer

Hypothyroidism is characterized by a decreased production of thyroid hormones, which can slow down many bodily functions. Constipation is a common symptom of hypothyroidism. Heat intolerance, weight loss, and hypertension are not typically associated with hypothyroidism.

Question 15

A client is diagnosed with a thyroid hormone imbalance.The nurse recognizes that the body tissues that do not depend on thyroid hormones to stimulate the metabolic rate include the: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of A client is diagnosed with a thyroid...

Question 16

The nurse is reviewing the results of a client's laboratory studies to find the level of an important chemical that must be available to assist in the synthesis of thyroid hormones,or:

Accepted Answer

Iodine is the key factor required in the production of thyroid hormones.

Question 17

The nurse should instruct the parents of a client with cretinism that the duration of thyroid replacement is expected to be:

Accepted Answer

The answer of The nurse should instruct the parents of...

Question 18

A client is receiving thyroid hormone replacement therapy which increases the number of beta₁- and beta₂-adrenergic receptors.The nurse knows that this increase in receptors will make the receptors more responsive to which neurotransmitters? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of A client is receiving thyroid hormone replacement...

Question 19

A client has low levels of T3 and T . The nurse realizes that in response to these levels,the anterior pituitary will secrete:

Accepted Answer

When levels of T3 and T4 are low, the hypothalamus will release thyrotropin-releasing hormone (TRH), which then signals the anterior pituitary to secrete thyroid-stimulating hormone (TSH). TSH then stimulates the thyroid gland to produce and release more T3 and T4.

Question 20

The nurse would anticipate the client with hyperthyroidism to exhibit which symptom?

Accepted Answer

Hyperthyroidism is characterized by an overactive thyroid gland, which leads to an increase in metabolic rate and subsequent hypertension. Hypothermia and bradycardia are more common symptoms of hypothyroidism, while weight gain is associated with both hypothyroidism and hyperthyroidism depending on the severity of the disease.

Quiz 67: Pharmacotherapy of Thyroid Disorders

The nurse would monitor carefully the client concurrently taking levothyroxine (Synthroid) and: