Question 1

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

Accepted Answer

SSKI can discolor teeth if not sipped through a straw; no iodide drug should be doubled; excessive salivation is a sign of toxicity and the medication should be taken after meals.

Question 2

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

Accepted Answer

Teaching the patient to hold and support the head after a thyroidectomy will ease the postoperative period.Consistently supporting the head will prevent stress on the suture line.

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:

Accepted Answer

Older patients have slower drug metabolism; consequently,the drug stays in their systems.All patients receiving hormone replacement need to be periodically evaluated.

Question 4

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

Accepted Answer

The skin requires moisturizing lotion to decrease the risk breakdown.Frequent bathing and antihistamines will dry the skin.Exercise does little for skin perfusion.

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:

Accepted Answer

The test determines whether the problem is in the pituitary gland or in the thyroid gland.In this patient,the high level of TSH is coming from the pituitary gland as it should,but the thyroid gland is not responding with adequate hormone production.

Question 6

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

Accepted Answer

The patient with hyperthyroidism has trouble staying asleep because of the metabolic disorder.Persons with hyperthyroidism feel uncomfortably warm,which also contributes to their sleeping difficulty.

Question 7

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

Accepted Answer

Because the dressing is on the front of the neck,blood might flow under the dressing to the back of the neck,since it flows to the most-dependent position.Patients are positioned in a high Fowler position after a thyroidectomy to diminish swelling.

Question 8

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

Accepted Answer

The calcium has been leeched from the bones,leading to hypercalcemia and leaving the patient with multiple problems such as a risk for fractures,urinary calculi,and bone pain.

Question 9

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

Accepted Answer

Bedtime rituals like a warm bath,reading,listening to music cue the body for sleep.Naps during the day may make night time sleep difficult,exercising and drinking caffeine-filled drinks are stimulating and should be avoided by the person with insomnia.

Question 10

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

Accepted Answer

The patient needs to recognize the nurse's role in giving accurate,timely information.

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:

Accepted Answer

The carpopedal spasm is the Trousseau sign,which indicates hypercalcemia.Chvostek sign also signals hypocalcemia.

Question 12

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

Accepted Answer

Overdosing on the thyroid replacement medication will lead to signs and symptoms of hyperthyroidism.The medication is best taken every morning so as not to unduly interrupt sleep patterns.

Question 13

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

Accepted Answer

The drug targets the thyroid gland to slow its function.Thionamides may cause suppression of neutrophils leading to a lowered resistance.

Question 14

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

Accepted Answer

The patient needs to be instructed to use soap and water to wash his or her hands after each voiding for the next 24 hours.If caregivers discard the urine,gloves should be worn,then washed and removed.Caregivers should wash their hands after glove removal.

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:

Accepted Answer

The honest answers without any embellishments are best.Suggesting that any emergency is imminent will alarm the patient further.The presence of the tray is an item that should be covered in preoperative teaching.

Question 16

In initiating the Chvostek sign,the nurse will:

Accepted Answer

Spasm of the facial muscles is an indicator of low serum calcium levels.

Question 17

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

Accepted Answer

Turnips,rutabagas,and soybeans are goitrogen substances and suppress the thyroid hormone.Such foods would synergize iodides and increase the symptoms of the patient with hypothyroidism.

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:

Accepted Answer

These complaints are strongly suggestive of thyroid disorder; T? and T? laboratory diagnostic tests are the most useful.

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:

Accepted Answer

Call the charge nurse; these signs and symptoms suggest excessive stimulation caused by an elevated level of thyroid hormones,and the patient needs immediate care.

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:

Accepted Answer

The "startled" appearance of the patient with exophthalmos usually subsides several weeks after therapy for hyperthyroidism becomes effective.

Quiz 45: Thyroid and Parathyroid Disorders

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