Deck 49: Thyroid and Parathyroid Disorders

Question 1

What is the appropriate action of the nurse when assessing for hemorrhage in a post-thyroidectomy patient?

A) Assess upper chest for the patient positioned in high Fowler position.
B) Turn the patient to the side to check; the patient must be kept flat in the bed.
C) Lift up the neck dressing to assess for excessive bleeding.
D) Examine behind patient's neck and upper back to assess for hemorrhage.

Answer 1

Examine behind patient's neck and upper back to assess for hemorrhage.

Question 2

What is the priority nursing concern for a patient with hyperparathyroidism?

A) Potential urinary obstruction
B) Decreased cardiac output
C) Potential for injury
D) Inadequate nutrition

Answer 2

Potential urinary obstruction

Question 3

What action should a nurse implement to address dry skin in the patient with hypothyroidism?

A) Increase the frequency of bathing to get rid of dry skin.
B) Apply lotions and creams to help maintain moisture.
C) Increase activities to stimulate circulation in the skin.
D) Take antihistamines to prevent itching.

Answer 3

Apply lotions and creams to help maintain moisture.

Question 4

A patient, newly diagnosed with hypothyroidism, is anxious to begin her drug regimen.What should the nurse's instructions relative to hormone replacement include?

A) "Be certain that no dose is skipped."
B) "Be sure and take these drugs just before bedtime."
C) "Know the signs and symptoms of hyperthyroidism."
D) "You will be able to notice the benefits of thyroid replacement therapy right away."

Question 5

On returning from surgery after undergoing a thyroidectomy, a patient is alarmed about the large tracheostomy tray on the bedside table.What is the nurse's most reassuring response when the patient asks why it is there?

A) "We have it there as a precautionary measure in the unlikely event that you have difficulty breathing."
B) "If you start bleeding, we'll be able to take care of it right here at the bedside."
C) "We have to keep it there in case of an emergency and the physician needs it."
D) "It's hospital policy to have it available for persons who are likely to have respiratory arrest."

Question 6

What action should a nurse implement to initiate the Chvostek sign?

A) Ask the patient to grimace and note if the facial response is symmetrical.
B) Inflate a blood pressure cuff to the systolic level and watch for a carpopedal spasm.
C) Tap the face over the facial nerve and watch for a spasm of the facial muscle.
D) Check the pupillary response to light and determine whether the pupil accommodates and reacts.

Question 7

A physician ordered T₃ and T₄ tests for a young woman complaining of fatigue, weight gain, muscle aches and pains, and constipation.Which laboratory test results will help confirm the diagnosis of hypothyroidism?

A) Both tests show decreases.
B) Both tests show increases.
C) The T₃ test elevates, and the T₄ test decreases.
D) The level of thyroxin rises and then falls back to subnormal levels.

Question 8

What should a nurse caring for a patient with hyperthyroidism include when developing a plan of care? (Select all that apply.)

A) Decreasing weight
B) Provision of a cool environment
C) Eye care
D) Nutritional support
E) Prevention of diarrhea

Question 9

Why are antithyroid medications provided presurgically to a patient with hyperthyroidism? (Select all that apply.)

A) To decrease the level of hormone in the blood before surgery
B) To help reduce the risk of hemorrhage during surgery
C) To decrease the threat of a thyroid storm
D) To reduce exophthalmia
E) To increase weight

Question 10

A patient with exophthalmos is distressed about her appearance and asks when it will go away.What is the best response by the nurse?

A) It is not reversible.
B) It can be disguised with sunglasses and makeup.
C) It usually subsides after medication for hyperthyroidism is started.
D) It can be minimized with plastic surgery to the eyelids.

Question 11

A 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 the patient feels warm to the touch.The patient says that she feels frightened.What is the best initial implementation by the nurse?

A) Tell her that there is nothing to be afraid of and stay to calm her.
B) Ask her if she would like pain medication.
C) Call the charge nurse; these are signs of a thyroid storm.
D) Get a tracheostomy set at the bedside.

Question 12

What is the nurse aware is happening when the patient with hypoparathyroidism complains of fatigue and a lack of energy?

A) Hypertension is the cause of the fatigue.
B) Hypocalcemia has caused decreased cardiac output.
C) Dyspnea has sapped the patient's energy.
D) Poor muscle tone makes any activity tiring.

Question 13

What patient recommendation should a nurse include when preparing to present presurgical teaching of a patient scheduled for a subtotal thyroidectomy?

A) Lie flat on her back for 24 hours to prevent undue strain on the suture line.
B) Be able to verbalize the signs and symptoms of thyroid crisis.
C) Demonstrate how to deep breathe and support her head during position changes.
D) Have a tube in her trachea to assist in breathing.

Question 14

What symptoms should a nurse anticipate in the history of a patient with hyperparathyroidism?

A) Fatigue, hyperactive reflexes, muscle cramps, and twitching
B) Poor muscle tone, bone pain, urinary calculi, and fractures
C) Hunger, thirst, and urinary retention
D) Tachycardia, air hunger, and nervousness

Question 15

Which intervention is necessary to assist a patient with hypothyroidism to understand how he can live a full and normal life?

A) Teach the importance of taking antithyroid medication until it is no longer needed.
B) Encourage exercise to burn extra calories and maintain a normal weight.
C) Teach him to take care of energy needs through adequate nutrition.
D) Encourage treatment with thyroid replacement therapy.

Question 16

How do foods such as soybeans, turnips, and rutabagas affect people with thyroid disorders?

A) Suppress thyroid hormone.
B) Decrease the hypothermia of the person with hypothyroidism.
C) Supplement the diet of a person with hypothyroidism.
D) Counteract the effect of iodide therapy.

Question 17

What is the most appropriate nursing concern for the patient recently diagnosed with hyperthyroidism?

A) Hypothermia
B) Constipation
C) Disturbed body image
D) Disturbed sleep pattern

Question 18

A 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.What should the nurse recognize this movement as an indication of?

A) Hyperkalemia, called the Allen sign
B) Hypernatremia, called the Hogan sign
C) Hypocalcemia, called the Trousseau sign
D) Hypokalemia, called the Chvostek sign

Question 19

A patient with a hyperthyroid complains of fatigue but still cannot get to sleep.What is the best suggestion by the nurse?

A) Taking "cat naps" during the day
B) Adhering to a bedtime ritual
C) Drinking a cup of cocoa before bedtime
D) Performing mild prebedtime exercises

Question 20

A nurse is explaining Graves disease to a newly diagnosed patient.Which statement by the nurse best clarifies the pathophysiologic changes of Graves disease?

A) "Your thyroid gland is not producing enough hormones; consequently, you will need replacement therapy."
B) "Your thyroid gland is overactive, but there are ways to treat it through medicine or surgery."
C) "It's an autoimmune disorder that has no satisfactory treatment."
D) "Graves disease is a temporary disorder that will gradually subside."

Question 21

To meet the nutritional needs of a patient with Graves disease, the nurse recommends a diet of 4,000 to ______ calories.(Use numeric characters only, no punctuation.)

Question 22

Congenital hypothyroidism, if left untreated, will result in ______.