Deck 63: Care of Patients with Problems of the Thyroid and Parathyroid Glands

Question 1

A nurse evaluates the following laboratory results for a client who has hypoparathyroidism:

Based on these results,which medications should the nurse anticipate administering? (Select all that apply.)

A) Oral potassium chloride
B) Intravenous calcium chloride
C) 3% normal saline IV solution
D) 50% magnesium sulfate
E) Oral calcitriol (Rocaltrol)

Answer 1

Intravenous calcium chloride
50% magnesium sulfate

Question 2

A nurse assesses clients for potential endocrine disorders.Which client is at greatest risk for hyperparathyroidism?

A) A 29-year-old female with pregnancy-induced hypertension
B) A 41-year-old male receiving dialysis for end-stage kidney disease
C) A 66-year-old female with moderate heart failure
D) A 72-year-old male who is prescribed home oxygen therapy

Answer 2

A 41-year-old male receiving dialysis for end-stage kidney disease

Question 3

A nurse assesses a client who is recovering from a total thyroidectomy and notes the development of stridor.Which action should the nurse take first?

A) Reassure the client that the voice change is temporary.
B) Document the finding and assess the client hourly.
C) Place the client in high-Fowler's position and apply oxygen.
D) Contact the provider and prepare for intubation.

Answer 3

Contact the provider and prepare for intubation.

Question 4

A nurse assesses a client who is recovering from a subtotal thyroidectomy.On the second postoperative day the client states,"I feel numbness and tingling around my mouth." What action should the nurse take?

A) Offer mouth care.
B) Loosen the dressing.
C) Assess for Chvostek's sign.
D) Ask the client orientation questions.

Question 5

A nurse cares for a client who has hypothyroidism as a result of Hashimoto's thyroiditis.The client asks,"How long will I need to take this thyroid medication?" How should the nurse respond?

A) "You will need to take the thyroid medication until the goiter is completely gone."
B) "Thyroiditis is cured with antibiotics.Then you won't need thyroid medication."
C) "You'll need thyroid pills for life because your thyroid won't start working again."
D) "When blood tests indicate normal thyroid function, you can stop the medication."

Question 6

A nurse assesses a client with hyperthyroidism who is prescribed lithium carbonate.Which assessment finding should alert the nurse to a side effect of this therapy?

A) Blurred and double vision
B) Increased thirst and urination
C) Profuse nausea and diarrhea
D) Decreased attention and insomnia

Question 7

A nurse assesses a client who is prescribed levothyroxine (Synthroid)for hypothyroidism.Which assessment finding should alert the nurse that the medication therapy is effective?

A) Thirst is recognized and fluid intake is appropriate.
B) Weight has been the same for 3 weeks.
C) Total white blood cell count is 6000 cells/mm³.
D) Heart rate is 70 beats/min and regular.

Question 8

While assessing a client with Graves' disease,the nurse notes that the client's temperature has risen 1° F.Which action should the nurse take first?

A) Turn the lights down and shut the client's door.
B) Call for an immediate electrocardiogram (ECG).
C) Calculate the client's apical-radial pulse deficit.
D) Administer a dose of acetaminophen (Tylenol).

Question 9

A nurse teaches a client who is prescribed an unsealed radioactive isotope.Which statements should the nurse include in this client's education? (Select all that apply.)

A) "Do not share utensils, plates, and cups with anyone else."
B) "You can play with your grandchildren for 1 hour each day."
C) "Eat foods high in vitamins such as apples, pears, and oranges."
D) "Wash your clothing separate from others in the household."
E) "Take a laxative 2 days after therapy to excrete the radiation."

Question 10

A nurse cares for a client newly diagnosed with Graves' disease.The client's mother asks,"I have diabetes mellitus.Am I responsible for my daughter's disease?" How should the nurse respond?

A) "The fact that you have diabetes did not cause your daughter to have Graves' disease.No connection is known between Graves' disease and diabetes."
B) "An association has been noted between Graves' disease and diabetes, but the fact that you have diabetes did not cause your daughter to have Graves' disease."
C) "Graves' disease is associated with autoimmune diseases such as rheumatoid arthritis, but not with a disease such as diabetes mellitus."
D) "Unfortunately, Graves' disease is associated with diabetes, and your diabetes could have led to your daughter having Graves' disease."

Question 11

A nurse cares for a client who is recovering from a parathyroidectomy.When taking the client's blood pressure,the nurse notes that the client's hand has gone into flexion contractions.Which laboratory result does the nurse correlate with this condition?

A) Serum potassium: 2.9 mEq/L
B) Serum magnesium: 1.7 mEq/L
C) Serum sodium: 122 mEq/L
D) Serum calcium: 6.9 mg/dL

Question 12

A nurse assesses a client with hypothyroidism who is admitted with acute appendicitis.The nurse notes that the client's level of consciousness has decreased.Which actions should the nurse take? (Select all that apply.)

A) Infuse intravenous fluids.
B) Cover the client with warm blankets.
C) Monitor blood pressure every 4 hours.
D) Maintain a patent airway.
E) Administer oral glucose as prescribed.

Question 13

A nurse teaches a client with hyperthyroidism.Which dietary modifications should the nurse include in this client's teaching? (Select all that apply.)

A) Increased carbohydrates
B) Decreased fats
C) Increased calorie intake
D) Supplemental vitamins
E) Increased proteins

Question 14

A nurse cares for a client who presents with bradycardia secondary to hypothyroidism.Which medication should the nurse anticipate being prescribed to the client?

A) Atropine sulfate
B) Levothyroxine sodium (Synthroid)
C) Propranolol (Inderal)
D) Epinephrine (Adrenalin)

Question 15

A nurse plans care for a client with hypothyroidism.Which priority problem should the nurse plan to address first for this client?

A) Heat intolerance
B) Body image problems
C) Depression and withdrawal
D) Obesity and water retention

Question 16

A nurse plans care for a client who has hypothyroidism and is admitted for pneumonia.Which priority intervention should the nurse include in this client's plan of care?

A) Monitor the client's intravenous site every shift.
B) Administer acetaminophen (Tylenol) for fever.
C) Ensure that working suction equipment is in the room.
D) Assess the client's vital signs every 4 hours.

Question 17

After teaching a client who is recovering from a complete thyroidectomy,the nurse assesses the client's understanding.Which statement made by the client indicates a need for additional instruction?

A) "I may need calcium replacement after surgery."
B) "After surgery, I won't need to take thyroid medication."
C) "I'll need to take thyroid hormones for the rest of my life."
D) "I can receive pain medication if I feel that I need it."

Question 18

A nurse assesses a client on the medical-surgical unit.Which statement made by the client should alert the nurse to the possibility of hypothyroidism?

A) "My sister has thyroid problems."
B) "I seem to feel the heat more than other people."
C) "Food just doesn't taste good without a lot of salt."
D) "I am always tired, even with 12 hours of sleep."

Question 19

A nurse cares for a client with elevated triiodothyronine and thyroxine,and normal thyroid-stimulating hormone levels.Which actions should the nurse take? (Select all that apply.)

A) Administer levothyroxine (Synthroid).
B) Administer propranolol (Inderal).
C) Monitor the apical pulse.
D) Assess for Trousseau's sign.
E) Initiate telemetry monitoring.

Question 20

A nurse plans care for a client with hyperparathyroidism.Which intervention should the nurse include in this client's plan of care?

A) Ask the client to ambulate in the hallway twice a day.
B) Use a lift sheet to assist the client with position changes.
C) Provide the client with a soft-bristled toothbrush for oral care.
D) Instruct the unlicensed assistive personnel to strain the client's urine for stones.