Deck 66: Care of Patients With Problems of the Thyroid and Parathyroid Glands

Question 1

A client has been diagnosed with hypothyroidism.Which medication is the nurse prepared to administer to treat the client's bradycardia?

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

Answer 1

Levothyroxine sodium (Synthroid)

Question 2

Twelve hours after a total thyroidectomy,the client develops stridor.Which is the nurse's priority intervention?

A) Reassure the client that the voice change is temporary.
B) Document the finding and assess the client hourly.
C) Hyperextend the client's neck and apply oxygen.
D) Prepare for emergency tracheostomy and call the health care provider.

Answer 2

Prepare for emergency tracheostomy and call the health care provider.

Question 3

Which dietary modification does the nurse provide for a client with hyperthyroidism?

A) Decreased calories and proteins and increased carbohydrates
B) Elimination of carbohydrates and increased proteins and fats
C) Increased calories, proteins, and carbohydrates
D) Supplemental vitamins and reduction of calories

Answer 3

Increased calories, proteins, and carbohydrates

Question 4

Which is the best instruction for the nurse to give a client scheduled for a thyroid scan?

A) "You will have external beam radiation."
B) "No radiation is used for this scan."
C) "No special radiation precautions are needed."
D) "Your thyroid will be radioactive for weeks."

Question 5

A client has hypothyroidism and has been started on levothyroxine (Synthroid).Which assessment finding leads the nurse to conclude that the treatment is effective?

A) Thirst is recognized and the client drinks fluids appropriately.
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 6

A client has hypothyroidism.Which problem does the nurse address as a priority for this client?

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

Question 7

A client has undergone a complete thyroidectomy.Which statement by the client indicates that further instruction is needed?

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 life."
D) "I can receive pain medication if I feel that I need it."

Question 8

A client has diabetes mellitus.Her daughter has recently been diagnosed with Graves' disease.The client asks the nurse if she is responsible for the fact that her daughter has Graves' disease.Which is the best response of the nurse?

A) "No connection is known between Graves' disease and diabetes, so you can be certain that the fact that you have diabetes did not cause your daughter to have Graves' disease."
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."
D) "Unfortunately, Graves' disease is associated with diabetes, and your diabetes could have led to your daughter having Graves' disease."

Question 9

The client is receiving methimazole (Tapazole).Which statement by the client indicates good understanding of teaching regarding this medication?

A) "If I become pregnant, I need to notify my health care provider immediately."
B) "Liver problems can occur with this drug so I need to report jaundice."
C) "I will take my pulse daily, and if it is too fast, I will call my provider."
D) "This medication may cause dyspnea or vertigo. I will be careful with activity."

Question 10

A client has hyperparathyroidism.Which intervention is the priority for the nurse to add to the client's plan of care?

A) Instruct the client to place both hands behind the neck when moving.
B) Use a lift sheet to assist the client with position changes.
C) Instruct the client to use a soft-bristled toothbrush.
D) Strain all urine for at least 24 hours and send stones to the laboratory.

Question 11

A client scheduled for a partial thyroidectomy asks the nurse why she is being given an iodine preparation before surgery.Which is the nurse's best response?

A) "Iodine will help make the internal surgical environment sterile."
B) "It is given to stimulate the storage of excess thyroid hormones."
C) "This will replace the hormones you will lose after your operation."
D) "It will prevent excessive bleeding during surgery."

Question 12

A client with hypothyroidism as a result of Hashimoto's thyroiditis asks the nurse how long she will have to take thyroid medication.Which is the nurse's best response?

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 13

A client being treated for hypothyroidism has been admitted for pneumonia.Which activity does the nurse include as a priority in this client's care plan?

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

Question 14

The nurse is assessing a client with Graves' disease and finds that the client's temperature has risen 1° F.Before notifying the health care provider,which action by the nurse takes priority?

A) Turn the lights down in the client's room and shut the 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 15

When taking the blood pressure of a client after a parathyroidectomy,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 potassium, 5.8 mEq/L
C) Serum sodium, 122 mEq/L
D) Serum calcium, 6.9 mg/dL

Question 16

On the second postoperative day after a subtotal thyroidectomy,the client tells the nurse that he feels numbness and tingling around his mouth.Which is the nurse's priority intervention?

A) Offer mouth care.
B) Loosen the dressing.
C) Assess Chvostek's sign.
D) Assess the client hourly.

Question 17

Which client statement alerts 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 10 or 12 hours of sleep."

Question 18

The nurse is reviewing client medical histories.Which client is at greatest risk for hyperparathyroidism?

A) Client with pregnancy-induced hypertension
B) Client receiving dialysis for end-stage kidney disease
C) Older adult client with moderate heart failure
D) Older adult client on home oxygen therapy

Question 19

A client presents with elevations in triiodothyronine (T₃)and thyroxine (T₄)and with normal thyroid-stimulating hormone (TSH)levels.Which is the nurse's priority intervention?

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

Question 20

A client with hyperthyroidism is taking lithium carbonate.Which finding indicates that the client is having side effects of this therapy?

A) Blurred vision
B) Increased thirst and urination
C) Increased sweating and diarrhea
D) Decreased attention span and insomnia

Question 21

A client has been admitted with hypoparathyroidism.The client's serum laboratory values are as follows: calcium,7.2 mg/dL; sodium,144 mEq/L; magnesium,1.2 mEq/L; potassium,5.7 mEq/L.Which medications does the nurse anticipate administering?

A) Potassium chloride orally
B) Calcium chloride IV
C) 3% NS IV solution
D) 50% magnesium sulfate
E) Calcitriol (Rocaltrol) orally