Question 1

Which clinical symptoms would the nurse observe in a patient with thyrotoxicosis? (Select all that apply.)&#10;A) Decreased metabolic rate&#10;B) Decreased heart rate&#10;C) Decreased body temperature&#10;D) Muscle tremors&#10;E) Restlessness&#10;F) Anxiety&#10;G) Sweating

Accepted Answer

Thyrotoxicosis is caused by an excessive level of circulating thyroid hormone. Therefore, the clinical symptoms that a nurse would observe in a patient with thyrotoxicosis include muscle tremors (due to increased muscle activity), restlessness, anxiety, and sweating (due to increased sympathetic nervous system activity). The metabolic rate increases, not decreases, in thyrotoxicosis, leading to weight loss despite increased appetite. The heart rate increases, not decreases, and body temperature may also increase due to increased metabolism.

Question 2

Which clinical manifestations would the nurse assess in a patient with hypothyroidism? (Select all that apply.)&#10;A) Cold intolerance, weight gain&#10;B) Nervousness, agitation&#10;C) Increased susceptibility to infection&#10;D) Exophthalmos, fatigue&#10;E) Hypoactive reflexes

Accepted Answer

Cold intolerance, weight gain&#10;Increased susceptibility to infection&#10;Hypoactive reflexes

Question 3

A patient with myxedema complains to the nurse that he has a &#34;hangover&#34; the next morning after taking a pain medication at night. Which explanation by the nurse is the most accurate?&#10;A) &#34;You have increased sensitivity to the medicine because of your thyroid condition.&#34;&#10;B) &#34;Because you haven't been sleeping, you have increased fatigue and should increase the analgesic.&#34;&#10;C) &#34;You are not taking enough thyroid medication and you should increase the dosage.&#34;&#10;D) &#34;The pain medication is incompatible with your thyroid medication and you should find another analgesic to take.&#34;

Accepted Answer

Myxedema is a severe form of hypothyroidism and can lead to decreased metabolism and sensitivity to certain medications. This may explain why the patient is experiencing a "hangover" effect the next morning after taking the pain medication at night. Increasing the dosage of the pain medication or changing to a different analgesic may not be necessary if the patient is properly managing their thyroid condition.

Question 4

Which condition can occur if congenital hypothyroidism is not treated?&#10;A) Diabetes&#10;B) Impaired vision&#10;C) Periorbital edema&#10;D) Cretinism

Accepted Answer

Congenital hypothyroidism can lead to cretinism, a condition in which growth and mental development are severely stunted. If left untreated, it can lead to permanent intellectual disability and physical deformities. A, B, and C are not directly related to congenital hypothyroidism.

Question 5

A patient with a history of heart failure has been diagnosed with hypothyroidism. The drug interaction with glycosides and thyroid replacement therapy will most likely require which change in therapy?&#10;A) Decrease in the daily digoxin dosage&#10;B) Gradual increase in the daily glycoside dosage&#10;C) Not able to begin thyroid replacement therapy because of the underlying heart condition&#10;D) Increased thyroid replacement dosage

Accepted Answer

Hypothyroidism can decrease the sensitivity of the heart to digoxin, so when thyroid replacement therapy is initiated, the metabolism and sensitivity to digoxin may increase, necessitating a gradual increase in the glycoside dosage to maintain therapeutic effects.

Question 6

Which medication is used to treat hyperthyroidism?&#10;A) Levothyroxine (Synthroid)&#10;B) Liotrix (Thyrolar)&#10;C) Propylthiouracil (Propacil)&#10;D) Liothyronine (Cytomel)

Accepted Answer

Propylthiouracil (Propacil) is a medication commonly used to treat hyperthyroidism by blocking the thyroid gland's ability to produce excessive amounts of thyroid hormone. Levothyroxine (Synthroid), Liotrix (Thyrolar), and Liothyronine (Cytomel) are medications used to treat hypothyroidism, not hyperthyroidism.

Question 7

Which nursing diagnosis may be identified for a patient with hyperthyroidism?&#10;A) Imbalanced Nutrition: More Than Body Requirements&#10;B) Constipation&#10;C) Disturbed Sleep Pattern&#10;D) Ineffective Airway Clearance

Accepted Answer

Hyperthyroidism often causes symptoms such as increased metabolism and restlessness, which can lead to disturbed sleep patterns.

Question 8

Which patient would be a candidate for radioactive iodine therapy?&#10;A) 17-year-old woman with Graves' disease&#10;B) 64-year-old woman with hypothyroidism&#10;C) 46-year-old man with heart disease and thyroid cancer&#10;D) 82-year-old man with myxedema crisis

Accepted Answer

The answer of Which patient would be a candidate for...

Question 9

A postoperative total thyroidectomy patient is started on levothyroxine (Synthroid) daily. Which information will the nurse include in discharge teaching? (Select all that apply.)&#10;A) &#34;Close follow-up with your health care provider is important.&#34;&#10;B) &#34;Notify your health care provider if you experience any palpitations or tachycardia.&#34;&#10;C) &#34;A variation in emotions and personality is normal during this adjustment period.&#34;&#10;D) &#34;Synthroid may be stopped as soon as the thyroid gland resumes functioning.&#34;&#10;E) &#34;When energy levels have returned, Synthroid will be gradually tapered.&#34;

Accepted Answer

Patients who have undergone total thyroidectomy require lifelong thyroid hormone replacement therapy with levothyroxine (Synthroid). Therefore, close follow-up with a healthcare provider is important to ensure an appropriate dose is maintained. Palpitations or tachycardia may indicate an overactive thyroid, so the patient should notify their provider if they experience these symptoms. A variation in emotions and personality can occur as the patient adjusts to their new medication, so the nurse should provide education on this to prevent patient anxiety. Synthroid should not be stopped unless advised by a healthcare provider, and it should not be tapered unless the patient's thyroid levels have stabilized and require a dose adjustment.

Question 10

Which is characteristic of antithyroid drugs that act on the thyroid gland? (Select all that apply.) A) They are a physiologic hormone replacement. B) They block synthesis of T₃ and T₄ in the thyroid gland. C) They destroy T₃ and T₄. D) Immediate improvement is observed. E) They may be used before subtotal thyroidectomy.

Accepted Answer

Antithyroid drugs that act on the thyroid gland block the synthesis of thyroid hormones T₃ and T₄ in the thyroid gland. They may also be used before subtotal thyroidectomy to reduce thyroid hormone levels prior to surgery. They are not a physiologic hormone replacement and do not immediately improve symptoms. They do not destroy thyroid hormones in the thyroid gland.

Question 11

What is the mechanism of action of propylthiouracil?&#10;A) Blocks reuptake of thyroid hormone in the liver&#10;B) Destroys hormone in the thyroid gland&#10;C) Increases synthesis of hormone in the thyroid gland&#10;D) Blocks synthesis of hormone in the thyroid gland

Accepted Answer

The answer of What is the mechanism of action of...

Question 12

A patient recently completed radiation treatment for throat cancer and presents to the health care provider's office with symptoms indicating possible hypothyroidism. Which symptoms would most likely be exhibited and/or reported? (Select all that apply.)

A) Inability to sleep
B) Weight gain
C) Lethargy
D) Nervousness
E) Cold intolerance

Accepted Answer

The answer of A patient recently completed radiation treatment for...

Question 13

Which medication is used in the treatment of hypothyroidism?&#10;A) Levothyroxine (Synthroid)&#10;B) Radioactive iodine&#10;C) Propylthiouracil (Propacil)&#10;D) Methimazole (Tapazole)

Accepted Answer

The answer of Which medication is used in the treatment...

Question 14

The nurse is providing instruction to a patient recently prescribed a radioactive iodine isotope. Which is the correct action of this medication? A) Stimulates the synthesis of T₃ and T₄ hormones B) Increases the storage of thyroxine before thyroid surgery C) Destroys hyperactive thyroid tissue D) Replaces deficient thyroid hormone

Accepted Answer

The answer of The nurse is providing instruction to a...

Deck 37: Drugs Used to Treat Thyroid Disease