Question 1

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

Accepted Answer

After a thyroidectomy, bleeding can pool behind the neck and upper back, so it's important to check these areas for signs of hemorrhage.

Question 2

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

Accepted Answer

Hyperparathyroidism can lead to the formation of kidney stones, which may obstruct the urinary tract. Therefore, potential urinary obstruction is a priority concern for these patients. Decreased cardiac output, potential for injury, and inadequate nutrition may be issues for some patients with hyperparathyroidism, but they are not the priority concern.

Question 3

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

Accepted Answer

Applying lotions and creams can help maintain moisture in the skin, which is important for patients with hypothyroidism who may experience dry skin as a symptom of their condition. Increasing the frequency of bathing can actually strip the skin of natural oils and exacerbate dryness. Increasing activities to stimulate circulation in the skin may not have a significant impact on dryness, and taking antihistamines is not necessary unless the patient is experiencing itching as a result of their dry skin.

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?

Accepted Answer

The nurse should instruct the patient to know the signs and symptoms of hyperthyroidism because overtreatment with thyroid hormone can lead to hyperthyroidism.

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?

Accepted Answer

Option A is the most appropriate answer because it provides a reassuring explanation for the presence of the tracheostomy tray while also addressing the patient's concerns about potential breathing difficulties. It acknowledges the possibility of complications, but emphasizes that the tray is there as a safety measure rather than because of an imminent danger. The other options (B, C, and D) could potentially increase the patient's anxiety and are not as helpful in addressing the patient's concerns.

Question 6

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

Accepted Answer

To initiate the Chvostek sign, the nurse should tap the patient's face over the facial nerve and watch for a spasm of the facial muscle. This sign can indicate hypocalcemia or nerve irritability. Grimacing or checking pupillary response are not related to the Chvostek sign, and inflating a blood pressure cuff to the systolic level is a test for Trousseau's sign.

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?

Accepted Answer

Hypothyroidism is characterized by decreased levels of thyroid hormones, which would be reflected in decreased test results for thyroid function tests such as TSH (thyroid-stimulating hormone) and T4 (thyroxine).

Question 8

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

Accepted Answer

Patients with hyperthyroidism often experience heat intolerance, so a cool environment is beneficial. Eye care is important due to potential exophthalmos. Nutritional support is needed due to increased metabolism, and preventing diarrhea is crucial as it is a common symptom. Decreasing weight is not a goal, as patients often experience weight loss.

Question 9

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

Accepted Answer

The answer of Why are antithyroid medications provided presurgically to...

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?

Accepted Answer

Exophthalmos is a common symptom of hyperthyroidism, and when the underlying disease is treated, exophthalmos usually subsides. While it may take several months, medications and/or radiation therapy are successful in reducing protrusion of the eyes in approximately 90% of cases.

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?

Accepted Answer

The symptoms described indicate a thyroid storm, which is a life-threatening complication of a subtotal thyroidectomy. The charge nurse should be immediately notified to initiate emergency measures to stabilize the patient.

Question 12

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

Accepted Answer

Hypoparathyroidism can lead to hypocalcemia, which can cause decreased cardiac output and lead to fatigue and a lack of energy. None of the other options listed are directly related to hypoparathyroidism.

Question 13

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

Accepted Answer

The nurse should teach the patient how to deep breathe and support her head during position changes to prevent strain on the neck and suture line after a subtotal thyroidectomy.

Question 14

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

Accepted Answer

Hyperparathyroidism is a condition in which the parathyroid glands produce too much parathyroid hormone (PTH), which leads to increased calcium levels in the blood. The symptoms that a nurse should anticipate in the history of a patient with hyperparathyroidism may include poor muscle tone, bone pain, urinary calculi (stones), and fractures, as high levels of calcium can weaken bones and cause kidney stones. Other symptoms may include fatigue, weakness, depression, memory loss, and constipation, among others. However, poor muscle tone, bone pain, urinary calculi, and fractures are specific to hyperparathyroidism and should be anticipated when taking a patient's history.

Question 15

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

Accepted Answer

The most effective intervention to help a patient with hypothyroidism to live a full and normal life is to encourage treatment with thyroid replacement therapy. This treatment provides synthetic thyroid hormones that the patient's body needs to function normally. In addition to medication, it is also important to teach the patient to take care of their energy needs through adequate nutrition, as hypothyroidism can cause weight gain and fatigue. Encouraging exercise and promoting a healthy weight is also beneficial, but it is not the most important intervention for treating hypothyroidism. Antithyroid medication is used to treat hyperthyroidism, not hypothyroidism.

Question 16

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

Accepted Answer

These foods contain goitrogens, which can interfere with thyroid hormone production, potentially suppressing thyroid function.

Question 17

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

Accepted Answer

Disturbed sleep pattern is the most appropriate nursing concern for the patient with hyperthyroidism as excess thyroid hormone can cause anxiety, tremors, and restlessness which can lead to disturbed sleep patterns. Hypothermia and constipation are not typical symptoms of hyperthyroidism. While disturbed body image may be a concern for some patients, it is not the most appropriate nursing concern for a patient recently diagnosed with hyperthyroidism.

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?

Accepted Answer

The carpopedal spasm or Trousseau’s sign is a classic sign of hypocalcemia, which is often seen in patients who have undergone thyroidectomy. It is characterized by spontaneous carpopedal spasm, numbness or tingling of the lips, fingers, and toes, and facial twitching.

Question 19

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

Accepted Answer

Adhering to a bedtime ritual can help establish a routine that signals the body it's time to sleep, which can be particularly beneficial for someone with hyperthyroidism experiencing sleep disturbances.

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?

Accepted Answer

Graves disease is an autoimmune disorder that results in the overproduction of thyroid hormones, leading to hyperthyroidism. Therefore, correcting thyroid hormone levels is not the main issue. Instead, the focus is on treating the underlying cause, such as through medication or surgery. Option B best explains this concept. Options A, C, and D are incorrect or incomplete.

Quiz 49: Thyroid and Parathyroid Disorders