Question 1

The nurse is caring for a patient with elevated serum thyroid hormones and new-onset proptosis. Which problem would be a priority for this patient?

Accepted Answer

The patient's symptoms suggest hyperthyroidism, possibly Graves' disease, which can cause proptosis (bulging eyes) and significantly alter appearance. This can be distressing and impact psychological well-being, making it a priority.

Question 2

The nurse is describing the manifestations of myxedema coma to a patient with hypothyroidism. What should the nurse identify as precipitating factors for this health problem?

Accepted Answer

Myxedema coma can be precipitated by factors such as infections (like pneumonia) and stressors (like gastrointestinal bleeding) in patients with hypothyroidism.

Question 3

A patient whose thyroid gland produces an insufficient amount of thyroid hormone is concerned about an elevated cholesterol level. What should the nurse explain to this patient?

Accepted Answer

The thyroid gland is responsible for producing thyroid hormone, which plays a role in regulating cholesterol metabolism. When the thyroid gland is not functioning properly, as in the case of a patient with an insufficient amount of thyroid hormone, cholesterol levels can become elevated.

Question 4

The nurse is reviewing orders for a patient in myxedema coma. Which orders should the nurse question before administering to this patient?

Accepted Answer

The answer of The nurse is reviewing orders for a...

Question 5

A patient taking steroids for an autoimmune disorder asks when the weight loss in the legs is going to stop. What should the nurse realize the patient is experiencing?

Accepted Answer

Steroids can cause muscle wasting, particularly in the legs, which can result in weight loss. This is a common side effect of long-term steroid use. The nurse should explain this to the patient and recommend appropriate exercises or physical therapy to help maintain muscle strength.

Question 6

A 35-year-old female patient taking oral contraceptives is prescribed steroid therapy. What is a priority teaching point for this patient?

Accepted Answer

Oral contraceptives can decrease the effectiveness of steroid therapy, so it is important for the patient to consider adding another form of contraception while using both medications. This will help avoid unplanned pregnancy while taking steroids.

Question 7

The nurse is caring for a patient with elevated serum T3 and T4 levels who receives a new prescription for methimazole (Tapazole). Which patient statement indicates that additional teaching is needed about this medication?

Accepted Answer

Methimazole is used to treat hyperthyroidism by inhibiting thyroid hormone production. Therefore, it decreases the metabolism. Patient statement A indicates a misunderstanding of the medication's action and requires further teaching.

Question 8

The nurse is assessing a female patient who has an abnormally high level of parathyroid hormone. Which assessment findings would be consistent with this diagnosis?

Accepted Answer

Parathyroid hormone regulates calcium and phosphate metabolism. An abnormally high level of parathyroid hormone can lead to hyperparathyroidism, which can cause muscle atrophy and weakness.

Question 9

While assessing a patient with an alteration in thyroid function, the nurse notes smooth, fine hair and warm, dry skin. Which question should the nurse ask this patient?

Accepted Answer

Smooth, fine hair and warm, dry skin are common symptoms of hyperthyroidism, which is associated with weight loss. Therefore, asking if the patient has experienced any recent weight loss would be the most appropriate question to gather further information about their thyroid function.

Question 10

The nurse is reviewing postoperative care for a patient scheduled for a thyroidectomy. What information should the nurse include in this teaching?

Accepted Answer

Patients who undergo a thyroidectomy should avoid the use of iodized salt, as it can impact the production of thyroid hormones.

Question 11

The nurse is reviewing the relationship between thyroid hormone and iodine with a group of nursing students. The nurse knows further teaching is required when a student states that patients may experience iodine deficiency and hypothyroidism if they:

Accepted Answer

Eating large amounts of shellfish is actually a source of iodine, not a cause of iodine deficiency and hypothyroidism.

Question 12

A patient comes into the emergency department with manifestations of Addisonian crisis. What should the nurse expect to provide to this patient?

Accepted Answer

Intravenous fluids are important to support blood pressure and address dehydration in patients experiencing Addisonian crisis. Warm blankets and thyroid replacement hormone are not specifically needed for this condition, and blood transfusions may only be necessary in severe cases with significant blood loss.

Question 13

The nurse is reviewing the laboratory results for a group of patients. Which set of results should the nurse identify as being consistent with primary hypothyroidism?

Accepted Answer

Primary hypothyroidism is characterized by elevated thyroid-stimulating hormone (TSH) levels and depressed levels of both triiodothyronine (T3) and thyroxine (T4). Elevated T3 and T4 levels are seen in hyperthyroidism, while depressed TSH, elevated T3, and T4 levels are indicative of secondary hyperthyroidism, and depressed levels of all three hormones are seen in tertiary hypothyroidism.

Question 14

A patient with an adrenal gland alteration does not understand why his skin is tanning when he does not spend any time outdoors in the sun. What should the nurse do to address the patient's concern?

Accepted Answer

Tanning of the skin without exposure to sunlight can be a symptom of excess glucocorticoids produced by the adrenal glands. Steroids are commonly prescribed for various medical conditions and can cause adrenal gland alterations. The nurse should ask if the patient is still taking prescribed steroids.

Question 15

The family of an older patient with hypothyroidism is concerned about the open wounds on the patient's legs and arms. How should the nurse respond to the family's questions about bathing?

Accepted Answer

The nurse should recommend using warm water to bathe the patient to help prevent further skin irritation or damage. Daily bathing may not be necessary and could potentially further dry out the patient's already compromised skin. Using firm, consistent strokes or using rubbing alcohol can also further irritate the skin and should not be recommended.

Question 16

A patient with Cushing syndrome is concerned about having a head cold every few weeks. What should the nurse do to address this patient's concern?

Accepted Answer

Cushing syndrome can cause immunosuppression, leading to frequent infections. Assessing the patient's protein and vitamin intake can help determine if they are meeting their nutritional needs to support their immune system. Planning for frequent rest periods, encouraging daily weights, and reviewing coping strategies may also be appropriate interventions but are not directly related to addressing the patient's concern about frequent head colds.

Question 17

The nurse is providing care to a patient recovering from a bilateral adrenalectomy. What should the nurse do to assess for the onset of adrenal insufficiency?

Accepted Answer

Monitoring strict intake and output is crucial for assessing the onset of adrenal insufficiency in a patient recovering from a bilateral adrenalectomy because it helps in evaluating the balance between fluid intake and output, which can be affected by changes in adrenal function.

Question 18

The nurse is providing preoperative teaching to a patient scheduled for a subtotal thyroidectomy. What should the nurse include in these instructions?

Accepted Answer

Reporting sensations of tingling in toes, fingers, or lips can be a sign of hypocalcemia, which can occur after a subtotal thyroidectomy due to damage or removal of the parathyroid glands. It is important to monitor for this and report any symptoms to the healthcare provider.

Answer: B
 While constipation is a possible side effect of surgery, it is not specific to a subtotal thyroidectomy and is not a priority for the preoperative teaching for this procedure.

Answer: C
 While improvement in hoarseness may occur after the surgery, this is not a priority for preoperative teaching.

Answer: D
 Taking aspirin before surgery can interfere with blood clotting and is not recommended. In fact, patients should be instructed to avoid any medication that can affect blood clotting before surgery, unless specifically instructed to do so by their healthcare provider.

Question 19

The nurse is caring for a patient with untreated hypothyroidism. For which health problems should the nurse assess this patient?

Accepted Answer

Hypothyroidism can cause elevated serum cholesterol and anemia.

Question 20

The nurse is providing care to a patient with a low level of serum parathyroid hormone. What should the nurse expect to assess in this patient?

Accepted Answer

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

Quiz 19: Nursing Care of Patients With Endocrine Disorders