Endocrine Part 2
Which is the consequence of the action of the parathyroid hormone (PTH) on the kidneys? A. Calcium excretion and phosphorus excretion B. Calcium reabsorption and phosphorus excretion C. Calcium excretion and phosphorus reabsorption D. Calcium reabsorption and phosphorus reabsorption
B
Which manifestation would the nurse expect in a patient who has hyperparathyroidism? A. Weight gain B. Presence of renal calculi C. Decreased serum gastrin D. Serum calcium less than 9 mg/dL
B
Which postoperative assessment finding in a patient who underwent a parathyroidectomy indicates potential tetany? A. Voice pattern changes B. Positive Trousseau test C. Serum calcium level of 9.5 mg/dL D. Tingling in the extremities and face
B
Which statement defines hyperplasia? A. Cellular decay B. Tissue overgrowth C. Excessive hydration D. Tingling and numbness
B
Which symptom is usually present with mild to moderate hypocalcemia? A. Seizures B. Numbness C. Incontinence D. Muscle cramps
B
Which treatment would the nurse expect to be prescribed for a patient with acute vitamin D deficiency? A. Calcium chloride B. Calcitriol C. Ergocalciferol oral D. Magnesium sulfate
B
Which information would the nurse teach an older patient about the effect of aging on thyroid hormones? Select all that apply. A. The thyroid gland increases in size. B. The basal metabolic rate decreases. C. Thyroid hormone secretion decreases. D. Body composition changes from muscular to fatty. E. Thyroid replacement will start with a high dose.
B, C, D
Which element does the parathyroid glands help keep in balance? Select all that apply. A. Iodine B. Calcium C. Sodium D. Phosphate E. Potassium F. Iron
B, D
Which patient assessment finding indicates the likely presence of hypothyroidism? Select all that apply. A. Insomnia B. Muscle aches C. Hyperactivity D. Difficulty in speech E. Intolerance to cold
B, D, E
Which factor is a cause of hyperparathyroidism? Select all that apply. A. Hypomagnesemia B. Vitamin D deficiency C. Congenital dysgenesis D. Congenital hyperplasia E. Neck trauma or radiation F. Parathyroid tumor or cancer
B, D, E, F
Which consequence results from the action of parathyroid hormone (PTH) on the bones? A. Increased osteoblastic activity B. Unaltered osteoblastic activity C. Decreased osteoblastic activity D. Decreased osteoclastic activity
C
Which factor is a cause of hyperparathyroidism? A. Sepsis B. Hypomagnesemia C. Vitamin D deficiency D. Chronic bladder disease
C
Which information would the nurse incorporate in planning care for a patient with acute thyroiditis? A. It is caused by a viral infection of the thyroid gland. B. It is triggered by a bacterial or viral infection. C. The problem usually resolves with antibiotic therapy. D. The thyroid gland feels hard and enlarged on palpation.
C
Which intervention would the nurse include in planning care for a patient with hyperthyroidism? A. Checking the patient's body weight daily B. Encouraging the patient to use artificial tears C. Monitoring the patient's body temperature D. Asking the patient about tingling around the mouth
C
Which mechanism alters serum calcium levels in the patient with hyperparathyroidism? A. Increased osteoblastic activity in the bone B. Decreased osteoclastic activity in the bone C. Increased reabsorption of calcium by the kidneys D. Increased reabsorption of phosphate by the kidneys
C
Which patient assessment finding is associated with hypoparathyroidism? A. Intolerance to heat B. Decreased attention span C. Presence of bands on the teeth D. Wide-eyed or startled appearance
C
Which recommendation would the nurse include for a patient with hypothyroidism who is being discharged home? A. Home care nursing visits B. Handrails in the bath C. Increased thermostat setting D. Strict infection-control measures
C
Which type of thyroid cancer often occurs with multiple endocrine neoplasia (MEN) type II? A. Follicular B. Papillary C. Medullary D. Anaplastic
C
Which type of thyroiditis would the nurse suspect in a patient who reports fever, chills, dysphagia, and muscle and joint pains after an upper respiratory infection? A. Acute thyroiditis B. Chronic thyroiditis C. Subacute thyroiditis D. Idiopathic thyroiditis
C
The nurse is providing emergency care to a patient experiencing thyroid storm. Which action would the nurse take? Select all that apply. A. Reduce fluid intake. B. Provide a warm blanket for comfort. C. Administer antithyroid drugs as prescribed. D. Place the patient on a continuous heart monitor. E. Assess for a patent airway and adequate ventilation.
C, D, E
Which GI problem is common when a patient has a high serum calcium level? Select all that apply. A. Obesity B. Diarrhea C. Anorexia D. Vomiting E. Constipation
C, D, E
Which cause of hypothyroidism results from a decrease in thyroid tissue? Select all that apply. A. Endemic iodine deficiency B. Congenital pituitary defects C. Cancer (thyroidal or metastatic) D. Autoimmune thyroid destruction E. Congenital poor thyroid development F. Pituitary tumors, trauma, infections, or infarcts
C, D, E
Which information is accurate regarding follicular carcinoma of the thyroid? A. It is a slow-growing tumor. B. It is a tumor that secretes calcitonin. C. It is confined to the thyroid gland. D. It occurs most often in older adults.
D
Which parathyroid disorder is associated with a total thyroidectomy? A. Hypercalcemia B. Hypomagnesemia C. Idiopathic hypoparathyroidism D. Iatrogenic hypoparathyroidism
D
Which patient assessment finding indicates a possibility of hyperthyroidism? A. Intolerance to cold B. Decreased appetite C. Heart rate of 54 beats/min D. Weight loss without dieting
D
Which patient condition would the nurse identify as increasing the risk for hypoparathyroidism? A. Hypocalcemia B. Parathyroid tumor C. Vitamin D deficiency D. Congenital dysgenesis
D
Which safety precaution is appropriate for the patient receiving an unsealed radioactive isotope? A. Stand while urinating. B. Avoid the use of laxatives. C. Flush the toilet once after each use. D. Maintain at least 3 feet of distance from women, young children, and infants.
D
Which serum calcium level puts a patient at high risk for coma? A. 8 mg/dL B. 10 mg/dL C. 12 mg/dL D. 14 mg/dL
D
Which statement describes hypoparathyroidism? A. It is a temporary condition. B. Symptoms are not present. C. There are no treatments for it. D. Glandular function is reduced.
D
patient with hyperparathyroidism is prescribed calcitonin with glucocorticoids. Which action of the drug lowers serum calcium levels? A. It prevents bone resorption. B. It lowers the levels of free calcium. C. It interferes with calcium absorption. D. It reduces the release of skeletal calcium.
D
The nurse manager for the medical-surgical unit is making staff assignments. Which patient would the nurse consider as being in the most stable condition? A. Patient with chronic hypothyroidism and dementia who takes levothyroxine daily B. Patient with follicular thyroid cancer who has vocal hoarseness and difficulty swallowing C. Patient with Graves disease who is experiencing increasing anxiety and diaphoresis D. Patient with hyperparathyroidism who has just arrived on the unit after a parathyroidectomy
A
The nurse notes that the patient's upper eyelid fails to descend when the patient slowly gazes downward. Which term does the nurse use to document this finding? A. Eyelid lag B. Globe lag C. Photophobia D. Exophthalmos
A
The primary health care provider prescribes IV phosphates to a patient with hyperparathyroidism. The patient reports tingling and numbness in the muscles after the treatment. Which change would explain the patient's symptoms? A. Sudden drop in serum calcium levels B. Sudden drop in serum magnesium levels C. Sudden drop in serum phosphorus levels D. Sudden drop in serum parathyroid hormone (PTH) levels
A
Which condition would the nurse anticipate in a patient who has undergone parathyroidectomy? A. Hypocalcemia B. Hyponatremia C. Hypercalcemia D. Hypophosphatemia
A
Which finding would the nurse expect in a patient who has thyroiditis? A. Dysphagia B. Weight gain C. Heat intolerance D. Cold intolerance
A
Which term is used for Graves disease? A. Toxic diffuse goiter B. Hypothyroidism C. Toxic multinodular goiter D. Exogenous hyperthyroidism
A
Which type of thyroid cancer is most common? A. Papillary B. Follicular C. Medullary D. Anaplastic
A
Which type of thyroid cancer is the most common in younger women? A. Papillary carcinoma B. Follicular carcinoma C. Medullary carcinoma D. Anaplastic carcinoma
A
Which radiologic finding would the nurse expect when reading the health record of a patient with hyperparathyroidism? Select all that apply. A. Bone cysts B. Renal calculi C. Osteoporosis D. Osteopetrosis E. Osteosclerosis
A, B, C
Which clinical manifestation is consistent with hyperthyroidism? Select all that apply. A. Insomnia B. Palpitations C. Low-grade fever D. Slowed respiration E. Decreased appetite F. Restlessness and irritability
A, B, C, F
Which problem commonly occurs with myxedema? Select all that apply. A. Coma B. Hypertension C. Hypothermia D. Hypoglycemia E. Hypernatremia F. Respiratory failure
A, C, D, F
A patient being treated for hyperthyroidism tells the home health nurse that his heart rate is slower than usual. Which action would the nurse take? A. Advise the patient to go to a calming environment. B. Ask whether the patient has increased cold sensitivity or weight gain. C. Instruct the patient to see his health care provider immediately. D. Tell the patient to check his pulse again and call back later.
B
A patient has undergone a total thyroidectomy. Which postoperative intervention would the nurse include in the plan of care? A. Provide supplemental oxygen to promote respiration. B. Inspect the back of the neck and the dressing for blood. C. Ask the patient to cough out any respiratory secretions. D. Monitor vital signs every 30 minutes until the patient is stable.
B
A patient recently admitted with hyperparathyroidism had a very high urine output during the previous shift. Which action would the nurse take? A. Slow the rate of IV fluids. B. Monitor intake and output. C. Notify the health care provider. D. Perform an immediate cardiac assessment.
B
A patient with hyperparathyroidism is being treated with cinacalcet. The primary health care provider recommends that the patient discontinue cinacalcet and begin furosemide. Which condition would the nurse suspect? A. Parathyroid carcinoma B. Mild hyperparathyroidism C. Severe primary hyperparathyroidism D. Severe secondary hyperparathyroidism
B
The condition of a pregnant patient with hyperthyroidism rapidly worsens and leads to thyroid storm. Which drug administration process would the nurse anticipate? A. Oral administration of Lugol solution 1 hour after methimazole B. Oral administration of Lugol solution 1 hour after propylthiouracil C. Simultaneous oral administration of Lugol solution and methimazole D. Simultaneous oral administration of Lugol solution and propylthiouracil
B
Which condition is caused by hyperparathyroidism? A. Anemia B. Hypercalcemia C. Hypernatremia D. Hyperphosphatemia
B
Which condition would the nurse suspect in a patient who reports tingling and numbness of the hands and feet? A. Severe hypokalemia B. Moderate hypocalcemia C. Severe hypophosphatemia D. Moderate hypermagnesemia
B
Which factor is a cause of hypoparathyroidism? A. Hypocalcemia B. Hypomagnesemia C. Vitamin D deficiency D. Neck trauma
B
Which factor is the most common cause of hypothyroidism in the United States? A. Intake of tyrosine B. Autoimmune disorder C. Reduced intake of iodide D. Radioactive iodine treatment
B
Which finding requires immediate attention for a patient who had a parathyroidectomy 18 hours ago? A. Sore throat B. Stridor C. Pain on moving the head D. Edema at the surgical site
B
Which finding would the nurse expect when assessing a patient with hyperthyroidism? A. Weight gain B. Increased appetite C. Increased body fat D. Decreased blood glucose
B
Which form of hypoparathyroidism is the most common? A. Idiopathic B. Iatrogenic C. Hypomagnesemia D. Hypophosphatemia
B
Which manifestation would the nurse expect to find in a patient who has hypothyroidism? Select all that apply. A. Oily hair B. Husky voice C. Thick tongue D. Pitting edema E. Mucinous edema
B, C, E
A patient admitted with hyperthyroidism is fidgeting with the bedcovers and talking very fast. Which action would the nurse take? A. Call the health care provider. B. Tell the patient to speak slowly. C. Encourage the patient to rest. D. Immediately assess cardiac status.
C
A patient diagnosed with hypothyroidism has been prescribed hormone replacement therapy. Which teaching does the nurse provide the patient about this therapy? A. Include fiber supplements in the diet. B. Take the prescribed therapy before bedtime. C. Periodic blood tests are needed to guide dosing. D. Monitor urine frequency for therapy effectiveness.
C
A nurse is assessing a patient with a goiter because of hypothyroidism. Which factor likely caused a goiter in this patient? A. Presence of nodules or benign tumors B. Presence of thyroid-stimulating immunoglobulins (TSI) C. Increase in the number and size of thyroid glandular cells D. Increased production of thyroid-stimulating hormones (TSH)
D
A patient is prescribed 50,000 units of ergocalciferol daily. Which disorder would the nurse suspect is being treated in this patient? A. Hyperthyroidism B. Hypomagnesemia C. Calcium deficiency D. Vitamin D deficiency
D
A patient who underwent a thyroid scan tested positive for multiple thyroid nodules. What percentage of radioactive iodine uptake (RAIU) by the thyroid gland would the nurse expect to be reported in the health record? A. 5% B. 15% C. 30% D. 50%
D
A patient with a history of radiation therapy to the neck has bone degeneration and an electrolyte imbalance. Which condition is the likely cause? A. Thyroid disorder B. Pituitary disorder C. Pancreatic disorder D. Parathyroid disorder
D
A patient's preliminary thyroid function test reveals a decrease in serum triiodothyronine (T3) and thyroxine (T4) hormone levels, which might indicate hypothyroidism. Which other parameter should be assessed to determine the origin of hypothyroidism as primary or secondary? A. Free T4 index B. Thyrotropin receptor antibodies (TRAb) C. Thyroid-stimulating immunoglobulins (TSI) D. Thyroid-stimulating hormone (TSH) stimulation test
D
An older patient with an elevated serum calcium level is receiving IV furosemide and an infusion of normal saline at 150 mL/hr. Which nursing action would the registered nurse (RN) delegate to assistive personnel (AP)? A. Monitor the patient for shortness of breath. B. Ask the patient about any numbness or tingling. C. Check for bone deformities in the patient's back. D. Measure the patient's intake and output hourly.
D
Which assessment finding is consistent with a grade 1 goiter? A.No bruits upon auscultation of the neck B. No visible or palpable swallowing movements C. Easily palpable and usually asymmetric thyroid enlargement D. No visible thyroid enlargement with the neck in a normal position
D
Which factor is a common cause of hyperparathyroidism? A. Hypercalcemia B. Hypomagnesaemia C. Hypophosphatemia D. Congenital hyperplasia
D
Which factor is a common cause of hypoparathyroidism? A. Neck trauma B. Hypocalcemia C. Vitamin K deficiency D. Congenital dysgenesis
D
Which factor is the cause of iatrogenic hypoparathyroidism? A. Chronic kidney disease B. Malabsorption syndromes C. Low serum magnesium levels D. Removal of the glands
D
Which finding is specific to Graves disease? A. Increased sweating B. Intolerance to heat C. Dyspnea with or without exertion D. Abnormal protrusion of the eyes
D
Which integumentary change would the nurse expect while assessing the skin of a patient who has hyperparathyroidism? A. Waxy pallor B. Diaphoresis C. Soft body hair D. Cool, dry skin
A
Which outcome is the nursing priority for a patient who has chronic hyperparathyroidism? A. Preventing injury B. Reducing stimulation C. Encouraging exercise D. Maintaining normal temperature
A
Which food would the nurse recommend for the patient with hypoparathyroidism to include in the diet? A. Milk B. Yogurt C. Cheese D. Soy milk
D
Which laboratory finding would the nurse expect in a patient who has hyperparathyroidism? A. Serum calcium level of 11 mg/dL B. Serum magnesium level of 1.7 mEq/L C. Serum phosphorus level of 2.5 mg/dL D. Serum parathyroid hormone level of 55 pg/mL (ng/L)
A
Which class of drugs is used to reduce a patient's parathyroid hormone (PTH) production? A. Diuretics B. Hormones C. Calcimimetics D. Glucocorticoids
C
Which long-term therapy would the nurse expect to be prescribed for a patient with hypoparathyroidism who has a serum calcium level of 8 mg/dL? A. Calcium B. Calcitriol C. Calcitonin D. Cinacalcet
A
Which medication would the nurse anticipate being prescribed for a patient with hyperparathyroidism? A. Calcitonin B. Ergocalciferol C. Vitamin D D. Calcium chloride
A
Which intervention would the nurse include when planning care for a patient who is experiencing myxedema coma? A. Replacing fluids with IV normal saline B. Maintaining a reduced room temperature C. Monitoring temperature every 2 hours D. Monitoring blood pressure every 2 hours
A
A nurse is caring for a patient with hyperparathyroidism. Which laboratory finding indicates a high risk for psychosis? A. Serum calcium 15 mg/dL B. Serum phosphorus 3.1 mg/dL C. Serum magnesium 2.1 mEq/L D. Serum parathyroid hormone 60 pg/mL
A
A patient has been prescribed radioactive iodine (RAI) therapy for hyperthyroidism. Which information would the nurse teach the patient about this therapy? A. "You will receive RAI in oral form." B. "This treatment is done on an inpatient basis." C. "The radiation dose will be eliminated within a week." D. "You will have complete relief from symptoms in 1 week."
A
A patient with hypoparathyroidism reports severe muscle cramps. Which condition would the nurse suspect? A. Severe hypocalcemia B. Moderate hyperkalemia C. Severe hypomagnesemia D. Moderate hyperphosphatemia
A
How often would the nurse monitor the patient with hyperparathyroidism who is receiving hydration therapy? A. Every 2 hours B. Every 12 hours C. Every 16 hours D. Every 30 minutes
A
Which information would the nurse teach a patient with hypoparathyroidism about treating hypocalcemia? A. Eat foods that are high in calcium but low in phosphorus. B. Include milk, yogurt, and cheese in the daily diet. C. Long-term oral therapy for calcium is 2 to 4 g daily. D. Treatment can be stopped after desired calcium levels are achieved.
A
Which assessment finding would the nurse expect in a patient who has follicular carcinoma of the thyroid? Select all that apply. A. Dyspnea B. Dysphagia C. Hoarseness D. Heat intolerance E. Muscle weakness
A, B, C
Which instruction would the nurse give to the assistive personnel (AP) assigned to help with care of a patient who has Graves disease? Select all that apply. A. Reduce the room temperature. B. Encourage frequent visitors to keep the patient company. C. Assist the patient with a hot shower. D. Ensure that the patient has a fresh pitcher of ice water. E. Change the bed linen whenever it becomes damp from diaphoresis.
A, D, E
Which finding is common in patients with hypothyroidism? Select all that apply. A. Anorexia B. Hot flashes C. Hypertension D. Hyperventilation E. Impaired memory F. Poor wound healing
A, E, F
The nurse teaches a patient with hyperparathyroidism about self-management. Which action by the patient indicates effective action for reducing the incidence of renal calculi? A. Decreases alcohol ingestion B. Drinks large amounts of water and fluids C. Includes fiber-containing foods in the diet D. Reduces the consumption of caffeinated drinks
B
The primary health care provider prescribed cinacalcet to a patient with hyperparathyroidism; however, the patient did not respond to the medication. Which treatment would be the alternative of choice for this patient? A. Calcitonin B. Phosphates C. Glucocorticoids D. Mineralocorticoids
B
A patient diagnosed with hypothyroidism is prescribed levothyroxine sodium. Which instruction would the nurse provide to the patient about this treatment? A. The treatment lasts for a year. B. A fixed dose will be maintained throughout the treatment. C. The patient should take the drug exactly as prescribed. D. The patient must be assessed for fever during the initiation of therapy.
C
A patient has been diagnosed with hypothyroidism. Which medication is routinely prescribed to treat this disorder? A. Atenolol B. Methimazole C. Levothyroxine sodium D. Propylthiouracil (PTU)
C
A patient is diagnosed with hypoparathyroidism. Which prescribed intervention will treat symptoms that include severe muscle cramps, spasms of the hands and feet, and seizures? A. 0.5 to 2 mg of oral calcitriol daily B. 50,000 units of oral ergocalciferol daily C. 10% solution of IV calcium chloride over 10 to 15 minutes D. 50% solution of IV magnesium sulfate in 2-mL doses, up to 4 g daily
C
A patient who has hypoparathyroidism related to vitamin D deficiency receives a prescription for oral ergocalciferol. The health care provider informs the patient that the dosage will be adjusted throughout the therapy, but the patient is confused about the reason. Which information would the nurse provide to the patient? A. "You can decide how much of it you want to take depending on how you feel." B. "The dosage is adjusted to make sure your body does not adapt to the treatment." C. "Your calcium levels need to be kept in the low range to prevent kidney stones." D. "We want your calcium levels high to prevent symptoms of hypocalcemia."
C
A patient who is receiving thyroid replacement therapy for hypothyroidism reports constipation and insomnia. Which intervention would the nurse expect to include in this patient's plan of care? A. Administering sedatives B. Increasing fiber in the diet C. Increasing the medication dose D. Discontinuing thyroid treatment
C
A patient will be discharged with propylthiouracil (PTU). Which statement by the patient indicates a need for further teaching by the nurse? A. "I must call if my urine is dark." B. "I need to report weight gain." C. "I can return to my job at the nursing home." D. "I should take the drug every 8 hours."
C
A patient with thyroid cancer has just received 131I ablative therapy. Which statement by the patient indicates a need for further teaching? A. "I cannot share my toothpaste tube with anyone." B. "I must flush the toilet three times after I use it." C. "I'm ready to hold my newborn grandson now." D. "I need to wash my clothes separately from everyone else's clothes."
C
The nurse assigns assistive personnel (AP) to monitor the temperature of a patient who has Graves disease. Which instruction would the nurse give to the AP? A. Monitor the patient's temperature every 6 hours. B. Document the findings and report them at the end of the shift. C. Report even a 1°F increase in temperature immediately. D. It is normal and expected for the patient to have an elevated temperature.
C
The nurse is evaluating how well a patient understands the hormonal replacement therapy that has been prescribed for the management of hypothyroidism. Which patient statement indicates a need for further teaching? A. "I should get my thyroid levels checked regularly." B. "I should consume more fluids and foods rich in fiber." C. "I can stop taking my medications when I feel better." D. "I should not take over-the-counter medications without checking with my health care provider."
C
The nurse is teaching a patient about thyroid replacement therapy. Which statement by the patient indicates a need for further teaching? A. "I should take it every morning." B. "I should begin to have more energy with this medication." C. "If I continue to lose weight, I may need an increased dose." D. "If I gain weight and feel tired, I may need an increased dose."
C
The primary health care provider diagnoses a patient with hyperparathyroidism caused by congenital hyperplasia. Which treatment would the nurse anticipate being recommended for this patient? A. Medication management B. Fluid and electrolyte management C. Surgical removal of nearly all parathyroid glands D. Surgical removal of the affected parathyroid gland
C
The nurse is caring for a patient receiving hydration therapy. Which assessment finding would the nurse expect with a sudden drop in calcium levels? A. Nausea B. Constipation C. Epigastric pain D. Muscle numbness
D
The nurse reviews the vital signs of a patient diagnosed with Graves disease. The patient's temperature is up to 99.6°F (37.5°C). After notifying the health care provider, the nurse would take which action? A. Ask any family members to leave. B. Administer levothyroxine. C. Palpate the thyroid gland. D. Assess the patient's cardiac status.
D
Which autoimmune disorder may be triggered by a bacterial or viral infection? A. Graves disease B. Thyroid cancer C. Myxedema coma D. Hashimoto disease
D
Which electrolyte disturbance may cause hypoparathyroidism? A. Hyperkalemia B. Hyponatremia C. Hypercalcemia D. Hypomagnesemia
D
Which eye assessment finding is termed as a "globe lag"? A. The patient has a wide-eyed, startled look at all times. B. There is excessive tearing, and the eyes appear bloodshot. C. The upper eyelid fails to descend when the patient gazes down. D. The upper eyelid pulls back faster than the eyeball when the patient gazes up.
D
Which factor can trigger thyroid storm in the patient with Graves disease? A. Lack of iodine B. Use of artificial tears C. Reduced room temperature D. Palpation of the goiter
D