Thyroid, Parathyroid, Adrenal, and Pituitary

A female patient is admitted with a diagnosis of primary hypofunction of the adrenal glands. Which nursing assessment finding supports this diagnosis? 1. Patchy areas of pigment loss over the face

1

A nurse is caring for a client who had an adrenalectomy. for what clinical response should the nurse monitor while steroid therapy is being regulated? 1. Hypotension

1

A nurse is monitoring for clinical manifestations of infection in a client with a diagnosis of Addison disease. Which body mechanism related to infectious processes does the nurse conclude is impaired as a result of this disease? 1. Stress response

1

A patient is hospitalized with adrenocortical insufficiency. Which nursing activity should the nurse delegate to unlicensed assistive personnel (UAP)? 1. Reminding the patient to change positions slowly

1

The nurse is caring for a patient who has just undergone hypophysectomy for hyperpituitarism. Which postoperative finding requires immediate intervention? 1. Presence of glucose in the nasal drainage

1

The nurse is caring for a patient with hyperthyroidism who had a partial thyroidectomy yesterday. Which change in assessment would the nurse report to the health care provider immediately? 1. Temperature elevation to 100.2°F (37.9°C)

1

The nurse is orienting a new graduate RN who is providing care for a postoperative patient after a thyroidectomy. The new graduate assesses the patient and notes laryngeal stridor with a pulse oximetry measure of 89%. What is the priority action for the nurse and new graduate? 1. Immediately notify the Rapid Response Team (RRT).

1

The nurse is providing care for a patient who underwent thyroidectomy 2 days ago. Which laboratory value requires close monitoring by the nurse? 1. Calcium Level

1

When providing care for a patient with Addison disease, the nurse should be alert for which laboratory value change? 1. Decreased hematocrit

1

Which change in vital signs would the nurse instruct the unlicensed assistive personnel to report immediately for a patient with hyperthyroidism? 1. Rapid heart rate

1

Fludrocostisone is prescribed for a client with adrenal insufficiency. Which response to the medication should the nurse teach the client to report? SATA 1. Edema 2. Rapid weight gain

1, 2

Which actions prescribed by the health care provider for the patient with Addison disease should the nurse delegate to the experienced unlicensed assistive personnel (UAP)? Select all that apply. 1. Weigh the patient every morning. 2. Obtain fingerstick glucose before each meal and at bedtime. 3. Check vital signs every 2 hours. 6. Record intake and output.

1, 2, 3, 6

Which actions should the nurse assign to the experienced LPN/LVN for the care of a patient with hypothyroidism? Select all that apply. 1. Assessing and recording the rate and depth of respirations 2. Auscultating lung sounds every 4 hours 5. Checking blood pressure, heart rate, and respirations every 4 hours 6. Reminding the patient to report any episodes of chest pain or discomfort

1, 2, 5, 6

The nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which patient care actions should the nurse delegate to the experienced unlicensed assistive personnel? Select all that apply. 1. Monitor and record strict intake and output. 3. Remind the patient about his or her fluid restriction. 4. Weigh the patient every morning using the same scale. 5. Report a weight gain of 2.2 lb (1 kg) to the nurse

1, 3, 4, 5

The nurse is preparing to discharge a patient with hyperpituitarism caused by a benign pituitary tumor, who is prescribed the drug bromocriptine. Which key points would the nurse teach the patient about this drug? Select all that apply. 1. Take this drug with a meal or snack to avoid gastrointestinal (GI) symptoms. 3. Seek medical care if you experience chest pain or dizziness while taking this drug. 4. If the drug causes headaches, you can take over-the-counter acetaminophen. 6. The purpose of bromocriptine is to shrink your pituitary to normal size.

1, 3, 4, 6

A patient with adrenal insufficiency is to be discharged and will take prednisone 10 mg orally each day. Which instruction would the nurse be sure to teach the patient? 1. Excessive weight gain or swelling should be reported to the health care provider.

1.

For a patient with hyperthyroidism, which task should the nurse delegate to an experienced unlicensed assistive personnel (UAP)? 2. Monitoring the apical pulse, blood pressure, and temperature every 4 hours

2

The LPN/LVN who is assigned to care for a patient with Cushing disease asks the RN why the patient has bruising and petechiae across her abdomen. What is the RN's best response? 2. "Patients with Cushing disease have very fragile capillaries."

2

The nurse admits a patient whose assessment reveals prominent brow ridge, large hands and feet, and large lips and nose. Which pituitary hormone does the nurse suspect is elevated? 2. Growth hormone

2

The nurse assesses a newly admitted patient with a diagnosis of hyperthyroidism (see figure). How would the nurse best document the finding in this patient? 2. Large Visible Goiter

2

The nurse is caring for a 25-year-old patient admitted to the acute care unit with an extra strong thirst, and dilute, excessive straw-colored urine output (up to 15 L/day). What does the nurse suspect? 2. Diabetes Insipidus

2

Which is an important intervention that the nurse should include in the plan of care that is specific for a client with Addison Disease? 2. Protecting client from exertion

2

The nurse is preparing a care plan for a patient with Cushing disease. Which abnormal laboratory values would the nurse expect? Select all that apply. 2. Increased salivary cortisol level 3. Increased urinary cortisol level 6. Increased serum cortisol level

2, 3, 6

A Client is admitted to a medical unit with a diagnosis of Addisons Disease. The client is emaciated and reports muscular weakness and fatigue. Which Disturbed body process does the nurse determine is the root cause of the client's clinical manifestations? 3. Protein anabolism

3

A HCP writes orders addressing the needs of a client with Addison Disease. Which outcome does the nurse conclude is the main focus of the treatment for this client? 3. Restoration of electrolyte balance

3

A patient is admitted to the medical unit with possible Graves disease (hyperthyroidism). Which assessment finding by the nurse supports this diagnosis? 3. Exophthalmos

3

As the shift begins, the nurse is assigned to care for the following patients. Which patient should the nurse assess first? 3. A 58-year-old patient with hypothyroidism and a heart rate of 48 beats/min

3

The patient with hyperparathyroidism who is not a candidate for surgery asks the nurse why she is receiving IV normal saline and IV furosemide. What is the nurse's best response? 3. "Diuretic and hydration therapies are used to reduce your serum calcium."

3

Which prescribed order for a patient with diabetes insipidus (DI) would the nurse be sure to question? 3. Restrict fluids for 6 hours.

3

A 24-year-old patient with diabetes insipidus makes all of these statements when the nurse is preparing the patient for discharge from the hospital. Which statement indicates to the nurse that the patient needs additional teaching? 4. I will gradually wean myself off the vasopressin."

4

A client with a tentative diagnosis of Cushing syndrome has an increased cortisol level. For what response should the nurse assess this client? 4. Hypernatremia

4

A health care provider orders a low-sodium, high-potassium diet for a client with Cushing Syndrome. which explanation should the nurse provide as to why the client needs to follow this diet? 4. "Excessive aldosterone and cortisone cause retention of sodium and loss of potassium."

4

A nurse is caring for a client with Addison disease. Which information should the nurse include in a teaching plan as a means of encouraging this client to modify dietary intake? 4. Extra salt is needed to replace the amount being lost due to lack of sufficient aldosterone to conserve sodium

4

A nurse is caring for a client with the clinical manifestation of hypotension associated with a diagnosis of Addison disease. Which Hormone is impaired in its production as the result of this disease? 4. Mineralocorticoids

4

A patient with pheochromocytoma underwent surgery to remove his adrenal glands. Which nursing intervention should the nurse delegate to an unlicensed assistive personnel (UAP)? 4. Monitoring lying and standing blood pressure every 4 hours with a cuff placed on the same arm

4

Assessment findings for a patient with Cushing disease include all of the following. For which finding would the nurse notify the health care provider (HCP) immediately? 4. Crackles bilaterally in the lower lobes of the lungs

4

The nurse is instructing a senior nursing student on the techniques for palpation of the thyroid gland. What precaution would the nurse be sure to include when instructing the student about thyroid palpation? 4. always palpate the thyroid gland gently

4

A patient has the following assessment findings: elevated TSH level, low T3 and T4 levels, difficulty with memory, lethargy, and muscle stiffness. There are clinical manifestations of which disorder? A. Hypothyroidism b. Hyperthyroidism c. Hypoparathyroidism d. Hyperparathyroidism

A

The UAP is providing a bath for a patient with hyperparathyroidism. What essential teaching must the nurse provide to the UAP? A. Handle the patient carefully and use a lift sheet for repositioning

A

The nurse assesses a patient in the ED and finds the following; constipation, fatigue with increased sleeping time impaired memory, facial puffiness, and weight gain. Which deficiency does the nurse recognize? A. Hyperthyroidism b. Hypothyroidism c. Hyperparathyroidism d. Hypoparathyroidism

B

Which factor is a main assessment finding that signifies hypothyroidism? A. Irritability b. Cold intolerance c. Diarrhea d. Fatigue

B

A patient with exophthalmos from hyperthyroidism reports dry eyes, especially in the morning. The nurse teaches the patient to perform which intervention to help correct this problem? A. Wear sunglasses at all times when outside in the bright sun b. Use cool compresses to the eye four times a day c. Tape the eyes closed with nonallergenic tape d. There is nothing that can be done to relieve this problem.

C

The nurse is caring for a young female patient with papillary carcinoma of the thyroid gland. Which treatment is most likely to be prescribed to this patient? D. Thyroidectomy

D

Which laboratory result is consistent with a diagnosis of hyperthyroidism? A. Decreased serum T3 and T4 levels b. Elevated serum TRH level c. Decreased radioactive iodine uptake d. Increased serum T3 and T4

D

After a visit to the health care provider's office, a patient is diagnosed with general thyroid enlargement and elevate thyroid hormone level. Which condition do these findings indicate? A. Hyperthyroidism and goiter b. Hypothyroidism and goiter c. Nodules on the parathyroid gland d. Thyroid or parathyroid cancer

a

Production of which hormones causes lower levels of calcium? A. Calcitonin b. PTH c. T4 d. TSH

a

The clinical manifestations of hyperthyroidism are known as which condition? A thyrotoxicosis. B. Euthyroid function c. Graves' disease d. Hypermetabolism

a

Which assessment finings of hypocalcemia? (SATA) a. Numbness and tingling around the mouth b. muscle cramping c. Bone fractures d. fever e. Tachycardia

ab

Which disorders/conditions can cause hyperparathyroidism? (SATA) a. Chronic kidney diseases b. Neck trauma c. Thyroidectomy d. Vitamin D deficiency e. Parathyroidectomy

abd

Which statement about thyroiditis are accurate? (SATA) a. It is an inflammation of the thyroid gland b. Hashimoto's disease is the most common type c. IT always resolves with antibiotic therapy d. There are three types: acute, subacute, and chronic. E. The patient must take thyroid hormones

abde

Which statements about hypothyroidism are accurate? (SATA) a. It occurs more often in women b. It can be caused by iodine deficiency c. Weight loss is a common manifestation d. It can be caused by autoimmune thyroid destruction e. Myxedema coma is a rare but serious complication

abde

Which statements about hyperthyroidism are accurate? (SATA) a. It is most commonly caused by Graves' disease b. It can be caused by overuse of thyroid replacement medication c. It occurs more often in med between the ages of 20-40 d. Weight gain is a common manifestation e. Serum T3 and T4 results will be elevated

abe

Discharge planning for a patient with chronic hypoparathyroidism includes which instructions? (SATA) a. Prescribed medications must be taken for the patient entire life b. Eat foods low in vitamin D and high in phosphorous c. Eat foods high in calcium, but low in phosphorous d. After several weeks, medications can be discontinued e. Kidney stones are no longer a risk to the patient

ac

Which signs and symptoms are assessment findings indicative of thyroid storm? (SATA) a. Abdominal pain and nausea b. Hypothermia c. Elevated temperature d. Tachycardia e. Elevated systolic blood pressure f. Bradycardia

acde

A patient who has been diagnosed with Graves' disease is going to receive radioactive iodine (RAI) in the oral form of 131I. what does the nurse teach the patient about how this drug works? A. It destroys the hormones T3 and T4 b. It destroys the tissue that produces thyroid hormones c. IT blocks thyroid hormone production d. It prevents T4 from being converted to T3

b

The nurse is providing instructions to a patient who is taking the antithyroid medication propylthiouracil (PTU). The nurse instructs the patient to notify the health care provider immediately if which sign/symptom occurs? A. Weight gain b. Dark-colored urine c. Cold intolerance d. Headache

b

What is the hallmark of thyroid cancer? A. aggressive tumors b. Elevated serum thyroglobulin level c. Metastasis to other organs d. Invasion of blood vessels

b

Which are preoperative instructions for a patient having thyroid surgery? (SATA) a. Teach postoperative restrictions such as no coughing and deep-breathing exercises to prevent strain on the suture line b. Teach the moving and turning technique of manually supporting the head and avoiding neck extension to minimize strain on the suture line c. Inform the patient that hoarseness for a few days after surgery is usually the result of a breathing tube (endotracheal tube) used during surgery d. Humidification of air may be helpful to promote expectoration of secretions. Suctioning may also be used e. Clarify any questions regarding placement of incision, complications, and postoperative care f. A supine position and lying flat will be maintained postoperatively to avoid strain on suture line

bcde

Which foods will the nurse instruct a patient with hypoparathyroidism to avoid? (SATA) a. Canned vegetables b. yogurt c. Fresh fruit d. Red meat e. Milk f. Processed cheese

bef

In addition to regulation of calcium levels, PTH and calcitonin regulate the circulating blood levels of which substance? A. Potassium b. Sodium c. Phosphate d. Chloride

c

The nurse is assessing a patient after thyroid surgery and discovers harsh, high-pitched respiratory sounds. What is the nurses best first action? A. Administer oxygen at 5L via nasal cannula b. Administer IV calcium chloride c. Notify the Rapid Response Team D. Suction the patient for oral secretions

c

Which statement best describes globe lag in a patient with hyperthyroidism? A. Abnormal protrusion of the eyes b. Upper eyelid fails to descend when the patient gazes downward c. Upper eyelid pulls back faster than the eyeball when the patient gazes upward d. Inability of both eyes to focus on an object simultaneously

c

After a thyroidectomy, a patient reports tingling around the mouth and muscle twitching. Which complication do these assessment findings indicate to the nurse? A. hemorrhage b. Respiratory distress c. Thyroid storm d. hypocalcemia

d

Laboratory findings of elevated T# and T4, decreased TSH, and high thyrotropin receptor antibody titer indicate which condition? A. Multinodular goiter b. Hyperthyroidism related to overmedication c. Pituitary tumor suppressing TSH d. Graves' disease

d

The nurse assessing a patient palpates enlargement of the thyroid gland, along with noticeable swelling of the neck. How does the nurse interpret this finding? A. globe lag b. Myxedema c. Exophthalmos d. Goiter

d

The nurse is performing a physical examination of a patient's thyroid gland. Precautions are takin in performing the correct technique because palpation can result in which occurrence? A. Damage to the esophagus causing gastric reflux b. Obstruction of the carotid arteries causing a stroke c. Pressure on the trachea and laryngeal nerve causing hoarseness d. Exacerbation of symptoms by releasing additional thyroid hormone

d

What is the most common cause of death from myxedema coma? A myocardial infarction b. Acute kidney failure c. High serum level of iodide d. Respiratory failure

d