Ch 45 PREP U

The primary function of the thyroid gland includes which of the following? Facilitation of milk ejection Reabsorption of water Control of cellular metabolic activity Reduction of plasma level of calcium

Correct response: Control of cellular metabolic activity Explanation: The primary function of the thyroid hormone is to control cellular metabolic activity. Oxytocin facilitates milk ejection during lactation and increases the force of uterine contraction during labor and delivery. Antidiuretic hormone (ADH) release results in reabsorption of water into the bloodstream rather than excretion by the kidneys. Calcitonin reduces the plasma level of calcium by increasing its deposition in bone.

The nurse is aware that the clinical symptoms of a patient with hypoparathyroidism are the result of the initial physiologic response of: Cardiac arrhythmias. Increased serum levels of phosphate. Hypocalcemia. Decreased levels of vitamin D.

Correct response: Hypocalcemia. Explanation: Hypoparathyroidism results in hypocalcemia, which triggers a series of physiologic responses, including the choices presented.

Which diagnostic test is done to determine suspected pituitary tumor? computed tomography scan measurement of blood hormone levels radioimmunoassay radiographs of the abdomen

Correct response: computed tomography scan Explanation: A computed tomography or magnetic resonance imaging scan is done to detect a suspected pituitary tumor. Radiographs of the chest or abdomen are taken to detect tumors. Radiographs also determine the size of the organ and their location. Measuring blood hormone levels helps determine the functioning of endocrine glands. A radioimmunoassay determines the concentration of a substance in plasma.

A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for: decreased body temperature and cold intolerance. flushed, warm, moist skin. systolic murmur at the left sternal border. exophthalmos and conjunctival redness.

Correct response: "I may stop taking this medication when I feel better." Explanation: The client requires additional teaching because he states that he may stop taking corticosteroids when he feels better. Corticosteroids should be gradually tapered by the physician. Tapering the corticosteroid allows the adrenal gland to gradually resume functioning. Corticosteroids increase the risk of infection and may mask the early signs of infection, so the client should avoid people who are sick. Corticosteroids cause muscle wasting in the extremities, so the client should increase his protein intake by eating foods such as chicken and dairy products. Corticosteroids have been linked to glaucoma and corneal lesions, so the client should visit his ophthalmologist regularly.

A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching? "I'll schedule a follow-up visit with my physician as soon as I get home." "I will take my pain medications according to the schedule we developed." "I will increase my fluid and calcium intake." "I'll call my physician if I notice tingling around my lips."

Correct response: "I will increase my fluid and calcium intake." Explanation: The client requires additional teaching if he states that he will increase his calcium intake. Hyperparathyroidism causes extreme increases in serum calcium levels. The client should increase his fluid intake, but he should limit his calcium and vitamin D intake. The client should continue to take pain mediations as scheduled and have regular follow-up visits with his physician. Tingling around the lips is a sign of hypercalcemia and should be reported to the physician immediately.

A nursing student asks the instructor why the pituitary gland is called the "master gland." What is the best response by the instructor? "It is the gland that is responsible for regulating the hypothalamus." "The gland does not have any other function other than to cause secretion of the growth hormones." "It regulates metabolism." "It regulates the function of other endocrine glands."

Correct response: "It regulates the function of other endocrine glands." Explanation: The pituitary gland is called the master gland because it regulates the function of other endocrine glands. The term is somewhat misleading, however, because the hypothalamus influences the pituitary gland. The gland has many other hormones that it secretes.

A client with hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. Which instruction is most important for the nurse to include in the client's teaching plan? "Jog at least 2 miles per day." "Rest as much as possible." "Maintain a moderate exercise program." "Lose weight."

Correct response: "Maintain a moderate exercise program." Explanation: The nurse should instruct the client to maintain a moderate exercise program. Such a program helps strengthen bones and prevents the bone loss that occurs from excess parathyroid hormone. Walking or swimming provides the most beneficial exercise. Because of weakened bones, a rigorous exercise program such as jogging is contraindicated. Weight loss might be beneficial but it isn't as important as developing a moderate exercise program.

A patient is ordered desmopressin (DDAVP) for the treatment of diabetes insipidus. What therapeutic response does the nurse anticipate the patient will experience? A decrease in appetite A decrease in blood pressure A decrease in urine output A decrease in blood glucose levels

Correct response: A decrease in urine output Explanation: Desmopressin (DDAVP), a synthetic vasopressin without the vascular effects of natural ADH, is particularly valuable because it has a longer duration of action and fewer adverse effects than other preparations previously used to treat the disease. DDAVP and lypressin (Diapid) reduce urine output to 2 to 3 L/24 hours. It is administered intranasally; the patient sprays the solution into the nose through a flexible calibrated plastic tube. One or two administrations daily (i.e., every 12 to 24 hours) usually control the symptoms (Papadakis, McPhee, & Rabow, 2013). Vasopressin causes vasoconstriction; thus, it must be used cautiously in patients with coronary artery disease

Which of the following hormones controls secretion of adrenal androgens? Adrenocorticotropic hormone (ACTH) Calcitonin Thyroid-stimulating hormone (TSH) Parathormone

Correct response: Adrenocorticotropic hormone (ACTH) Explanation: ACTH controls the secretion of adrenal androgens. When secreted in normal amounts, the adrenal androgens appear to have little effect, but when secreted in excess, as in certain inborn enzyme deficiencies, masculinization may result. The secretion of T3 and T4 by the thyroid gland is controlled by TSH. Parathormone regulates calcium and phosphorous metabolism. Calcitonin reduces the plasma level of calcium by increasing its deposition in bone.

During the first 24 hours after a client is diagnosed with addisonian crisis, which intervention should the nurse perform frequently? Administer oral hydrocortisone. Weigh the client. Test urine for ketones. Assess vital signs.

Correct response: Assess vital signs. Explanation: Because the client in addisonian crisis is unstable, vital signs and fluid and electrolyte balance should be assessed every 30 minutes until he's stable. Daily weights are sufficient when assessing the client's condition. The client shouldn't have ketones in his urine, so there is no need to assess the urine for their presence. Oral hydrocortisone isn't administered during the first 24 hours in severe adrenal insufficiency.

Surgical removal of the thyroid gland is the treatment of choice for thyroid cancer. During the immediate postoperative period, the nurse knows to evaluate serum levels of __________ to assess for a serious and primary postoperative complication of thyroidectomy. Potassium Magnesium Calcium Sodium

Correct response: Calcium Explanation: Efforts are made to spare parathyroid tissue to reduce the risk of postoperative hypocalcemia with resultant tetany.

A nurse is assigned to care for a patient with increased parathormone secretion. Which of the following serum levels should the nurse monitor for this patient? Potassium Glucose Calcium Sodium

Correct response: Calcium Explanation: Increased secretion of parathormone results in bone resorption. Calcium is released into the blood, increasing serum levels.

A client with severe hypoparathyroidism is experiencing tetany. What medication, prescribed by the physician for emergency use, will the nurse administer to correct the deficit? Fludrocortisone Calcium gluconate Sodium bicarbonate Methylprednisolone

Correct response: Calcium gluconate Explanation: Tetany and severe hypoparathyroidism are treated immediately by the administration of an IV calcium salt, such as calcium gluconate. The other medications are not effective for the treatment of calcium deficit.

What dietary modifications should be recommended to a client with hyperthyroidism? Increase calorie intake by 70%. Limit intake of nutritionally dense foods such as milk products, eggs, and cheese. Consume a high-protein diet. Restrict calorie intake.

Correct response: Consume a high-protein diet. Explanation: A high protein intake helps replenish losses from muscle catabolism. Metabolism is increased with hyperthyroidism. Calorie needs increase between 10% and 50% above normal to replenish glycogen stores and correct weight loss. Encourage frequent meals and the intake of nutritionally dense foods (fortified milkshakes, foods fortified with skim milk powder, eggs, cheese, butter, or milk).

The actions of parathyroid hormone (PTH) are increased in the presence of which vitamin? E C D B

Correct response: D Explanation: The actions of PTH are increased by the presence of vitamin D.

A client sustained a head injury when falling from a ladder. While in the hospital, the client begins voiding large amounts of clear urine and reports being very thirsty. The client states feeling weak and having experienced an 8-pound weight loss since admission. What condition does the nurse expect the client to be tested for? Diabetes insipidus (DI) Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Hypothyroidism Pituitary tumor

Correct response: Diabetes insipidus (DI) Explanation: With diabetes insipidus, urine output may be as high as 20 L/24 hours. Urine is dilute, with a specific gravity of 1.002 or less. Limiting fluid intake does not control urine excretion. Thirst is excessive and constant. Activities are limited by the frequent need to drink and void. Weakness, dehydration, and weight loss develop. SIADH will have the opposite clinical manifestations. The client's symptoms are related to the trauma and not to a pituitary tumor. The thyroid gland does not exhibit these symptoms.

A patient has been diagnosed with thyroidal hypothyroidism. The nurse knows that this diagnosis is consistent with which of the following? Failure of the pituitary gland Inadequate secretion of TSH Dysfunction of the thyroid gland itself Disorder of the hypothalamus

Correct response: Dysfunction of the thyroid gland itself Explanation: Thyroidal hypothyroidism results from thyroid gland dysfunction. The other causes result in central, secondary, or tertiary causes if there is inadequate secretion of TSH.

The nurse is caring for a client diagnosed with hypothyroidism secondary to Hashimoto thyroiditis. When assessing this client, what sign or symptom would the nurse expect? Flushed skin Bulging eyes Palpitations Fatigue

Correct response: Fatigue Explanation: Symptoms of hypothyroidism include extreme fatigue, hair loss, brittle nails, dry skin, voice huskiness or hoarseness, menstrual disturbance, and numbness and tingling of the fingers. Bulging eyes, palpitations, and flushed skin would be signs and symptoms of hyperthyroidism.

What test should the nurse provide education on for the client with suspected posterior pituitary gland dysfunction? Computed tomography (CT) scan Magnetic resonance imaging (MRI) Fluid deprivation Serum thyroid-stimulating hormone (TSH)

Correct response: Fluid deprivation Explanation: Plasma levels of antidiuretic hormone (ADH) affected by posterior pituitary gland dysfunction can cause diabetes insipidus. A fluid deprivation test may be indicated for diabetes insipidus. Anterior pituitary gland dysfunction is associated with CT scan and MRI is used to identify the presence or extent of tumors. Several tests can be performed to test the functioning of the thyroid gland, including serum TSH screening.

The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as which of the following? Gigantism Dwarfism Acromegaly Simmonds' disease

Correct response: Gigantism Explanation: When oversecretion of GH occurs before puberty, gigantism results. Dwarfism occurs when secretion of GH is insufficient during childhood. Oversecretion of GH during adulthood results in acromegaly. An absence of pituitary hormonal activity causes Simmonds' disease.

A woman with a progressively enlarging neck comes into the clinic. She mentions that she has been in a foreign country for the previous 3 months and that she didn't eat much while she was there because she didn't like the food. She also mentions that she becomes dizzy when lifting her arms to do normal household chores or when dressing. What endocrine condition should the nurse expect the health care provider to diagnose? Goiter Cushing's syndrome Diabetes insipidus Diabetes mellitus

Correct response: Goiter Explanation: A goiter can result from inadequate dietary intake of iodine associated with changes in foods or malnutrition. It's caused by insufficient thyroid gland production and depletion of glandular iodine. Signs and symptoms of goiter include an enlarged thyroid gland, dizziness when raising the arms above the head, dysphagia, and respiratory distress. Signs and symptoms of diabetes mellitus include polydipsia, polyuria, and polyphagia. Signs and symptoms of diabetes insipidus include extreme polyuria (4 to 16 L/day) and symptoms of dehydration (poor tissue turgor, dry mucous membranes, constipation, dizziness, and hypotension). Cushing's syndrome causes buffalo hump, moon face, irritability, emotional lability, and pathologic fractures.

Which feature(s) indicates a carpopedal spasm in a client with hypoparathyroidism? Hand flexing inward Cardiac dysrhythmia Moon face and buffalo hump Bulging forehead

Correct response: Hand flexing inward Explanation: Carpopedal spasm is evidenced by the hand flexing inward. Cardiac dysrhythmia is a symptom of hyperparathyroidism. Moon face and buffalo hump are the symptoms of Cushing syndrome. A bulging forehead is a symptom of acromegaly.

Which instruction should be included in the discharge teaching plan for a client after thyroidectomy for Graves' disease? Have regular follow-up care. Exercise to improve cardiovascular fitness. Keep an accurate record of intake and output. Use nasal desmopressin acetate (DDAVP).

Correct response: Have regular follow-up care. Explanation: The nurse should instruct the client with Graves' disease to have regular follow-up care because most cases of Graves' disease eventually result in hypothyroidism. Annual thyroid-stimulating hormone tests and the client's ability to recognize signs and symptoms of thyroid dysfunction will help detect thyroid abnormalities early. Recording intake and output is important for clients with fluid and electrolyte imbalances but not thyroid disorders. DDAVP is used to treat diabetes insipidus. Although exercise to improve cardiovascular fitness is important, the importance of regular follow-up is most critical for this client.

The nurse is assessing a client in the clinic who appears restless, excitable, and agitated. The nurse observes that the client has exophthalmos and neck swelling. What diagnosis do these clinical manifestations correlate with? Hypothyroidism Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Diabetes insipidus (DI) Hyperthyroidism

Correct response: Hyperthyroidism Explanation: Clients with hyperthyroidism characteristically are restless despite feeling fatigued and weak, highly excitable, and constantly agitated. Fine tremors of the hand occur, causing unusual clumsiness. The client cannot tolerate heat and has an increased appetite but loses weight. Diarrhea also occurs. Visual changes, such as blurred or double vision, can develop. Exophthalmos, seen in clients with severe hyperthyroidism, results from enlarged muscle and fatty tissue surrounding the rear and sides of the eyeball. Neck swelling caused by the enlarged thyroid gland often is visible. Hypothyroidism clinical manifestations are the opposite of what is seen as hyperthyroidism. SIADH and DI clinical manifestations do not correlate with the symptoms manifested by the client.

A client with acromegaly has been given the option of a surgical approach or a medical approach. The client decides to have a surgical procedure to remove the pituitary gland. What does the nurse understand this surgical procedure is called? Thyroidectomy Ablation Hysteroscopy Hypophysectomy

Correct response: Hypophysectomy Explanation: The treatment of choice is surgical removal of the pituitary gland (transsphenoidal hypophysectomy) through a nasal approach. The surgeon may substitute an endoscopic technique using microsurgical instruments to reduce surgical trauma. A hysteroscopy is a gynecologic procedure. The thyroid gland is not involved for a surgical procedure. Ablation is not a removal of the pituitary gland.

A client is admitted to the hospital and will be undergoing tests to determine if an abdominal mass is present. What should the nurse be sure to document when asking about allergies? If the client is allergic to beef If the client is allergic to shellfish If the client is allergic to pork If the client is allergic to grapefruit

Correct response: If the client is allergic to shellfish Explanation: The nurse documents an allergy to iodine, a component of contrast dyes, or shellfish, and informs the physician. Pork, beef, and grapefruit do not interact with the contrast dye that the client will receive during testing.

A client is experiencing an increase in blood glucose levels. The nurse understands that which of the following hormones would be important in lowering the client's blood glucose level? Insulin Calcitonin Parathormone Melatonin

Correct response: Insulin Explanation: Insulin is a hormone released by the beta islet cells that lowers the level of blood glucose when it rises above normal limits. Parathormone increases the level of calcium in the blood when a decrease in serum calcium levels occurs. Melatonin aids in regulating sleep cycles and mood. Calcitonin is a thyroid hormone that inhibits the release of calcium from the bone into the extracellular fluid.

The nurse assesses a patient who has an obvious goiter. What type of deficiency does the nurse recognize is most likely the cause of this? Thyroxine Iodine Calcitonin Thyrotropin

Correct response: Iodine Explanation: Oversecretion of thyroid hormones is usually associated with an enlarged thyroid gland known as a goiter. Goiter also commonly occurs with iodine deficiency.

The nurse is teaching a client that the body needs iodine for the thyroid to function. What food would be the best source of iodine for the body? Eggs Soy products Iodized table salt Red meat

Correct response: Iodized table salt Explanation: The major use of iodine in the body is by the thyroid. Iodized table salt is the best source of iodine.

The preferred preparation for treating hypothyroidism includes which of the following? Methimazole (Tapazole) Levothyroxine (Synthroid) Radioactive iodine Propylthiouracil (PTU)

Correct response: Levothyroxine (Synthroid) Explanation: Synthetic levothyroxine (Synthroid or Levothroid) is the preferred preparation for treating hypothyroidism and suppressing nontoxic goiters (enlargements of the thyroid gland). Radioactive iodine is the most common form of treatment for Graves' disease in North America. Both PTU and Tapazole are used for hyperthyroidism.

The nurse is teaching a client about the dietary restrictions related to his diagnosis of hyperparathyroidism. What foods should the nurse encourage the client to avoid? Bananas Chicken livers Hamburger Milk

Correct response: Milk Explanation: Clients with hyperparathyroidism should use a low-calcium diet (fewer dairy products) and drink at least 3 to 4 L of fluid daily to dilute the urine and prevent renal stones from forming. It is especially important that the client drink fluids before going to bed and periodically throughout the night to avoid concentrated urine. Bananas, chicken livers, and hamburgers do not require avoidance. Milk is the highest in calcium content.

A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate? Diabetes insipidus Syndrome of inappropriate antidiuretic hormone (SIADH) Thyroid storm Myxedema coma

Correct response: Myxedema coma Explanation: Myxedema coma is a rare life-threatening condition. It is the decompensated state of severe hypothyroidism in which the patient is hypothermic and unconscious (Ross, 2012a). This condition may develop with undiagnosed hypothyroidism and may be precipitated by infection or other systemic disease or by use of sedatives or opioid analgesic agents. Patients may also experience myxedema coma if they forget to take their thyroid replacement medication.

A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication? Tibial myxedema Thyroid storm Myxedema coma Exophthalmos

Correct response: Myxedema coma Explanation: Myxedema coma, severe hypothyroidism, is a life-threatening condition that may develop if thyroid replacement medication isn't taken. Exophthalmos (protrusion of the eyeballs) is seen with hyperthyroidism. Although thyroid storm is life-threatening, it's caused by severe hyperthyroidism. Tibial myxedema (peripheral mucinous edema involving the lower leg) is associated with hypothyroidism but isn't life-threatening.

A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication? Thyroid storm Hemorrhage Laryngeal nerve damage Tetany

Correct response: Observe stool color. Explanation: The nurse should observe the color of each stool and test the stool for occult blood.

Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome? Observe the color of stool. Monitor bowel patterns. Monitor vital signs every 4 hours. Observe urine output.

Correct response: Observe the color of stool. Explanation: The nurse should observe the color of each stool and test the stool for occult blood. Bowel patterns, vital signs, and urine output do not help in determining the development of peptic ulcers.

The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease? Sodium of 140 mEq/L Glucose of 100 mg/dL Potassium of 6.0 mEq/L A blood pressure reading of 135/90 mm Hg

Correct response: Potassium of 6.0 mEq/L Explanation: Addison's disease is characterized by hypotension, low blood glucose, low serum sodium, and high serum potassium levels. The normal serum potassium level is 3.5 to 5 mEq/L.

A client with acromegaly is admitted to the hospital with complaints of partial blindness that began suddenly. What does the nurse suspect is occurring with this client? Glaucoma Pressure on the optic nerve Retinal detachment Corneal abrasions

Correct response: Pressure on the optic nerve Explanation: Partial blindness may result from pressure on the optic nerve. Glaucoma does not occur suddenly, and the client did not report injury to suspect corneal abrasions or retinal detachment.

The nurse is teaching a client that the body needs iodine for the thyroid to function. What is the function of iodine? Altering the responsiveness of body tissue to other hormones Maintaining body metabolism in a steady state Synthesis of thyroid hormones Maintaining effective oxygen consumption

Correct response: Synthesis of thyroid hormones Explanation: Iodine is essential to the thyroid for synthesis of its hormones. Thyroxine (T4), a relatively weak hormone, maintains body metabolism in a steady state. Triiodothyronine (T3) is about five times as potent as T4 and has a metabolic action that is more rapid. These hormones accelerate all bodily processes that contribute to oxygen consumption and altering the responsiveness of tissues to other hormones.

A nurse explains to a client with thyroid disease that the thyroid gland normally produces: T3, thyroxine (T4), and calcitonin. thyrotropin-releasing hormone (TRH) and TSH. TSH, triiodothyronine (T3), and calcitonin. iodine and thyroid-stimulating hormone (TSH).

Correct response: T3, thyroxine (T4), and calcitonin. Explanation: The thyroid gland normally produces thyroid hormone (T3 and T4) and calcitonin. The pituitary gland produces TSH to regulate the thyroid gland. The hypothalamus gland produces TRH to regulate the pituitary gland.

A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching? "I will see my ophthalmologist regularly for a check-up." "I will avoid friends and family members who are sick." "I will eat lots of chicken and dairy products." "I may stop taking this medication when I feel better."

Correct response: Tetany Explanation: Tetany may result if the parathyroid glands are excised or damaged during thyroid surgery. Hemorrhage is a potential complication after thyroid surgery but is characterized by tachycardia, hypotension, frequent swallowing, feelings of fullness at the incision site, choking, and bleeding. Thyroid storm is another term for severe hyperthyroidism — not a complication of thyroidectomy. Laryngeal nerve damage may occur postoperatively, but its signs include a hoarse voice and, possibly, acute airway obstruction.

When describing the difference between endocrine and exocrine glands, which of the following would the instructor include as characteristic of endocrine glands? The glands contain ducts that produce the hormones. The secreted hormones act like target cells. The glands play a minor role in maintaining homeostasis. The secretions are released directly into the blood stream.

Correct response: The secretions are released directly into the blood stream. Explanation: The endocrine glands secrete hormones, chemicals that accelerate or slow physiologic processes, directly into the bloodstream. This characteristic distinguishes endocrine glands from exocrine glands, which release secretions into a duct. Hormones circulate in the blood until they reach receptors in target cells or other endocrine glands. They play a vital role in regulating homeostatic processes.

Which group of clients should not receive potassium iodide? Those who are allergic to seafood Those who are allergic to corticosteroids Those who are pregnant Those taking medications such as cough medicines

Correct response: Those who are allergic to seafood Explanation: Potassium iodide should not be administered to anyone who is allergic to seafood, which is also high in iodine. Clients who take corticosteroids or cough medicines and those who are pregnant would be appropriate candidates for potassium iodide therapy.

Which of the following hormones would the nurse identify as being secreted by the thyroid gland? Parathormone Thyroxine Somatotropin Thymosin

Correct response: Thyroxine Explanation: The thyroid gland secretes thyroxine (T4 or tetraiodothyronine), triiodothyronine (T3), and calcitonin. Parathormone is secreted by the parathyroid glands. Thymosin is secreted by the thymus gland. Somatotropin is secreted by the anterior pituitary gland.

A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect? Exophthalmos, diarrhea, and cold intolerance Weight gain, constipation, and lethargy Weight loss, nervousness, and tachycardia Diaphoresis, fever, and decreased sweating

Correct response: Weight loss, nervousness, and tachycardia Explanation: Weight loss, nervousness, and tachycardia are signs of hyperthyroidism. Other signs of hyperthyroidism include exophthalmos, diaphoresis, fever, and diarrhea. Weight gain, constipation, lethargy, decreased sweating, and cold intolerance are signs of hypothyroidism.

When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect: bradycardia. a blood pressure of 130/70 mm Hg. a blood pressure of 176/88 mm Hg. a blood glucose level of 130 mg/dl.

Correct response: a blood pressure of 176/88 mm Hg. Explanation: Pheochromocytoma causes hypertension, tachycardia, hyperglycemia, hypermetabolism, and weight loss. It isn't associated with hypotension, hypoglycemia, or bradycardia.

For a client with hyperthyroidism, treatment is most likely to include: thyroid extract. a synthetic thyroid hormone. emollient lotions. a thyroid hormone antagonist.

Correct response: a thyroid hormone antagonist. Explanation: Thyroid hormone antagonists, which block thyroid hormone synthesis, combat increased production of thyroid hormone. Treatment of hyperthyroidism also may include radioiodine therapy, which destroys some thyroid gland cells, and surgery to remove part of the thyroid gland; both treatments decrease thyroid hormone production. Thyroid extract, synthetic thyroid hormone, and emollient lotions are used to treat hypothyroidism.

The nurse is performing a physical examination on a client suspected of having an endocrine disorder. Which assessment finding might be indicative of a problem with the thyroid gland? shortness of breath muscle twitching cold intolerance cataracts

Correct response: cold intolerance Explanation: The thyroid releases hormones that regulate the body's metabolic rate. During the health history, the nurse asks the client about changes in weight and appetite, bowel movements, heart rate and respiration, any marked tremors, nervousness, excitability, apprehension or impaired memory, decreased initiative, and slow thought processes. The nurse also asks about changes in the client's tolerance to heat and cold as well as excessive sweating, feeling very cold, lethargy or apathy, and changes in hair and skin. Muscle twitching, shortness of breath, and formation of a cataract are symptoms of parathyroid dysfunction.

A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find: thick, coarse skin. weight gain in arms and legs. hypotension. deposits of adipose tissue in the trunk and dorsocervical area.

Correct response: deposits of adipose tissue in the trunk and dorsocervical area. Explanation: Because of changes in fat distribution, adipose tissue accumulates in the trunk, face (moon face), and dorsocervical areas (buffalo hump). Hypertension is caused by fluid retention. Skin becomes thin and bruises easily because of a loss of collagen. Muscle wasting causes muscle atrophy and thin extremities.

A client presents with a huge lower jaw, bulging forehead, large hands and feet, and frequent headaches. What could be causing this client's symptoms? hyperpituitarism panhyperpituitarism hypopituitarism panhypopituitarism

Correct response: hyperpituitarism Explanation: Acromegaly (hyperpituitarism) is a condition in which growth hormone is oversecreted after the epiphyses of the long bones have sealed. A client with acromegaly has coarse features, a huge lower jaw, thick lips, a thickened tongue, a bulging forehead, a bulbous nose, and large hands and feet. When the overgrowth is from a tumor, headaches caused by pressure on the sella turcica are common.

Cardiac effects of hyperthyroidism include palpitations. bradycardia. decreased pulse pressure. decreased systolic BP.

Correct response: palpitations. Explanation: Cardiac effects may include sinus tachycardia, increased pulse pressure, and palpitations. Systolic BP is elevated.

During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and: magnesium. sodium. potassium. phosphorus.

Correct response: phosphorus. Explanation: PTH increases the serum calcium level and decreases the serum phosphate level. PTH doesn't affect sodium, potassium, or magnesium regulation.

A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply. Hyperventilation Hypertension Hypotension Hypothermia Hypoventilation

Hypothermia Hypotension Hypoventilation Explanation: Severe hypothyroidism is called myxedema. Advanced, untreated myxedema can progress to myxedemic coma. Signs of this life-threatening event are hypothermia, hypotension, and hypoventilation. Hypertension and hyperventilation indicate increased metabolic responses, which are the opposite of what the client would be experiencing.

Patients with hyperthyroidism are characteristically: Calm Sensitive to heat Emotionally stable Apathetic and anorexic

Correct response: Sensitive to heat Explanation: Those with hyperthyroidism tolerate heat poorly and may perspire unusually freely. Their condition is characterized by symptoms of nervousness, hyperexcitability, irritability, and apprehension.