Pharm test 1 EAQs
Which clinical manifestation is a classic finding in Graves' disease? a. gingivitis b. cretinism c. exophthalmos d. Muscular dystrophy
Exophthalmos Exophthalmos is the protrusion of eyeballs from the orbits; it results from increased fat deposits and fluid in orbital tissues. It is a classic clinical manifestation in Graves' disease. Gingivitis, cretinism, and muscular dystrophy are not classic clinical manifestations associated with Graves' disease.
Which nursing diagnostic statement is the highest priority for a patient with myxedema? A. Hypothermia B. Excess fluid volume C. Imbalanced nutrition: more than body requirements D. Risk for activity intolerance
A People with myxedema are at high risk for hypothermia. In myxedema severe hypothyroidism causes slower metabolism and subnormal body temperature. The nursing diagnoses in the other answer options are appropriate for a patient with myxedema, because edema, weight gain, and activity intolerance are likely a result of hypothyroidism.
A patient's T3 and T4 levels are decreased, and the TSH (thyroid-stimulating hormone) level is increased. The nurse suspects what condition? A. Hypoparathyroidism B. Hypothyroidism C. Hyperthyroidism D. Hyperparathyroidism
B A decrease in the level of thyroid hormone, evidenced by below-normal T3 and T4 levels and increased TSH, indicates hypothyroidism. TSH increases as the body attempts to compensate for decreased thyroid production by trying to stimulate more T3 and T4 production. Hypoparathyroidism is a decrease in parathormone that in turn causes a decrease in serum calcium. In hyperthyroidism T3 and T4 production are increased and TSH is decreased. Hyperparathyroidism is an increase in parathormone that causes an increase in serum calcium.
Which clinical manifestations does the nurse expect in a hospitalized patient diagnosed with Graves' disease? A. Anemia B. Dysrhythmia C. Systolic murmurs D. Distant heart sounds E. Systolic hypertension
B, C, E Graves' disease is a term used to describe hyperthyroidism. Clinical manifestations associated with this disease process include tachycardia, dysrhythmia, systolic murmurs, and systolic hypertension. Hypothyroidism is associated with anemia and distant heart sounds.
The nurse is assessing a patient for hyperthyroidism. What are the manifestations of hyperthyroidism? A. Enlarged scaly tongue B. Presence of bruits upon auscultation of the thyroid gland C. Presence of dry, thick, inelastic, and cold skin D. Presence of goiter detected on palpation of the thyroid gland E. Presence of clubbed and swollen fingers
B, D, E In a patient with hyperthyroidism, auscultation of the thyroid gland reveals bruits, palpation of the thyroid gland reveals goiter, and the nurse would observe the patient's clubbed and swollen fingers. Enlarged scaly tongue and dry, thick, inelastic, and cold skin are observed in patients with hypothyroidism.
The nurse creates a plan of care for a patient with Graves' disease. What is an appropriate expected outcome? A. The patient will be free of infection. B. The patient will remain awake, alert, and oriented. C. The patient will be compliant with fluid restrictions. D. The patient will demonstrate maintenance of his weight.
D Graves' disease, which results from hyperthyroidism, causes an increase in metabolism. Untreated, it may cause unexplained weight loss. It is important for the nurse to plan care to support an expected outcome to maintain or gain weight. Risk for infection and fluid overload are not direct issues related to hyperthyroidism. Because of the increased secretion of thyroid hormone, these patients will be hyperalert and anxious and may have difficulty sleeping. Therefore, the goal of remaining awake, alert, and oriented is not a priority.
