THYROID DISORDERS NCLEX REVIEW

4. perform a tracheotomy.

13. A client who has undergone a subtotal thy- roidectomy is subject to complications in the first 48 hours after surgery. The nurse should obtain and keep at the bedside equipment to: 1. begin total parenteral nutrition. 2. initiate defibrillation. 3. administer tube feedings. 4. perform a tracheotomy.

2. "Your behavior is caused by the excess thyroid hormone in your system."

5. A client with thyrotoxicosis says to the nurse, "I am so irritable. 1 am having problems at work because I lose my temper very easily." Which response by the nurse would give the client the most accurate explanation of this behavior? 1. "Your behavior is caused by temporary confusion brought on by your illness." 2. "Your behavior is your caused by the excess thyroid hormone in your system." 3. "Your behavior is caused by your worrying about the seriousness of your illness." 4. "Your behavior is caused by the stress of trying to manage a career and cope with illness."

3. Contact the HCP and discuss the prescription for propranolol because of the client's histor of having asthma.

07. A client with hyperthyroidism is hospitalized to have a thyroidectomy. The healthcare provider (HCP) has prescribed propranolol. In reviewing the client's history, the nurse notes that the client has asthma. The nurse should next: 1. take the client's pulse and withhold the propranolol if the pulse is <100 beats per minute. 2. count the client's respirations and withhold the propranolol if the respirations are <20 breaths per minute. 3. Contact the HCP and discuss the prescription for propranolol because of the client's history of having asthma. 4. instruct the client to make position change slowly.

2. tachycardia.

1. The nurse is completing a health assessment of a 42-year-old female with suspected Graves' disease. The nurse should assess this client for: 1. anorexia. 2. tachycardia. 3. weight gain. 4. cold skin.

4. decreased activity due to fatigue.

17. The nurse should assess a client with hypothyroidism for: 1. corneal abrasion due to inability to close the eyelids. 2. weight loss due to hypermetabolism. 3. fluid loss due to diarrhea. 4. decreased activity due to fatigue.

3. oligomenorrhea

2. When conducting a health history with a female client with thyrotoxicosis, the nurse should ask about which changes in the menstrual cycle? 1. dysmenorrhea 2. metrorrhagia 3. oligomenorrhea 4. menorrhagia

2. decreased energy and fatigue 3. weight gain of 10 lb (4.5 kg) 5. constipation 6. menorrhagia

3. A 34-year-old female is diagnosed with hypothyroidism. What should the nurse assess the client for? Select all that apply. 1. rapid pulse 2. decreased energy and fatigue 3. weight gain of 10 lb (4.5 kg) 4. fine, thin hair with hair loss 5. constipation 6. menorrhagia

1. Sore throat.

4. Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse should teach the client to immediately report: 1. Sore throat. 2. painful, excessive menstruation. 3. constipation. 4. increased urine output.

3. laryngeal nerve damage.

12. Following a subtotal thyroidectomy, the nurse asks the client to speak immediately upon regaining consciousness. The nurse does this to monitor for signs of: 1. internal hemorrhage. 2. decreasing level of consciousness. 3. laryngeal nerve damage. 4. upper airway obstruction.

2. notify the healthcare provider (HCP).

14. One day following a subtotal thyroidectomy a client begins to have tingling in the, fingers and toes. The nurse should first 1. encourage the client to flex and extend the fingers and toes. 2. notify the healthcare provider (HCP). 3. assess the client for thrombophlebitis. 4. ask the client to speak.

2. calcium gluconate

15. Which medication should be available to provide emergency treatment if a client develops tetany after a subtotal thyroidectomy? 1. Sodium phosphate 2. calcium gluconate 3. echothiophate iodide 4. sodium bicarbonate

2. weight gain

16. A 60-year-old female is diagnosed with hypothyroidism. The nurse should assess the client for: 1. tachycardia. 2. weight gain. 3. diarrhea. 4. nausea.

2. reduce the vascularity of the thyroid gland.

10. A client with a large goiter is scheduled for a subtotal thyroidectomy to treat thyrotoxicosis. Saturated solution of potassium iodide (SSKI) is prescribed preoperatively for the client. The expected outcome of using this drug is that it helps: 1.slow progression of exophthalmos 2. reduce the vascularity of the thyroid gland. 3. decrease the body's ability to store thyroxine. 4. increase the body's ability to excrete thyroxine.

3. dilute the solution with water, milk, or fruit juice and have the client drink it with a straw.

11. The nurse is administering a saturated solution of potassium iodide (SSKI). The nurse should: 1. pour the solution over ice chips. 2. mix the solution with an antacid. 3. dilute the solution with water, milk, or fruit juice and have the client drink it with a straw. 4. disguise the solution in a pureed fruit or vegetable.

4. most likely related to low thyroid hormone levels and will improve with treatment.

18. When discussing recent onset of feelings of sadness and depression in a client with hypothyroidism who has just started to take thyroid hormone replacement, the nurse should inform the client that these feelings are: 1. the effects of hyroid bormone replacement therapy and will diminish over time. 2. related to thyroid hormone replacement therapy and will not diminish over time. 3. a normal part of having a chronic illness. 4. most likely related to low thyroid hormone levels and will improve with treatment.

2. the levothyroxine before breakfast and the other medications 4 hours later

19. The nurse is instructing the client with hypothyroidism who takes levothyroxine 100 mco digoxin, and simvastatin. Teaching regarding the use of these medications is effective if the client will take: 1. the levothyroxine with breakfast and the other medications after breakfast. 2. the levothyroxine before breakfast and the other medications 4 hours later 3. all medications together 1 hour after eating breakfast. 4. all medications before going to bed.

2. "1 am able to sleep and rest at night."

6. The nurse is evaluating a client with hyperthyroidism who is taking propylthiouracil (PTU) 100 mg/day in three divided doses for maintenance therapy. Which statement from the client indicates the drug is effective? 1. "I have excess energy throughout the day." 2. "1 am able to sleep and rest at night." 3. "I have lost weight since taking this medication." 4. "I do perspire throughout the entire day."

3. wearing dark-colored glasses.

8. The nurse should teach the client with Graves' disease to prevent corneal irritation from mild exophthalmos by: 1. massaging the eyes at regular intervals. 2. instilling an ophthalmic anesthetic as prescribed. 3. wearing dark-colored glasses. 4. Covering both eyes with moistened gauze pads.

3. take thyroxine replacement for the remainder of the client's life.

9. After treatment with radioactive iodine (RAI, 1-131) I, the nurse should teach the client to: 1. monitor for signs and symptoms of hyperthyroidism. 2. rest for 1 week to prevent complications of the medication. 3. take thyroxine replacement for the remainder of the client's life. 4. assess for hypertension and tachycardia resulting from altered thyroid activity