Thyroid and Parathyroid

15. The nurse is providing care for a patient who underwent thyroidectomy 2 days ago. Which lab value requires close monitoring by the nurse? 1. calcium level 2. sodium level 3. potassium level 4. WBC count

1. calcium level

29. The nurse is caring for a patient with hyperthyroidism who had a partial thyroidectomy yesterday. Which change is assessment would the nurse report to the HCP immediately? 1. temperature elevation to 101.2F 2. HR increases from 64 to 76 3. respiratory rate decreases from 26 to 16 4. pulse ox reading of 92%

1. temperature elevation to 101.2F

419. A nurse is caring for a client who just had a thyroidectomy. For which client response should the nurse assess the client when concerned about an accidental removal of the parathyroid glands during surgery? 1. tetany 2. myxedema 3. hypovolemic shock 4. adrenocortical stimulation

1. tetany

425. A client is diagnosed with hyperthyroidism and is experiencing exophthalmia. Which measures should the nurse include when teaching this client how to manage the discomfort associated with exophthalmia? SATA 1. use tinted glasses 2. use warm, moist compresses 3. elevate the head of bed 45 degress 4. tape eyelids shut at night if they do not close 5. apply a petroleum-based jelly along the lower lid

1. use tinted glasses 3. elevate the head of bed 45 degress 4. tape eyelids shut at night if they do not close

410. Propylthiouracil (PTU) is prescribed for a client diagnosed with with hyperthyroidism. The client asks the nurse, "why do I have to take this medication if I am going to get the atomic cocktail?" The nurse explains that the medication is being prescribed because it decreases the: 1. vascularity of the thyroid gland 2. production of thyroid hormones 3. need for thyroid iodine supplements 4. amount of already formed thyroid hormones

2. production of thyroid hormones

411. A nurse is caring for a client with an underactie thyroid gland. Which responses should the nurse expect the client to exhibit as a result of decreased levels of triiodothyronine (T3) and T4? SATA 1. irritability 2. tachycardia 3. weight gain 4. cold intolerance 5. profuse diaphoresis

3. weight gain 4. cold intolerance

424. Levothyroxine (Synthroid) 0.125 mg by mouth is prescribed for a client with hypothyroidism. The only tablets available contain 25mcg per tablet. How many tablets should the nurse administer? (round to whole number)

5 tablets

423. A nurse is assessing a client with a diagnosis of hypothyroidism. Which clinical manifestations should the nurse expect when assessing the client? SATA 1. dry skin 2. brittle hair 3. weight loss 4. resting tremors 5. heat intolerance

1. dry skin 2. brittle hair

427. A nurse is caring for a client who is admitted to the hospital with the diagnosis of primary hyperparathyroidism. Which action should be included in the client's plan of care? 1. ensuring a large fluid intake 2. providing a high-calcium diet 3. instituting seizure precautions 4. encouraging complete bed rest

1. ensuring a large fluid intake

417. A nurse is caring for a newly admitted client with a diagnosis of graves disease. In preparing a teaching plan, the nurse anticipates which diet will be ordered for this client? 1. high-calorie 2. low-sodium 3. high-roughage 4. mechanical-soft

1. high-calorie

409. A nurse is caring for a client who is experiencing an underproduction of thyroxine . Which client response is associated with an underproduction of thyroxine (T4)? 1. Myxedema 2. Acromegaly 3. Graves Disease 4. Cushing Disease

1. Myxedema

412. Which clinical findings should have the nurse expect when assessing a client with hyperthyroidism? SATA 1. diarrhea 2. listlessness 3. weight loss 4. bradycardia 5. decreased appetite

1. diarrhea 3. weight loss

415. A nurse is assessing a client for possible laryngeal nerve injury following a thryoidectomy. Which action should the nurse implement on an hourly basis? 1. ask the client to speak 2. instruct the client to swallow 3. have the client hum a familiar tune 4. swab the clients throat to test the gag reflex

1. ask the client to speak

28. Which actions should the nurse assign to the experienced LPN for the care of a patient with hypothyroidism? SATA 1. assessing and recording the rate and depth of respirations 2. auscultating lung sounds every 4 hours 3. creating an individualized nursing care plan for the patient 4. administering sedation medications every 6 hours 5. Checking BP, HR, respirations every 4 hours 6. reminding the patient to report any episodes of chest pain or discomfort

1. assessing and recording the rate and depth of respirations 2. auscultating lung sounds every 4 hours 5. Checking BP, HR, respirations every 4 hours 6. reminding the patient to report any episodes of chest pain or discomfort

420. When taking the blood pressure of a client who had a thyroidectomy, the nurse identifies that the client is pale and has spasms of the hand. The nurse notifies the HCP. Which should the nurse expect the HCP to prescribe? 1. calcium 2. magnesium 3. bicarbonate 4. potassium chloride

1. calcium

31. The nurse is orienting a new graduate RN who is providing care for a postoperative patient after a thyroidectomy. The new graduate assess the patient and notes laryngeal stridor with a pulse ox measure of 89%. What is the priority action for the nurse and new grad? 1. immediately notify RRT 2. apply oxygen by face mask 3. prepare to suction the patient 4. assess for numbness and tingling around the mouth

1. immediately notify RRT

4. Which changes in vital signs would the nurse instruct the UAP to report immediately for a patient with hyperthyroidism? 1. rapid heart rate 2. decreased systolic blood pressure 3. increased respiratory rate 4. decreased oral temperature

1. rapid heart rate

416. A client with hyperthyroidism asks the nurse about the tests that will be ordered. Which diagnostic test should the nurse include in a discussion with this client? 1. T4 and x-ray films 2. TSH assay and T3 3. thyroglobulin level and Po2 4. Protein-bound iodine and SMA

2. TSH assay and T3

33. The nurse assesses a newly admitted patient with a diagnosis of hyperthyroidism (see figure, pg. 127). How would the nurse best document the findings in the patient? 1. bilateral exophthalmos 2. large visible goiter 3. myxedema 4. moon face

2. large visible goiter

27. 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? 1. "this therapy is to protect your kidney function" 2. "You are receiving these therapies to prevent edema formation" 3. "diuretic and hydration therapies are used to reduce your serum calcium; 4. "these therapies may help to improve your candidacy for surgery"

3. "diuretic and hydration therapies are used to reduce your serum calcium;

6. As the shift begins, the nurse is assigned to care for the following patients. Which patient should the nurse assess first? 1. a 38-year-old patient with graves disease and a HR of 94 2. a 63-year-old patient with type 2 diabetes and fingerstick glucose level of 137 mg/dL 3. a 58-year-old patient with hypothyroidism and a HR of 48 4. a 49-year-old patient with cushing disease and dependent edema rated as +1

3. a 58-year-old patient with hypothyroidism and a HR of 48

422. On the first postoperative day following a thyroidectomy, a client tolerates a full-fluid diet. This is changed to a soft diet on the second postoperative day. The client reports having a sore throat when swallowing. What should the nurse do first? 1. reorder the full fluid diet 2. notify HCP 3. administer analgesics as prescribed before meals 4. provide saline gargles to moisten the mucus membranes

3. administer analgesics as prescribed before meals

426. For which client response should the nurse monitor when assessing for complications of hyperparathyroidism? 1. tetany 2. seizures 3. bone pain 4. graves disease

3. bone pain

3. A patient is admitted to the medical unit with possible graves disease (hyperthyroidism). Which assessment finding by the nurse supports this diagnosis? 1. periorbital edema 2. bradycardia 3. exophthalmos 4. hoarse voice

3. exophthalmos

413. A nurse is caring for a client after radioactive iodine is administered for graves disease. What information about the client's condition after this therapy should the nurse consider when providing care? 1. not radioactive and can be handled as any other individual 2. highly radioactive and should be isolated as mush as possible 3. mildly radioactive but should be treated with routine safety precautions 4. not radioactive but may still transmit some dangerous radiations and must be treated with precautions

3. mildly radioactive but should be treated with routine safety precautions

421. What should a nurse do immediately when a client returns from the PACU following a subtotal thyroidectomy? 1. inspect the incision 2. instruct the client not to speak 3. place a tracheostomy set at the bedside 4. place in the supine position for 24 hours

3. place a tracheostomy set at the bedside

414. A client is scheduled to have a thyroidectomy. Which medication does the nurse anticipate the health care provider will prescribe to decrease the size and vascularity of the thyroid gland before surgery? 1. vasopressin (pitressin) 2. propylthiouracil (PTU) 3. potassium iodine (SSKI) 4. levothyroxine (synthroid)

3. potassium iodine (SSKI)

22. 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? 1. always stand to the side of the patient 2. instruct the patient not to swallow 3. palpate using one hand and then the other 4. always palpate the thyroid gland gently

4. always palpate the thyroid gland gently

428. A client's lab values demonstrate an increased serum calcium level, and further diagnostic tests reveal hyperparathyroidism. For which clinical manifestations should the nurse assess the client? SATA 1. muscle tremors 2. abdominal cramps 3. increased peristalsis 4. cardiac dysrhythmias 5. hypoactive bowel sounds

4. cardiac dysrhythmias 5. hypoactive bowel sounds

418. A nurse in the PACU is caring for a client who just had a thyroidecctomy. For which client response is it most important for the nurse to monitor? 1. urinary retention 2. signs of resstlessness 3. decreased BP 4. signs of respiratory obstruction

4. signs of respiratory obstruction

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

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

abd a. Chronic kidney diseases b. Neck trauma d. Vitamin D deficiency

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

AA. Hypothyroidism

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

B b. Cold intolerance

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 b. Hypothyroidism

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.

Cc. Tape the eyes closed with nonallergenic tape

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 d. Increased serum T3 and T4

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

a A thyrotoxicosis.

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

a, b, e a. It is most commonly caused by Graves' disease b. It can be caused by overuse of thyroid replacement medication e. Serum T3 and T4 results will be elevated

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. Hyperthyroidism and goiter

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 a. It is an inflammation of the thyroid gland b. Hashimoto's disease is the most common type d. There are three types: acute, subacute, and chronic. E. The patient must take thyroid hormones

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

aA. Calcitonin

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

ab a. Numbness and tingling around the mouth b. muscle cramping

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 a. It occurs more often in women b. It can be caused by iodine deficiency d. It can be caused by autoimmune thyroid destruction e. Myxedema coma is a rare but serious complication

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 a. Prescribed medications must be taken for the patient entire life c. Eat foods high in calcium, but low in phosphorous

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. Abdominal pain and nausea c. Elevated temperature d. Tachycardia e. Elevated systolic blood pressure

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 b. Dark-colored urine

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 b. It destroys the tissue that produces thyroid hormones

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

bb. Elevated serum thyroglobulin level

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 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

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 b. yogurt e. Milk f. Processed cheese

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 d. Goiter

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

cc. Notify the Rapid Response Team

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

cc. Phosphate

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

cc. Upper eyelid pulls back faster than the eyeball when the patient gazes upward

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

dd. Exacerbation of symptoms by releasing additional thyroid hormone

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

dd. Graves' disease

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

dd. Respiratory failure

5. For a patient with hyperthyroidism, which task should the nurse delegate to an experienced UAP? 1. instructing the patient to report any occurrence of palpitations, dyspnea, vertigo, or chest pain 2. monitoring the apical pulse, BP, and temperature every 4 hours 3. drawing blood to measure levels of TSH, triiodothyronine, and thyroxine 4. teaching the patient about side effects of the drug proplythiouracil

2. monitoring the apical pulse, BP, and temperature every 4 hours

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

dd. hypocalcemia