thyroidpractice questions
A heel-stick screening of a newborn reveals the presence of T4 deficiency along with elevated thyroid-stimulating hormone (TSH). The infant is diagnosed with hypothyroidism. Which information should the nurse provide the parents? A.The child will need lifelong thyroid medication supplementation. B.The child will eventually grow out of this and no longer need treatment. C.The child will be involved in infertility treatment later in life. D.The child will require evaluation for radioactive iodine.
A - the child will need lifelong thyroid medication supplement -Hypothyroidism detected in neonates requires lifelong supplementation of thyroid hormone. The drug of choice for children is oral levothyroxine. The child would not require radioactive iodine, as this is reserved for hyperthyroidism. Infertility is a possibility for those women with hypothyroidism who do not ovulate. The child will not grow out of this, and will need lifelong treatment.
Which physical assessment parameter is most appropriate for the nurse to include when assessing the client for possible hyperthyroidism? (Select all that apply.) A.Vision test B.Vital signs C.Deep tendon reflexes D.Confusion E.Weight loss
A,B,C,E - vision test -vital signs -deep tendon flexes - weight loss Hyperthyroidism may affect many systems in the body, and the nurse would include the weight of the client in the physical assessment, a vision test, vital signs, and a test of the tendon reflexes. Confusion is associated with hypothyroidism.
The nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? (Select All That Apply) A) Insomnia B) Weight Loss C) Bradycardia D) Constipation E) Mild Heat Intolerance
A,B,E - insomnia -weight loss -mild heat intolerance Rationale: Remember levothyroxine is going treat hypothyroidism, so think of levothyroxine as a medication that is going to make them go into hyperthyroidism. So s/s of hyperthyroidism are insomnia, weight loss, and mild heat intolerance.
The nurse is preparing a client with hyperthyroidism for radioactive iodine treatments. Which information should the nurse provide to the client prior to this procedure? (Select all that apply.) A.That the client may need lifelong thyroid replacement B.That radioactive iodine is given intravenously C.How to measure the radial pulse D.That the end results are immediately seen E.That hospitalization is usually required
A,C - the client may need lifelong thyroid replacement - how to measure radial pulse Clients are instructed on measuring their own pulse until stores of thyroid hormone are depleted and notifying the healthcare provider if the heart rate is over 100 beats per minute. The client will more than likely require lifelong thyroid replacement due to radiation effects on the remaining thyroid tissue. The results may take up to 6 to 8 weeks to notice. This procedure is performed with an oral contrast on an outpatient basis.
You are performing discharge teaching with a patient who is going home on Synthroid. Which statement by the patient causes you to re-educate the patient about this medication? A. "I will take this medication at bedtime with a snack." B. "I will never stop taking the medication abruptly." C. "If I have palpitations, chest pain, intolerance to heat, or feel restless, I will notify the doctor." D. "I will not take this medication at the same time I take my Carafate."
A. "I will take this medication at bedtime with a snack." Synthroid is best taken in the MORNING on an empty stomach. All the other statements are correct about taking Synthroid.
The client with hypothyroidism asks the nurse why the thyroid-stimulating hormone (TSH) level is increased if the thyroid is not working properly. Which response by the nurse is accurate? A."Your TSH level is increased due to an inadequately functioning negative hormonal feedback process." B."Your TSH level is increased because the thyroid is working harder to produce more hormone." C."Your TSH level is increased from a malfunction in the hypothalamus, leading to thyroid insufficiency." D."Your TSH level is increased due to an increase in metabolism noted in clients with hypothyroidism."
A. "Your TSH level is increased due to an inadequately functioning negative hormonal feedback process." The TSH level increases in clients with hypothyroidism due to a loss of the negative hormonal feedback system, not because the thyroid is working harder. Metabolism is decreased in hypothyroidism, not increased. The pituitary gland, not the hypothalamus, is responsible for TSH production.
A patient who is in her first trimester of pregnancy is diagnosed with hyperthyroidism. Which medication do you suspect the patient will be started on? A. Propylthiouracil (PTU) B. Radioactive Iodine C. Tapazole D. Synthroid
A. Propylthiouracil (PTU) -Propylthiouracil (PTU) is the only anti-thyroid medication that can be used during the 1st trimester of pregnancy.
Which of the following are treatment options for hyperthyroidism? Please select all that apply: A. Thyroidectomy B. Methimazole C. Liothyronine Sodium "Cytomel" D. Radioactive Iodine
A. Thyroidectomy B. Methimazole D. radioactive iodine The answers are A, B,and D. Liothyronine Sodium "Cytomel" is a treatment for hypothyroidism. All the other options are for hyperthyroidism.
An adult client reports a weight gain and feeling cold all the time. Which condition should the nurse suspect? A.Hypothyroidism B.Chronic renal failure C.Hyperthyroidism D.Depression
A. hypothyroidism - Weight gain and feeling cold can be symptoms of hypothyroidism. The nurse would conduct an assessment to validate this assumption. Depression would not usually include weight gain or feeling cold. The weight gain of renal failure is usually associated with fluid retention. Hyperthyroidism presents with weight loss and increased sweating.
Fill in the blank regarding the negative feedback loop for thyroid hormone production: The ______________ produces TRH (Thyrotropin-Releasing Hormone) which causes the anterior pituitary gland to produce _______________ which in turn causes the thyroid gland to release _______ and _______.* A. Thalamus, CRH (Corticotropin-releasing hormone) TSH (thyroid-stimulating hormone) and T4 B. Hypothalamus, TSH (thyroid-stimulating hormone), T3 and T4 C. Posterior pituitary gland, TSH (thyroid-stimulating hormone), T3 and T4 D. Hypothalamus, CRH (Corticotropin-releasing hormone), TSH (thyroid-stimulating hormone), T3 and TSH
B. Hypothalamus, TSH (thyroid-stimulating hormone), T3 and T4
A patient was recently discharged home for treatment of hypothyroidism and was ordered to take Synthroid for treatment. The patient is re-admitted with signs and symptoms of the following: heart rate 42, blood pressure 70/56, blood glucose 55, and body temperature of 96.8 'F. The patient is very fatigued and drowsy. The family reports the patient has not been taking Synthroid since being discharged home from the hospital. Which of the following conditions is this patient most likely experiencing? A. Thryoid Storm B. Myxedema Coma C. Iodism D. Toxic Nodular Goiter
B. Myxedema Coma The red flags in this question are the patient's signs/symptoms and the report from the family the patient hasn't been taking the prescribed Synthroid. The patient is showing signs and symptoms of extreme hypothyroidism known as Myxedema coma (which is life-threatening if not treated).
Which treatment should the nurse anticipate for a client who is newly diagnosed with hypothyroidism? A.Partial thyroidectomy B.Treatment with synthetic hormone C.Radiation D.Nonsteroidal anti-inflammatory medications
B. treatment with synthetic hormone The expected treatment for hypothyroidism is replacement with synthetic thyroid hormone. Surgical management, such as partial thyroidectomy, is used for management of hyperthyroidism. Radiation may also be used in the treatment plan for a client with hyperthyroidism. Nonsteroidal anti-inflammatory medications may be used in the management of a client with thyroiditis.
A patient is being discharged home for treatment of hypothyroidism. Which medication is most commonly prescribed for this condition? A. Tapazole B. PTU (Propylthiouracil) C. Synthroid D. Inderal
C. Synthroid Synthroid is the only medication listed that treats hypothyroidism. All the other medications are used for hyperthyroidism.
A patient has an extremely high T3 and T4 level. Which of the following signs and symptoms DO NOT present with this condition? A. Weight loss B. Intolerance to heat C. Smooth skin D. Hair loss
D. Hair loss
A patient reports they do not eat enough iodine in their diet. What condition are they most susceptible to?* A. Pheochromocytoma B. Hyperthyroidism C. Thyroid Storm D. Hypothyroidism
D. Hypothyroidism Iodine helps make T3 and T4....if a person does not consume enough iodine they are at risk for developing HYPOTHYROIDISM.
A client reports hoarseness and feelings of tightness in the throat. During the examination, the nurse notes visible swelling at the base of the neck, neck vein distention, a rapid pulse, and sweating. The nurse should suspect which condition in this client? A.toxic multinodular goiter B.Pretibial myxedema C.Exophthalmos D.Graves disease
D. graves disease Graves disease involves an enlargement of the thyroid gland due to overproduction of thyroid hormones. Therefore, the nurse would note swelling and neck vein distention. Exophthalmos would be evident by protruding eyeballs. Pretibial myxedema is nonpitting edema and would be noted in hypothyroidism. Toxic multinodular goiter is characterized by small nodules on the thyroid.
A patient is admitted with complaints of palpations, excessive sweating, and unable to tolerate heat. In addition, the patient voices concern about how her appearance has changed over the past year. The patient presents with protruding eyeballs and pretibial myxedema on the legs and feet. Which of the following is the likely cause of the patient's signs and symptoms? A. Thyroiditis B. Deficiency of iodine consumption C. Grave's Disease D. Hypothyroidism
c. graves disease
