Chapter 39 MS study set

b.) Wear gloves when emptying the bedside commode

A 26-year-old patient is hospitalized for radioactive iodine treatment for hyperthyroidism. Which of the following precautions by the nurse is appropriate? a.) Talk with the patient only over the intercom system. b.) Wear gloves when emptying the bedside commode c.) maintain reverse isolation for 3 months '

goitrogen

A food or medication that can cause enlargement of the thyroid gland is called a __________________.

euthyroid

A normally functioning thyroid gland produces a ___________________ state.

Syndrome of antidiuretic hormone (SIADH)

Water retention is a characteristic of ________________________.

Hypothyroidism

Weight gain and fatigue are characteristics of _________________________________

c.) vital signs

What assessment findings should the nurse monitor to detect the onset of thyrotoxicosis in a patient with hyperthyroidism? a.) peripheral pulses b.) serum sodium c.) vital signs d.) incision site

b.) deficient fluid volcume

Which of the following nursing diagnoses is most appropriate for the patient admitted in addisonian crisis? a.) imbalanced nutrition: more than body requirements b.) deficient fluid volume c.) disturbed body image d.) acute pain

Grave's Disease

___________________ is a problem caused by high T3 and T4 levels.

Addison's disease

________________________ is a result of steroid deficiency.

Hypoparathyroidism

________________________ is the result of low serum calcium levels.

pheochromocytoma

A ____________________ is a tumor of the adrenal medulla.

Hyperparathyroidism

High serum calcium levels leads to __________________________

Hypothyroidism

Insufficient levels of T3 and T4 hormones result in __________________.

epinephrine

Pheochromocytoma is the result of excess _______________________.

b,c,e

Symptoms of hyperthyroidism include: (select all that apply) a.) Confusion b.) insomnia c.) warm/sweaty skin d.) dry hair e.) weight loss

b,c,d

Symptoms of hyperthyroidism include: (select all that apply) a.) dry hair b.) restlessness c.) frequent stools d.) tremors e.) lethargy

a,c,e

Symptoms of hypothyroidism include: (select all that apply) a.) bradycardia b.) restlessness c.) lethargy d.) frequent stools e.) hypercholesterolemia

a,c,e

Symptoms of hypothyroidism include: (select all that apply) a.) dry hair b.) restlessness c.) mental dullness/confusion d.) tremor e.) decreased appetite

myxedema

Untreated hypothyroidism can lead to ______________________ coma.

c.) The pituitary makes more thyroid-stimulating hormone to try to stimulate the underactive thyroid.

A 42-year-old patient enters an outpatient clinic with symptoms of weight gain and fatigue. Labratory studies are done and a diagnosis of primary hypothyroidism is made. The patient asks why the thyroid stimulating hormone is elevated. Whic is the best response? a.) The thyroid makes more TSH to take the place of the deficient T3 and T4. b.) The TSH tries to directly raise the metabolic rate when there is not enough T3 and T4 c.) The pituitary makes more TSH to try to stimulate the underactive thyroid. d.) The extra fat cells from your weight gain make excess thyroid-stimulating hormone.

b.) Buffalo hump, easy bruising

A patient enters a clinic with possible Cushing syndrome. Which of the following physical examination findings support this diagnosis. a.) weight loss, pale skin b.) buffalo hump, easy bruising c.)

a.) I know I should call my doctor if my heart races

A patient with hypothyroidism is started on levothyroxine (Synthroid). WHich statement shows the patient understands teaching related to the new medication. a.) I know I should call my doctor if my heart races. b.) I understand that I may develop a moon-shaped face. c.) The sleepinesss I experience when I start this medication will subside within 2 weeks. d.) I'll have to watch my diet to avoid further weight gain while on this medication.

Syndrome of inappropriate antidiuretic hormone (SIADH)

ADH excess can lead to the disorder known as ____________________________________________.

d.) Growth hormone

An excess of which hormone is responsible for acromegaly? a.) thryoid-stimulating hormone b.) insulin c.) adrenocorticotropic hormone d.) growth hormone

Steroid

Cushing Syndrome can be a result of _________________ excess.

ADH

Diabetes insipidous is a result of _____________ deficiency.

a.) numb fingers, muscle cramps

Following surgery for thyroidectomy, the nurse watches carefully for which of the following signs and symptoms of tetany? a.) numb fingers, muscle cramps b.) weakness, muscle fatigue c.) hallucinations, delusions d.) dyspnea and tachycardia

hyperparathyroidism

Muscle weakness and brittle bones are signs/symptoms of ________________________.

tetany

Muscles spasms and tingling around the mouth are symptoms of ________________________.

diabetes insipidus

Polyuria and polydipsia are signs/symptoms of ______________________.

a.) increase fluids

Which of the following dietary recommendations will reduce the risk of kidney stones in the patient with hyperparathyroidism? a.) increase fluids b.) increase citrus fruits c.) limit meat products d.) limit bread products

a.) Assess for Chvostek's sign. A positive Chvostek sign can be indicative of hypocalcemia, which should be treated immediately. A tracheostomy may be required if edema of the neck occurs; these are clinical manifestations of hypocalcemia. The client should already have the HOB elevated since they just had a thyroidectomy, but even elevating the bed will not address these clinical manifestations. These clinical manifestations are not indicative of postoperative bleeding.

The nurse is caring for a client who underwent a thyroidectomy and is reporting numbness and tingling around the mouth. What is the best nursing action? a.) Assess for Chvostek's sign b.) Prepare the client for a tracheostomy c.) Elevate the head of the bed (HOB) d.) Assess the client's dressing

a.) Check the back of the neck for pooling of blood

The nurse is caring for a client who underwent a thyroidectomy. Which interventions should the nurse implement? a.) Check the back of the neck for pooling of blood b.) Monitor vital signs every hour initially c.) Instruct the client to avoid speaking d.) Monitor the client for signs of hypokalemia

c.) Moon-shaped face

The nurse is caring for a client with Cushing syndrome. Which clinical manifestation can the nurse expect to find upon assessment? a.) Bronze hyperpigmentation b.) Severe, pounding headache c.) Moon-shaped face d.) Exophthalmos

a.) Thick tongue b.) Fleshy appearance c.) Enlargement of facial features e.) Displaced teeth

The nurse is caring for a client with acromegaly. Which clinical manifestations would the nurse expect to find? Select all that apply. a.) Thick tongue b.) Fleshy appearance c.) Enlargement of facial features d.) Small hands e.) Displaced teeth

a.) Nocturia b.) Polydipsia

The nurse is caring for a client with diabetes insipidus (DI). Which clinical manifestations can the nurse expect to find? a.) Nocturia b.) Polydipsia c.) High serum osmolality d.) Increased specific gravity e.) Dark, concentrated urine

b.) Acromegaly

The nurse is caring for a client with growth hormone (GH) excess. The client would exhibit clinical manifestations consistent with which condition? a.) Grave's disease b.) Acromegaly c.) Dwarfism d) Cushing syndrome

b.) Myxedema coma

The nurse is caring for a client with hypothyroidism who develops edema of the face, hands, and feet. The nurse knows these symptoms are typically seen in which condition? a.) Thyroid storm b.) Myxedema coma c.) Pheochromocytoma d.) Cushing syndrome

d.) Unstable hypertension A severe, pounding headache is seen in clients with pheochromocytoma. Tachycardia is seen in clients with pheochromocytoma. Diaphoresis is a clinical manifestation of clients with pheochromocytoma. Unstable hypertension is the classic sign of pheochromocytoma.

The nurse is caring for a client with pheochromocytoma. Which prominent characteristic should the nurse expect to find in this client? a.) Mild headache b.) Bradycardia c.) Dry skin d.) Unstable hypertension

d.) Administer propranolol as ordered The head of bed should be elevated, not flat. A cooling blanket will be applied. Aspirin should be avoided because it binds with the same serum protein as T4, freeing additional T4 into the circulation. A beta-adrenergic blocker is administered for tachycardia and symptom control.

The nurse is caring for a client with thyrotoxic crisis. Which intervention should the nurse implement first? a.) Place the client flat in the bed b.) Apply a warming blanket c.) Administer aspirin as ordered d.) Administer propranolol as ordered

d.) "I should not quit taking the medication until my doctor tells me to."

The nurse is providing education for a client receiving fludrocortisone. Which statement indicates an understanding of the teaching? a.) "I need to return to have my calcium level checked." b.) "I should weigh myself every other week." c.) "I need to take this medication on an empty stomach." d.) "I should not quit taking the medication until my doctor tells me to."

d.) "I may have more energy after taking this medication for a few months."

The nurse is providing education for a client with hypothyroidism. Which statement made by the client indicates an understanding of the teaching? a.) "I should weigh myself every day." b.) "I can stop taking my medication once I feel better." c.) "My eyes will probably begin to bulge." d.) "I may have more energy after taking this medication for a few months."

c.) "I should report signs of infection to the doctor." The client should eat a diet low in sodium and high in potassium. The client should receive a flu and pneumonia vaccination. This statement is accurate. Any clinical manifestations of an infection should be reported immediately. Moisturizer should be encouraged.

The nurse is providing education to a client with Cushing syndrome. Which statement made by the client indicates an understanding of the teaching? a.) "I should eat a diet high in sodium and low in potassium." b.) "I should avoid the flu and pneumonia vaccines." c.) "I should report signs of infection to the doctor." d.) "I need to avoid using moisturizer on my skin."

c.) "The procedure should take about 30 minutes." Cold spots are biopsied for malignancy. A small amount of radiation is given, so the client's risk is minimal. This statement is correct. The procedure takes approximately 30 minutes to complete. This procedure is done to determine the presence of tumors or nodules.

The nurse is providing teaching to a client about to undergo a thyroid scan. Which of the following should the nurse include in the teaching? a.) "Hot spots will be biopsied to confirm malignancy." b.) "A large amount of radioactive material is used, so your risk is high." c.) "The procedure should take about 30 minutes." d.) "This procedure is done to determine how your thyroid is functioning."

a.) Elevated thyroid-stimulating hormone (TSH) level An elevated TSH is found in clients with hypothyroidism. A decreased GH level is seen in clients with dwarfism. A decrease in cortisol is seen in clients with Addison's disease. Besides with diabetes, elevated blood glucose is seen in clients with Cushing syndrome.

The nurse is reviewing lab values for a client with hypothyroidism. Which finding can the nurse expect to see? a.) Elevated thyroid-stimulating hormone (TSH) level b.)Decreased growth hormone (GH) level c.) Decreased cortisol level d.)Elevated blood glucose level