Cirrhosis & Thyroid Adaptive Quiz

Which management of action explains how propylthiouracil (PTU) helps in the management of hyperthyroidism? a) it binds previously formed thyroid hormones b) it decreases production of thyroid hormones c) vascularity of the thyroid gland is decreased d) the need for thyroid iodine supplements is reduced

b) it decreases production of thyroid hormones

The nurse is caring for a client that is scheduled to have a percutaneous liver biopsy. Which assessment findings warrant the postponement of the procedure? SELECT ALL THAT APPLY a) hemosiderosis b) marked ascites c) hepatic cirrhosis d) hemoglobin of less than 9g/dL e) platelet count of 150,000/mm3

b) marked ascites d) hemoglobin of less than 9g/dL

While inspecting the external eye structure of a client, the nurse finds bulging of the eyes. Which condition would be suspected in the client? a) eye tumors b) hypothyroidism c) hyperthyroidism d) neuromuscular injury

c) hyperthyroidism

The assessment of a newly admitted client reveals malnourishment, nausea, distention, and a firm abdomen with ascites. The client has tachycardia and is hypotensive. Which physiological change occurred that resulted in the client's development of ascites? a) an increase in vitamins to maintain cell coenzyme functions b) an increase in iron to maintain adequate hemoglobin synthesis c) a decrease in sodium to maintain its concentration in tissue fluid d) a decrease in plasma protein to maintain ad

d) a decrease in plasma protein to maintain adequate capillary-tissue circulation

The nurse is performing a physical assessment of a client admitted to the hospital with a diagnosis of cirrhosis. The nurse expects to observe which skin conditions? SELECT ALL THAT APPLY a) vitiligo b) hirsutism c) melanosis d) ecchymoses e) telangiectasia

d) ecchymoses e) telangiectasia

The serum ammonia level of a client with hepatic cirrhosis and ascites is elevated. Which is an important nursing intervention? a) weigh the client daily b) restrict the client's oral fluid intake c) measure the client's urine specific gravity d) observe the client for increasing confusion

d) observe the client for increasing confusion

Which reason will the nurse explain is the purpose for neomycin being prescribed to a client with cirrhosis? a) prevents an infection b) limits abdominal distention c) minimizes intestinal edema d) reduces the blood ammonia level

d) reduces the blood ammonia level

Which finding would be expected in a client with a history of hypothyroidism? SELECT ALL THAT APPLY a) cold intolerance b) lethargy and fatigue c) hemoglobin 11.2 g/dL d) 15-pound weight gain e) heart rate 59 beats/min

a) cold intolerance b) lethargy and fatigue c) hemoglobin 11.2 g/dL d) 15-pound weight gain e) heart rate 59 beats/min

A client with cirrhosis of the liver and ascites is scheduled to have a paracentesis. Which intervention would the nurse do to prepare the client for the procedure? a) instruct the client to void b) tell the client not to eat for 4 hours c) give the client an analgesic d) have the client turn to the lateral position

a) instruct the client to void

For which sign of hepatic encephalopathy would the nurse assess a client with cirrhosis of the liver? SELECT ALL THAT APPLY a) mental confusion b) increased cholesterol c) brown-colored stool d) flapping hand tremors e) musty, sweet breath odor

a) mental confusion d) flapping hand tremors e) musty, sweet breath odor

Which skin condition would the nurse expect when performing a physical assessment on a client with a new diagnosis of hyperthyroidism? SELECT ALL THAT APPLY a) warm b) moist c) pale d) smooth e) coarse f) dry

a) warm b) moist d) smooth

The nurse is providing discharge instructions to a client diagnosed with cirrhosis and varices. Which information would the nurse include in the teaching session? SELECT ALL THAT APPLY a) adhering to a low-carbohydrate diet b) avoiding aspirin and aspirin-containing products c) limiting alcohol consumption to two drinks weekly d) avoiding acetaminophen and products containing acetaminophen e) avoiding coughing, sneezing, and straining to have a bowel movement

b) avoiding aspirin and aspirin-containing products d) avoiding acetaminophen and products containing acetaminophen e) avoiding coughing, sneezing, and straining to have a bowel movement

Which statement would the nurse consider when administering opioids to a client with myxedema who has undergone abdominal surgery? a) tolerance to the medication develops readily b) one-third to one-half the usual dose should be prescribed c) opioids may interfere with the secretion of thyroid hormones d) sedation will have a paradoxical effect, causing hyperactivity

b) one-third to one-half the usual dose should be prescribed

A client who had a subtotal thyroidectomy asks how hypothyroidism may develop when the problem was hyperthyroidism. Which would the nurse consider when formulating a response? a) hypothyroidism is a gradual slowing of the body's function b) a decrease in pituitary thyroid-stimulating hormone (TSH) will occur c) less thyroid tissue is available to supply thyroid hormone after surgery d) atrophy of tissue remaining after surgery reduces secretion of thyroid hormones

c) less thyroid tissue is available to supply thyroid hormone after surgery

Which metabolic manifestations are likely to be observed in a client with hypothyroidism? SELECT ALL THAT APPLY a) impaired memory b) intolerance to cold c) difficulty breathing d) decreased blood pressure e) decreased body temperature

b) intolerance to cold e) decreased body temperature

A client with hyperthyroidism has been treated with radioactive iodine to destroy overactive thyroid gland cells. To reduce radiation exposure, which would the nurse consider when providing care? a) wearing a lead-shield apron at all times b) limiting time with and increasing distance from the client c) wearing a radiation meter to measure exposure d) remaining at least 6 feet away from the client at all times

b) limiting time with and increasing distance from the client

The nurse is caring for a client with hepatic encephalopathy and ascites. Which elements are important to include in the client's diet? SELECT ALL THAT APPLY a) high fat b) low sodium c) high vitamins d) moderate protein e) low carbohydrates

b) low sodium c) high vitamins d) moderate protein

A client with hepatic cirrhosis begins to exhibit slurred speech, confusion, drowsiness, and a flapping tremor. Based upon this assessment, which prescribed diet would the nurse anticipate? a) no protein b) moderate protein c) high protein d) strict protein restriction

b) moderate protein

Which situation in a client with hyperthyroidism may precipitate thyroid crisis (thyroid storm)? a) increased iodine in the blood b) removal of the parathyroid glands c) high levels of the hormone triiodothyronine d) rebound increase in metabolism after anesthesia

c) high levels of the hormone triiodothyronine

Which interventions would the nurse include in the plan of care during the first 4 hours after a thyroidectomy? SELECT ALL THAT APPLY a) ensure that the client lies flat b) monitor vital signs every hour c) monitor for stridor or dyspnea d) monitor for the signs and symptoms of tetany e) assess the sides and back of the client's neck for evidence of bleeding

c) monitor for stridor or dyspnea e) assess the sides and back of the client's neck for evidence of bleeding

Which intervention would be included in the plan of care for a client diagnosed with hyperthyroidism? a) monitor for hypoglycemia b) protect visitors and staff from radiation exposure c) provide foods to increase appetite d) arrange for sufficient rest periods

d) arrange for sufficient rest periods

Which manifestations of surgically induced hypothyroidism might the client exhibit after a thyroidectomy? SELECT ALL THAT APPLY a) fatigue b) dry skin c) insomnia d) excitability e) weight loss f) intolerance to heat

a) fatigue b) dry skin

The nurse is caring for a client with cirrhosis of the liver. The nurse anticipates a prescription for neomycin enemas based on which abnormal laboratory test? a) ammonia level b) culture and sensitivity c) white blood cell count d) alanine aminotransferase (ALT) level

a) ammonia level

The nurse is taking care of a client with cirrhosis of the liver. Which clinical manifestations would the nurse assess in the client? SELECT ALL THAT APPLY a) ascites b) hunger c) pruritus d) jaundice e) headache

a) ascites c) pruritus d) jaundice

Which instructions would be included when teaching a client with hyperthyroidism who just had radioactive iodine to ablate thyroid tissue? a) remain in the house b) avoid holding an infant c) save urine in a lead-lined container d) refrain from using a bathroom used by others

b) avoid holding an infant

Which clinical finding would the nurse expect when caring for a client with hyperthyroidism? SELECT ALL THAT APPLY a) lethargy b) tachycardia c) weight gain d) constipation e) exophthalmos

b) tachycardia e) exophthalmos

Which information about a client's condition would the nurse consider when providing care to a client who just received radioactive iodine for Graves disease? a) not radioactive and can be handled as any other individual b) highly radioactive and should be isolated as much as possible c) mildly radioactive and should be treated with routine safety precautions d) not radioactive but may still transmit some dangerous radiations and must be treated with precautions

c) mildly radioactive and should be treated with routine safety precautions

Which medication is indicated for decreasing the size and vascularity of the thyroid gland before thyroidectomy? a) vasopressin b) levothyroxine c) propylthiouracil d) potassium iodine

d) potassium iodine

An infant with congenital hypothyroidism receives levothyroxine for 3 months. Which finding would indicate to the nurse that the medication is effective? a) the infant is alert and interactive b) the skin is cool to the touch c) the baby's fine tremor has ceased d) the baby's thyroid stimulating hormone level has increased

a) the infant is alert and interactive

Which finding in a client with hypothyroidism and hypertension who reports taking an extra dose of levothyroxine indicates the need to obtain a thyroid function panel? SELECT ALL THAT APPLY a) tremors b) diaphoresis c) nervousness d) temp of 101 F e) heart rate 116 beats/min

a) tremors b) diaphoresis c) nervousness d) temp of 101 F e) heart rate 116 beats/min

Which interventions would the nurse implement when providing care to a client after a subtotal thyroidectomy? SELECT ALL THAT APPLY a) assess for frequent swallowing b) ambulate the client the evening of surgery c) assess for facial spasms, apprehension, or tingling of the lips, fingers, or toes d) instruct the client to support the head and maintain the neck in a flexed position e) ensure that oxygen, suction equipment, and a tracheostomy tray are at the bedside

a) assess for frequent swallowing b) ambulate the client the evening of surgery c) assess for facial spasms, apprehension, or tingling of the lips, fingers, or toes e) ensure that oxygen, suction equipment, and a tracheostomy tray are at the bedside

The nurse is admitting a client with severe myxedema coma. Which interventions would the nurse include in the plan of care? SELECT ALL THAT APPLY a) administer IV levothyroxine b) avoid use of corticosteroids c) give IV normal saline d) wait for laboratory results before treating e) monitor blood pressure every 4 hours

a) administer IV levothyroxine c) give IV normal saline

In preparing a teaching plan for a client with hyperthyroidism, the nurse anticipates which diet will be prescribed? a) high-calorie diet b) low-sodium diet c) high-roughage diet d) mechanical-soft diet

a) high-calorie diet

A client with a long history of alcohol abuse develops cirrhosis of the liver. The client exhibits the presence of ascites. Which would the nurse conclude is the MOST likely cause of the client's ascites? a) impaired portal venous return b) impaired thoracic lymph channels c) excess production of serum albumin d) enhanced hepatic deactivation of aldosterone secretion

a) impaired portal venous return

Which information would the nurse provide to a client with hyperthyroidism receiving methimazole? a) initial improvement will take several weeks b) few side effects are associated with this medication c) this medication may be taken at any time during the day d) large loading doses are used initially to normalize thyroid function

a) initial improvement will take several weeks

A client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority? a) institute fall prevention and safety measures b) evaluate coping skills c) measure abdominal girth daily d) test stool specimen for blood

a) institute fall prevention and safety measures

Which clinical manifestation exhibited by a client taking levothyroxine for hypothyroidism for 3 months would cause a nurse to suspect that a decrease in dosage is needed? SELECT ALL THAT APPLY a) tremors b) bradycardia c) somnolence d) heat intolerance e) decreased blood pressure

a) tremors d) heat intolerance

A client with hyperthyroidism asks the nurse about the tests that will be ordered. Which diagnostic tests would the nurse include in a discussion with this client? a) thyroxine (T4) and x-ray films b) TSH assay and T3 c) thyroglobulin level and PO2 d) protein-bound iodine and sequential multichannel auto-analyzer (SMA)

b) TSH assay and T3

Which statement would the nurse include in the plan of care of a client with hyperthyroidism prescribed propylthiouracil and potassium iodine? a) administer propylthiouracil and potassium iodine on an empty stomach b) assess the client for signs of infection and bleeding every shift c) stop the medications 2 weeks before thyroid surgery d) discontinue the medications if the heart rate is maintained within the expected range for 48 hours

b) assess the client for signs of infection and bleeding every shift

Which condition is it MOST important for the nurse to assess for in a client admitted to the hospital for acute gastritis and ascites secondary to alcohol use and cirrhosis? a) nausea b) blood in the stool c) food intolerances d) hourly urine output

b) blood in the stool

The nurse is taking care of a client with cirrhosis of the liver and ascites. Which lunch is an appropriate choice for a client with this disorder? a) ham sandwich with cheese, whole milk, and potato chips b) penne pasta, spinach, banana, and decaffeinated iced tea c) baked lasagna with sausage, salad, and milkshake d) hamburger, french fries, and cola

b) penne pasta, spinach, banana, and decaffeinated iced tea

One week after beginning antithyroid medication for the treatment for hyperthyroidism, a client reports diarrhea, abdominal pain, and a fever. The client is admitted with a diagnosis of thyrotoxic crisis. Which intervention is appropriate to implement for this client? a) limit fluid intake b) reduce body temperature and heart rate c) observe for an exaggerated response to sedatives

b) reduce body temperature and heart rate

Which information will the nurse teach a client with thyroid cancer who is scheduled for thyroidectomy? a) the dietary intake of carbohydrates must be restricted b) thyroxine replacement therapy will be required indefinitely c) chemotherapy will be used in conjunction with the surgery d) a tracheostomy is required for clients having this procedure

b) thyroxine replacement therapy will be required indefinitely

Which manifestations would the nurse expect to find when assessing a client with hyperthyroidism? SELECT ALL THAT APPLY a) dry skin b) weight loss c) tachycardia d) restlessness e) constipation d) exophthalmos

b) weight loss c) tachycardia d) restlessness d) exophthalmos

Which condition would the nurse identify bulging eyeballs as? a) buffalo hump b) myxedema c) exophthalmos d) pheochromocytoma

c) exophthalmos

Assessment findings of a client include fatigue, hair loss, weight gain, and diagnostic tests indicating anemia. The nurse anticipates a prescription for which therapy? a) iodine b) methimazole c) levothyroxine d) propylthiouracil

c) levothyroxine

After assessing a client with a 25-year history of excessive alcohol use, which finding would the nurse consider consistent with the client's history? a) an elevated temperature b) signs of liver infection c) a low blood ammonia level d) a small liver with a rough surface

d) a small liver with a rough surface

The nurse provides education for a client with cirrhosis of the liver who has prolonged prothrombin time and a low platelet count. A regular diet is prescribed. Which instruction would the nurse include in the teaching? a) avoid foods high in phytonadione b) check the pulse several times a day c) drink a glass of milk when taking aspirin d) reports signs of bleeding no matter how slight

d) reports signs of bleeding no matter how slight

On the 3rd postoperative day after a subtotal thyroidectomy for a tumor, a client complains of a "funny, jittery feeling". Which intervention is appropriate for the nurse to take? a) explain that this reaction is expected and not a concern b) take the vital signs and place the client in a high-fowler position c) request stat serum calcium and phosphorus levels and chart the results d) test for Chvostek and Trousseau signs and notify the primary health care provider of the complaints

d) test for Chvostek and Trousseau signs and notify the primary health care provider of the complaints

A 10-year-old child is diagnosed with Hashimoto disease and develops a goiter. Which education would the nurse provide to the parents and child about this condition? a) the goiter is chronic b) treatment is difficult c) it is an inherited disorder d) the child may need thyroid replacement

d) the child may need thyroid replacement

Which additional supplement will be needed by a client with chronic liver disease who reports, "My gums have been bleeding spontaneously." and has small hemorrhagic lesions on the face? a) bile salts b) folic acid c) vitamin A d) vitamin K

d) vitamin K