Exam (elaborations)

Chapter 49: Thyroid and Parathyroid Disorders Linton: Medical-Surgical Nursing, 7th Edition

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Course
NURS 212

Institution
Columbia College (CC )

1. A physician ordered T3 and T4 tests for a young woman complaining of fatigue, weight gain, muscle aches and pains, and constipation. Which laboratory test results will help confirm the diagnosis of hypothyroidism? a. Both tests show decreases. b. Both tests show increases. c. The T3 test el...

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Chapter 49: Thyroid and Parathyroid Disorders
Linton: Medical-Surgical Nursing, 7th Edition

MULTIPLE CHOICE

1. A physician ordered T3 and T4 tests for a young woman complaining of fatigue, weight gain,
muscle aches and pains, and constipation. Which laboratory test results will help confirm the
diagnosis of hypothyroidism?
a. Both tests show decreases.
b. Both tests show increases.
c. The T3 test elevates, and the T4 test decreases.
d. The level of thyroxin rises and then falls back to subnormal levels.
ANS: A
These complaints are strongly suggestive of thyroid disorder; T3 and T4 laboratory diagnostic
tests are the most useful.

DIF: Cognitive Level: Knowledge REF: p. 950 OBJ: 1
TOP: Thyroid Diagnostic Tests KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance

2. A patient with a hyperthyroid complains of fatigue but still cannot get to sleep. What is the
best suggestion by the nurse?
a. Taking “cat naps” during the day
b. Adhering to a bedtime ritual
c. Drinking a cup of cocoa before bedtime
d. Performing mild prebedtime exercises
ANS: B
Bedtime rituals such as a warm bath, reading, and listening to music cue the body for sleep.
Naps during the day may make nighttime sleep difficult; exercising and drinking caffeine-
filled drinks are stimulating and should be avoided by the person with insomnia.

DIF: Cognitive Level: Comprehension REF: p. 953 OBJ: 2
TOP: Hyperthyroidism Insomnia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

3. A patient with exophthalmos is distressed about her appearance and asks when it will go away.
What is the best response by the nurse?
a. It is not reversible.
b. It can be disguised with sunglasses and makeup.
c. It usually subsides after medication for hyperthyroidism is started.
d. It can be minimized with plastic surgery to the eyelids.
ANS: C
The “startled” appearance of the patient with exophthalmos usually subsides several weeks
after therapy for hyperthyroidism becomes effective.

DIF: Cognitive Level: Comprehension REF: p. 954 OBJ: 2
TOP: Exophthalmia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

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, 4. A nurse is explaining Graves disease to a newly diagnosed patient. Which statement by the
nurse best clarifies the pathophysiologic changes of Graves disease?
a. “Your thyroid gland is not producing enough hormones; consequently, you will
need replacement therapy.”
b. “Your thyroid gland is overactive, but there are ways to treat it through medicine
or surgery.”
c. “It’s an autoimmune disorder that has no satisfactory treatment.”
d. “Graves disease is a temporary disorder that will gradually subside.”
ANS: B
The patient needs to recognize the nurse’s role in giving accurate, timely information.

DIF: Cognitive Level: Comprehension REF: p. 951 OBJ: 1
TOP: Graves Disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Physiological Adaptation

5. A nurse assessing a patient 1 day after a subtotal thyroidectomy notes that the patient’s color
is poor, the pulse and respirations are rapid, and the patient feels warm to the touch. The
patient says that she feels frightened. What is the best initial implementation by the nurse?
a. Tell her that there is nothing to be afraid of and stay to calm her.
b. Ask her if she would like pain medication.
c. Call the charge nurse; these are signs of a thyroid storm.
d. Get a tracheostomy set at the bedside.
ANS: C
Call the charge nurse; these signs and symptoms suggest excessive stimulation caused by an
elevated level of thyroid hormones, and the patient needs immediate care.

DIF: Cognitive Level: Application REF: p. 956 OBJ: 1
TOP: Thyroid Storm KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. What is the most appropriate nursing concern for the patient recently diagnosed with
hyperthyroidism?
a. Hypothermia
b. Constipation
c. Disturbed body image
d. Disturbed sleep pattern
ANS: D
The patient with hyperthyroidism has trouble staying asleep because of the metabolic disorder.
Persons with hyperthyroidism feel uncomfortably warm, which also contributes to their
sleeping difficulty.

DIF: Cognitive Level: Application REF: p. 951 OBJ: 1
TOP: Hyperthyroidism KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. A patient, newly diagnosed with hypothyroidism, is anxious to begin her drug regimen. What
should the nurse’s instructions relative to hormone replacement include?
a. “Be certain that no dose is skipped.”

This study source was downloaded by 100000812546443 from CourseHero.com on 07-20-2023 04:06:27 GMT -05:00

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Exam (elaborations)

Chapter 49: Thyroid and Parathyroid Disorders Linton: Medical-Surgical Nursing, 7th Edition

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