Exam (elaborations)
Med/surg endoctrine exam
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Med/surg endoctrine exam
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Page 1 of 117Med/surg endoctrine exam 2024-2025
a client with hyperthyroidism is treated with radioactive iodine to ablate thyroid tissue. what
should the nurse instruct the client to do after the procedure?
remain in the house.
avoid holding an infant.
save urine in a lead-lined container.
refrain from using a bathroom used by others. - answer-avoid holding an infant.
rationale
infants are particularly sensitive to radioactivity; even the small amount emitted after
treatment may affect infants. it is not necessary to avoid leaving the house as long as close
proximity to others is avoided. saving urine in a lead-lined container is not necessary; the same
bathroom may be used by all members of the family, but the toilet should be flushed twice
after use by the client. refraining from using a bathroom used by others is not necessary.
the nurse is caring for a client who had a thyroidectomy. which symptoms will the client exhibit
if having a thyrotoxic crisis?
an increased pulse deficit
a decreased blood pressure
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a decreased heart rate and respirations
an increased temperature and pulse rate - answer-an increased temperature and pulse rate
rationale
thyrotoxic crisis is severe hyperthyroidism; excessive amounts of thyroxine increase the
metabolic rate, thereby raising the pulse and temperature. during crisis there usually is no
increase in the difference between the apical and the peripheral pulse rates (pulse deficit). the
blood pressure will increase to meet the oxygen demand caused by the increased metabolic
rate during crisis. because of the increased metabolic rate, the pulse and respiratory rates
increase to meet the body's oxygen needs.
a female client who is scheduled for a thyroidectomy is concerned that the surgery will
interfere with her ability to become pregnant. what is the nurse's best response?
"as long as medication is continued, ovulation will occur."
"hyperthyroidism can cause abortions and fetal anomalies."
"pregnancy is not advisable for the client with a thyroidectomy."
"pregnancy affects metabolism and will require decreased thyroid hormone." - answer-"as long
as medication is continued, ovulation will occur."
rationale
medication is regulated to maintain the usual blood levels of thyroxine; therefore, ovulation is
not affected, and future pregnancy is possible. the client will no longer be hyperthyroid after
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surgery because the overactive tissue is excised; therefore, pregnancy is not contraindicated.
pregnancy is not contraindicated after a thyroidectomy because the overactive tissue is excised.
pregnancy is not contraindicated; however, thyroid hormone therapy may have to be increased
during pregnancy.
after recording the blood pressure of a client, the primary health care provider confirms a
diagnosis of pheochromocytoma. what blood pressure may have helped confirm the diagnosis?
90/70 mmhg
80/60 mmhg
120/80 mmhg
190/90 mmhg - answer-190/90 mmhg
the nurse is assessing a client with a suspected thyroid disorder. which diagnostic studies will
be most appropriate to confirm that the thyroid disorder is autoimmune in origin? select all
that apply.
free thyroxine
thyroglobulin antibody
thyroid peroxidase antibody
thyroid-stimulating antibody
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thyroid-stimulating hormone - answer-
a nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of
the feet. which statement made by the client shows that teaching was effective?
"i should massage my feet and legs with oil or lotion."
"i should apply heat intermittently to my feet and legs."
"i should eat foods high in protein and carbohydrate kilocalories."
"i should control my blood glucose with diet, exercise, and medication." - answer-"i should
control my blood glucose with diet, exercise, and medication."
rationale
controlling the diabetes decreases the risk of infection; this is the best prevention. oil or lotion
that is not completely absorbed may provide a warm, moist environment for bacterial growth.
coexisting neuropathy may result in injury from heat application. protein, carbohydrates, and
fats must be in an appropriate balance; high carbohydrate intake can provide too many
calories.
a client newly diagnosed with type 1 diabetes is taught to exercise on a regular basis. what is
the primary reason for instruction on exercise?
to decrease insulin sensitivity
to stimulate glucagon production
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