1. The nurse is performing a physical examination of a patient's thyroid gland. Precautions are taken in performing the correct technique because palpitation can result in which occurrence?
a. Damage to the esophagus causing gastric reflux
b. Obstruction
d
2. Which assessment findings indicate hyperthyroidism? (Select all that apply.)
a. Weight loss with increased appetite
b. Constipation
c. Increased heart rate
d. Insomnia
e. Decreased libido
f. Heat intolerance
a, c, d, f
3. The nurse assesses a patient in the emergency department (ED) and finds the following: constipation, fatigue with increased sleeping time, impaired memory, facial puffiness, and weight gain. Which deficiency does the nurse recognize?
a. Hyperthyroidism
b
4. Which factor is a hallmark assessment finding that signifies hyperthyroidism?
a. Weight loss
b. Increased libido
c. Heat intolerance
d. Diarrhea
c
5. Which factor is a main assessment finding that signifies hypothyroidism?
a. Irritability
b. Cold intolerance
c. Diarrhea
d. Fatigue
b
6. Which sign/symptom is one of the first indicators of hyperthyroidism that is often noticed by the patient?
a. Eyelid or globe lag
b. Vision changes or tiring of the eyes
c. Protruding eyes
d. Photophobia
b
7. Which laboratory result is consistent with a diagnosis of hyperthyroidism?
a. Decreased serum triiodothyronine (T3) and thyroxine (T4) levels
b. Elevated serum thyrotropin-releasing hormone (TRH) level
c. Decreased radioactive idoine uptake
d. Increase
d
8. The laboratory results for a 53-year-old patient indicate a low T3 level and elevated thyroid-stimulating hormone (TSH). What do these results indicate?
a. Hyperthyroidism
b. Hypothyroidism
c. Malfunctioning pituitary gland
d. Normal laboratory values
b
9. The clinical manifestations of hyperthyroidism are known as which condition?
a. Thyrotoxicosis
b. Euthyroid function
c. Graves' disease
d. Hypermetabolism
a
10. What is the most common cause of hyperthyroidism?
a. Radiation to thyroid
b. Graves' disease
c. Thyroid cancer
d. Thyroiditis
b
11. The nurse assessing a patient palpates enlargement of the thyroid gland, along with noticeable swelling of the neck. How does the nurse interpret this finding?
a. Globe lag
b. Myxedema
c. Exophthalmos
d. Goiter
d
12. The nurse is assessing a patient diagnosed with hyperthyroidism and observes dry, waxy swelling of the front surfaces of the lower legs. How does the nurse interpret this finding?
a. Globe lag
b. Pretibial myxedema
c. Exophthalmos
d. Goiter
b
13. Which statement best describes globe lag in a patient with hyperthyroidism?
a. Abnormal protrusion of the eyes
b. Upper eyelid fails to descend when the patient gazes downward
c. Upper eyelid pulls back faster than the eyeball when the patient gazes u
c
15. Which statements about hyperthyroidism are accurate? (Select all that apply.)
a. It is most commonly caused by Graves' disease .
b. It can be caused by overuse of thyroid replacement medication.
c. It occurs more often in men between the ages of 20-40
a, b, e
15. Which statements about hyperthyroidism are accurate? (Select all that apply.)
a. It is most commonly caused by Graves' disease .
b. It can be caused by overuse of thyroid replacement medication.
c. It occurs more often in men between the ages of 20-40
a, b, c
16. The nurse is providing instructions to a patient taking levothyroxine (Synthroid). When does the nurse tell the patient to take this medication?
a. With breakfast in the morning.
b. At lunchtime immediately after eating.
c. In the morning on an empty
c
17. The nurse is providing instructions to a patient who is taking the anti-thyroid medication propylthiouracil (PTU). The nurse instructs the patient to notify the health care provider immediately if which sign/symptom occurs?
a. Weight gain
b. Dark-colo
b
18. The patient who is prescribed methimazole (Tapazole) 4 mg orally every 8 hours tells the nurse that his heart rate is slow (60/minute), he has gained 7 pounds, and he wears a sweater even on warm days. What does the nurse suspect?
a. Indications of hy
a
19. A patient who has been diagnosed with Graves' disease is going to receive radioactive iodine (RAI) in the oral form of 131 I. What does the nurse teach the patient about how this drug works?
a. It destroys the hormones T3 and T4.
b. It destroys the ti
b
20. A patient who has been diagnosed with Graves' disease is to receive RAI in the oral form of 131 I as a treatment. What instructions does the nurse include in the teaching plan about preventing radiation exposure to others? (Select all that apply.)
a.
a, b, c, d
21. Which statements about hypothyroidism are accurate? (Select all that apply.)
a. It occurs more often in women.
b. It can be caused by iodine deficiency.
c. Weight loss is a common manifestation.
d. It can be caused by autoimmune thyroid destruction.
e
a, b, d, e
22. The nurse is assessing a patient with a diagnosis of Hashimoto's disease. What are the primary manifestations of this disease? (Select all that apply.)
a. Dysphagia
b. Painless enlargement of the thyroid gland
c. Painful enlargement of the thyroid gla
a, b
23. Laboratory findings of elevated T3 and T4, decreased TSH, and high thyrotropin receptor antibody titer indicate which condition?
a. Multinodular goiter
b. Hyperthyroidism related to overmedication
c. Pituitary tumor suppressing TSH
d. Graves' disease
d
24. The patient has multiple thyroid nodules resulting in thyroid hyperfunction. What is the most likely cause of this hyperthyroidism?
a. Thyroid carcinoma
b. Graves' disease
c. Toxic multinodular goiter
d. Pituitary hyperthyroidism
c
25. After a visit to the health care provider's office, a patient is diagnosed with general thyroid enlargement and elevated thyroid hormone level. Which condition do these findings indicate?
a. Hyperthyroidism and goiter
b. Hypothyroidism and goiter
c. N
a
27. A patient with exophthalmos from hyperthyroidism reports dry eyes, especially in the morning. The nurse teaches the patient to perform which intervention to help correct this problem?
a. Wear sunglasses at all times when outside in the bright sun.
b.
c
27. A patient with exophthalmos from hyperthyroidism reports dry eyes, especially in the morning. THe nurse teaches the patient to perform which intervention to help correct this problem?
a. Wear sunglasses at all times when outside in the bright sun.
b.
c
28. Which factors are considered to be triggers for thyroid storm? (Select all that apply.)
a. Infection
b. Cold temperatures
c. Vigorous palpation of a goiter
d. Diabetic ketoacidosis
e. Extremely warm temperatures
a, c, d
29. A patient has the following assessment findings: elevated TSH level, low T3 and T4 levels, difficulty with memory, lethargy, and muscle stiffness. These are clinical manifestations of which disorder?
a. Hypothyroidism
b. Hyperthyroidism
c. Hypoparathy
a
30. A patient has been prescribed thyroid hormone for treatment of hypothyroidism. Within what time frame does the patient expect improvement in mental awareness with this treatment?
a. A few days
b. 2 weeks
c. 1 month
d. 3 months
b
31. Which signs and symptoms are assessment findings indicative of thyroid storm? (Select all that apply.)
a. Abdominal pain and nausea
b. Hypothermia
c. Elevated temperature
d. Tachycardia
e. Elevated systolic blood pressure
f. Bradycardia
a, c, d, e
33. Which are preoperative instructions for a patient having thyroid surgery? (Select all that apply.)
a. Teach postoperative restrictions such as no coughing and deep-breathing exercises to prevent strain on the suture line.
b. Teach the moving and turni
b, c, d, e
33. Which are preoperative instructions for a patient having thyroid surgery? (Select all that apply.)
a. Teach postoperative restrictions such as no coughing and deep-breathing exercises to prevent strain on the suture line.
b. Teach the moving and turni
b, c, d, e
34. The nurse is preparing for a patient to return from thyroid surgery. What priority equipment does the nurse ensure is immediately available? (Select all that apply.)
a. Tracheostomy equipment
b. Calcium gluconate or calcium chloride for IV administrat
a, b, d, e, f
35. After a thyroidectomy, a patient reports tingling around the mouth and muscle twitching. Which complication do these assessment findings indicate to the nurse?
a. Hemorrhage
b. Respiratory distress
c. Thyroid storm
d. Hypocalcemia
d
36. The nurse assesses a patient postthyroidectomy for layrngeal nerve damage. Which findings indicate this complication? (Select all that apply.)
a. Dyspnea
b. Sore throat
c. Hoarseness
d. Weak voice
e. Dry cough
c, d
37. The nurse is assessing a patient after thyroid surgery and discovers harsh, high-pitched respiratory sounds. What is the nurse's best first action?
a. Administer oxygen at 5 L via nasal cannula.
b. Administer IV calcium chlroide.
c. Notify the Rapid R
c
38. After hospitalization for myxedema, a patient is prescribed thyroid replacement medication. Which statement by the patient demonstrates a correct understanding of this therapy?
a. "I'll be taking this medication until my symptoms are completely resolv
b
39. Which statements about thyroiditis are accurate? (Select all that apply.)
a. It is an inflammation of the thyroid gland.
b. Hashimoto's disease is the most common type.
c. It always resolves with antibiotic therapy.
d. There are three types: acute, su
a, b, d, e
40. Which statement about acute thyroiditis are accurate? (Select all that apply.)
a. It is caused by a bacterial infection of the thyroid gland.
b. It is treated with antibiotic therapy.
c. It results from a viral infection of the thyroid gland.
d. Subto
a, b, e
41. What is the hallmark of thyroid cancer?
a. Aggressive tumors
b. Elevated serum thyroglobulin level
c. Metastasis to other organs
d. Invasion of blood vessels
b
42. Serum calcium levels are maintained by which hormone?
a. Cortisol
b. Luteinizing hormone
c. Antidiuretic hormone (ADH)
d. Parathyroid hormone (PTH)
d
43. Production of which hormone causes lower levels of calcium?
a. Calcitonin
b. PTH
c. T4
d. TSH
a
44. Bone changes in the older adult are often seen with endocrine dysfunction and increased secretion of which substance?
a. PTH
b. Calcitonin
c. Insulin
d. Testosterone
a
45. In addition to regulation of calcium levels, PTH and calcitonin regulate the circulating blood levels of which substance?
a. Potassium
b. Sodium
c. Phsophate
d. Chloride
c
46. A patient has positive Trousseau's and Chvostek's signs resulting from hypoparathyrodism. What condition does this assessment finding indicate?
a. Hypercalcemia
b. Hypocalcemia
c. Hyperphosphatemia
d. Hypophosphatemia
b
47. Which foods will the nurse instruct a patient with hypoparathyroidism to avoid? (Select all that apply.)
a. Canned vegetables
b. Yogurt
c. Fresh fruit
d. Red meat
e. Milk
f. Processed cheese
b, e, f
48. A patient with continuous spasms of the muscles is diagnosed with hypoparathyroidism. The muscle spasms are a clinical manifestation of which condition?
a. Nerve damage
b. Seizures
c. Tetany
e. Decreased ppotassium
c
49. Which disorders/conditions can cause hyperparathyroidism? (Select all that apply.)
a. Chronic kidney disease
b. Neck trauma
c. Thyroidectomy
d. Vitamin D deficiency
e. Parathyroidectomy
a, b, d
50. A patient has hyperparathyroidism and high levels of serum calcium. Which initial treatment does the nurse prepare to administer to the patient?
a. Furosemide (Lasix) with IV saline
b. Calcitonin
c. Oral phosphates
d. Mmithramycin
a
51. Which are assessment findings of hypocalcemia? (Select all that apply.)
a. Numbness and tingling around the mouth
b. Muscle cramping
c. Bone fractures
d. Fever
e. Tachycardia
a, b
52. Which medication therapies does the nurse expect patients with hypoparathyroidism to receive? (Select all that apply.)
a. Calcium chlroide
b. Calcium gluconate
c. Calitrol (Rocaltrol)
d. Propranolol (Inderal)
e. Ergocalciferol
a, b, c, e
53. Discharge planning for a patient with chronic hypoparathyroidism includes which instructions? (Select all that apply.)
a. Prescribed medications must be taken for the patient's entire life.
b. Eat foods low in vitamin D and high in phosphorus.
c. Eat
a, c
54. In older adults, assessment findings of fatigue, altered thought processes, dry skin, and constipation are often mistaken for signs of aging rather than assessment findings for which endocrine disorder?
a. Hyperthyroidism
b. Hypothyroidism
c. Hyperpar
b
55. What is the most common cause of death from myxedema coma?
a. Myocardial infarction
b. Acute kidney failure
c. High serum level of iodide
d. Respiration failure
d
56. Which conditions may precipitate myxedema coma? (Select all that apply.)
a. Rapid withdrawal of thyroid medication
b. Vitamin D deficiency
c. Untreated hypothyroidism
d. Surgery
e. Excessive exposure to iodine
a, c, d