N4 test Thyroid and Parathyroid Glands

Ignatavicius & Workman: Medical-Surgical Nursing: Critical Thinking for Collaborative Care, 4th Edition

Chapter 64: Interventions for Clients with Problems of the Thyroid and Parathyroid Glands

1. What effect on metabolism is expected as a response to hyperthyroidism?

A. Markedly increased rate of metabolism
B. Markedly decreased rate of metabolism
C. Hyperthyroidism has no effect on metabolism
D. Hyperthyroidism increases metabolism in children and decreases metabolism in adults

2. What is the pathologic mechanism for the development of the Graves’ disease type of hyperthyroidism? It is an autoimmune:

A. response in which antibodies cause other tissues to activate the gene for thyroid hormone, causing ectopic hormone secretion.
B. reaction in which growth hormone stimulates the thyroid gland to undergo cell division resulting in hyperplasia of active thyroid tissue and thyroglobulin.
C. reaction caused by an infection in which lymphocytes invade the thyroid gland and destroy thyroid tissue along with the infectious organisms.
D. problem in which antibodies bind to the thyroid-stimulating hormone receptor site, stimulating the thyroid gland to overproduce thyroid hormones.

3. Which change in clinical manifestations indicates the drug therapy for hyperthyroidism is effective?

A. Temperature decreased 1° F
B. Weight loss of 1 kg in two days
C. Warm, pink, moist hands and feet
D. Systolic pressure elevated 6 mm Hg above baseline

4. What actions should you use with a client 12 hours after a thyroidectomy to reduce strain and tension on the suture line?

A. Place a small pillow under the client’s shoulders to keep the neck extended.
B. Teach the client to place both hands behind the neck when moving.
C. Use an elastic wrap to keep the dressing in place.
D. Keep the client on total bedrest.

5. What is the pathologic mechanism for the development of the Hashimoto’s thyroiditis type of hypothyroidism? It is an autoimmune:

A. response in which antibodies to the thyroid hormones inactivate them, leading to hypometabolism.
B. reaction in which growth hormone stimulates the thyroid gland to increase production of thyroglobulin, trapping the thyroid hormones inside the gland.
C. reaction caused by an infection in which lymphocytes invade the thyroid gland and destroy thyroid tissue along with the infectious organisms.
D. problem in which antibodies block the thyroid-stimulating hormone receptor site, preventing production of thyroid hormones.

6. What instructions should you provide to the client with hypothyroidism who is prescribed to take a synthetic thyroid hormone preparation?

A. “Avoid over-the-counter medications unless ordered by your doctor.”
B. “Restrict your intake of fluids, especially during hot weather.”
C. “Increase the amount of fiber in your diet.”
D. “Avoid prolonged exposure to direct sunlight.”

7. Which clinical manifestation exhibited by a client with hypothyroidism indicates a need for increased thyroid medication?

A. Increased urination
B. Tremors of the hands
C. Weight loss of 1 kg in two days
D. Respiratory rate of 8 breaths per minute

8. Which clinical manifestation is associated with hypoparathyroidism?

A. Elevated core body temperature and weight gain
B. Positive Chvostek’s and Trousseau’s signs
C. Profound skeletal muscle weakness
D. Polyuria and dehydration

9. What is the priority nursing diagnosis for the client immediately postoperative from a parathyroidectomy?

A. Risk for ineffective breathing pattern related to swelling at operative site
B. Impaired verbal communication related to pain
C. Risk for infection related to surgical incision
D. Risk for injury related to position restrictions

10. Which laboratory value indicates to you that medical therapy for hyperparathyroidism is effective? Serum:

A. sodium is 145 mmol/L
B. potassium is 4.5 mmol/L
C. calcium (total) is 9.2 mg/dL
D. albumin (total) is 4.1 g/dL