nr 511 differential diagnosis and primary care practicum
chamberlain
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NR 511
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NR 511 Quiz 6
NR 511 Differential Diagnosis and Primary Care Practicum, Chamberlain
, NR 511 Week 6 Quiz
Quiz 6
Question 1
pts
A client with hyperthyroidism presents with a complaint of a “gritty” feeling in her eyes. Over the past
week, her visual acuity has diminished, and her ability to see colors has changed. She also has a
feeling of pressure behind her eyes. The next step for the nurse practitioner is to:
Order a total thyroxine (T4).
Correct!
Refer the client for immediate evaluation by an ophthalmologist.
Order a thyroid ultrasound.
Prescribe a beta-adrenergic blocker.
The practitioner should refer the client for an immediate evaluation by an ophthalmologist. Clinically
recognized Graves ophthalmopathy occurs in about 50% of cases of Graves disease. A client with
Graves orbitopathy with these complaints is at risk of blindness if there is compression of the optic
nerve. Additional symptoms include photophobia and diplopia. Autoantibodies present in Graves
disease can cause increased muscle thickness in the eye, leading to edema and compression of the
optic nerve. Fundal exam may reveal disk swelling. This is an emergency situation that may require
hospitalization and treatment with prednisone to diminish the inflammation. Artificial tears are also
helpful. In 75% of clients, the onset of Graves orbitopathy occurs within a year before or after the
diagnosis of thyrotoxicosis but can sometimes precede or follow thyrotoxicosis by several years.
Question 2
pts
A low thyroid-stimulating hormone (TSH) can lead to:
Brittle hair.
Correct!
Osteoporosis.
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