Which statement by a 50-year-old female patient indicates to the nurse that further assessment of thyroid function may be necessary?
a. I notice my breasts are tender lately.
b. I am so thirsty that I drink all day long.
c. I get up several times at night to urinate.
d. I feel a lump in...
Which statement by a 50-year-old female patient indicates to the nurse that further
assessment of thyroid function may be necessary?
a. I notice my breasts are tender lately.
b. I am so thirsty that I drink all day long.
c. I get up several times at night to urinate.
d. I feel a lump in my throat when I swallow. correct answers d. I feel a lump in my
throat when I swallow.
Difficulty in swallowing can occur with a goiter. Nocturia is associated with diseases
such as diabetes mellitus, diabetes insipidus, or chronic kidney disease. Breast
tenderness would occur with excessive gonadal hormone levels. Thirst is a sign of
disease such as diabetes.
A 30-year-old patient seen in the emergency department for severe headache and
acute confusion is found to have a serum sodium level of 118 mEq/L. The nurse will
anticipate the need for which diagnostic test?
a. Urinary 17-ketosteroids
b. Antidiuretic hormone level
c. Growth hormone stimulation test
d. Adrenocorticotropic hormone level correct answers b. Antidiuretic hormone level
Elevated levels of antidiuretic hormone will cause water retention and decrease serum
sodium levels. The other tests would not be helpful in determining possible causes of
the patients hyponatremia.
Which question will provide the most useful information to a nurse who is interviewing a
patient about a possible thyroid disorder?
,a. What methods do you use to help cope with stress?
b. Have you experienced any blurring or double vision?
c. Have you had a recent unplanned weight gain or loss?
d. Do you have to get up at night to empty your bladder? correct answers c. Have you
had a recent unplanned weight gain or loss?
Because thyroid function affects metabolic rate, changes in weight may indicate
hyperfunction or hypofunction of the thyroid gland. Nocturia, visual difficulty, and
changes in stress level are associated with other endocrine disorders.
During the physical examination of a 36-year-old female, the nurse finds that the
patients thyroid gland cannot be palpated. The most appropriate action by the nurse is
to
a. palpate the patients neck more deeply.
b. document that the thyroid was nonpalpable.
c. notify the health care provider immediately.
d. teach the patient about thyroid hormone testing. correct answers b. document that
the thyroid was nonpalpable.
The thyroid is frequently nonpalpable. The nurse should simply document the finding.
There is no need to notify the health care provider immediately about a normal finding.
There is no indication for thyroid-stimulating hormone (TSH) testing unless there is
evidence of thyroid dysfunction. Deep palpation of the neck is not appropriate.
Which laboratory value should the nurse review to determine whether a patients
hypothyroidism is caused by a problem with the anterior pituitary gland or with the
thyroid gland?
a. Thyroxine (T4) level
b. Triiodothyronine (T3) level
c. Thyroid-stimulating hormone (TSH) level
, d. Thyrotropin-releasing hormone (TRH) level correct answers c. Thyroid-stimulating
hormone (TSH) level
A low TSH level indicates that the patients hypothyroidism is caused by decreased
anterior pituitary secretion of TSH. Low T3 and T4 levels are not diagnostic of the
primary cause of the hypothyroidism. TRH levels indicate the function of the
hypothalamus.
A 60-year-old patient is taking spironolactone (Aldactone), a drug that blocks the action
of aldosterone on the kidney, for hypertension. The nurse will monitor for
a. increased serum sodium.
b. decreased urinary output.
c. elevated serum potassium.
d. evidence of fluid overload. correct answers c. elevated serum potassium.
Because aldosterone increases the excretion of potassium, a medication that blocks
aldosterone will tend to cause hyperkalemia. Aldosterone also promotes the
reabsorption of sodium and water in the renal tubules, so spironolactone will tend to
cause increased urine output, a decreased or normal serum sodium level, and signs of
dehydration.
An 18-year-old male patient with a small stature is scheduled for a growth hormone
stimulation test. In preparation for the test, the nurse will obtain
a. ice in a basin.
b. glargine insulin.
c. a cardiac monitor.
d. 50% dextrose solution. correct answers d. 50% dextrose solution.
Hypoglycemia is induced during the growth hormone stimulation test, and the nurse
should be ready to administer 50% dextrose immediately. Regular insulin is used to
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