N3661 - Exam 1 Med Surg Questions With Complete
Solutions
______ disease is the most common cause of hyperthyroidism
Correct Answer Graves
______ is essential to thyroid gland for synthesis of its
hormones Correct Answer iodine
A patient just arrived on the unit from PACU; how often should
temperature be checked? Correct Answer q4h x 24h
A patient just arrived on the unit from PACU; how often should
vitals be checked? Correct Answer q15m x 1hr
then
q30m x 3hr
Absent bowel sounds are expected for the first ______ hrs after
abdominal surgery Correct Answer 24 hrs
acute hypercalcemic crisis occurs when serum Ca+ is _______
mg/dL Correct Answer greater than 13 mg/dL
Angina or dysrhythmias occur with initiation of thyroid
replacement therapy because Correct Answer thyroid hormone
↑ CV effects of catecholamines (epinephrine, etc.)
Another name for calcitonin Correct Answer thyrocalcitonin
,Beginning in the ventricles, describe events leading to RAS with
HF (6) Correct Answer 1. ventricular dysfunction, cant get
blood out
2. decreased output sensed in aortic & carotid arteries
3. sympathetic NS stimulated to release epi & norepi - increases
HR & contractility to support failing heart
4. this SNS stimulation causes vasoconstriction leads to
decreased perfusion to kidneys
5. kidneys release renin which starts RAS & ultimately releases
aldosterone
6. aldosterone makes body retain Na+ and water, increasing
fluid volume and overloading heart more!
Bipolar patients are at greater risk for developing what
endocrine disorder? Why? Correct Answer hypothyroidism
because lithium in medications decreases thyroid function
Causes of DKA Correct Answer 1. missed insulin dose
2. inadequate insulin d/t an increased insulin need (from stress
or infection)
3. new diagnosis of DM 1
Cool temperatures in a surgical suite are due to Correct Answer
reduced infection rates during surgery
Coughing and deep breathing should be done how often for post
op patient?
Incentive spirometry? Correct Answer C&DB: q1h
IC: q1-2h
Define Chvostek's sign
,When is it seen? Correct Answer spasm of facial muscle when
facial nerve in front of ear is tapped
seen with hypocalcemia aka hypoparathyroidism
Define nephropathy and how is it related to diabetes Correct
Answer kidney disease secondary to diabetic microvascular
changes in the kidney
high levels of BG long term causes stress to kidney filtration
system, blood proteins begin to leak out, leads to proteins in
urine
Define SIADH Correct Answer syndrome of inappropriate
antidiuretic hormone
Define the acronym DASH diet Correct Answer dietary
approach to stop hypertension
Define thyrotoxicosis Correct Answer condition caused by
excessive endogenous (from within) or exogenous (ie drugs)
thyroid hormone
dehiscence vs evisceration Correct Answer d: separation of
wound
, e: evidence of bowel through incision (painful and med
emergency!)
Describe anticipated findings of goiter upon palpation
Upon auscultation Correct Answer palpation: thrill
auscultation: bruit
remember thyroid has massive blood flow!
Describe disease course of hyperthyroidism Correct Answer
differs person to person
could spontaneously go away, could have periods of
exacerbations, could be nonstop
Diabetes insipidus is characterized by deficiency/excess of what
hormone?
Where is it produced? Correct Answer deficiency
ADH (aka vasopressin)
posterior pituitary
Discuss blood flow to the thyroid (3) Correct Answer VERY
high
~5mL/min per gram of thyroid tissue
~5x blood flow to liver
Discuss expected radioactive iodine uptake (RAIU) test results
for;
hyperthyroidism
hypothyroidism Correct Answer hyper: high absorption rate of
ingested iodine (hyperactive thyroid absorbs all iodine it can to
pump out more hormones; T3/T4)
hypo: low absorption of iodine
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