Test 4 practice questions
Need to add:
Davis
Med surg success
1. When teaching a patient newly diagnosed with Graves’ disease about the disorder, the nurse
explains that it is related to
1. development of thyroid-stimulating antibodies that cause growth and overproduction of the thyroid
gland.
2. A patient with Graves’ disease is prepared for surgery with drug therapy consisting of 4 weeks of
propylthiouracil (PTU) and 10 days of iodine prior to surgery. When teaching the patient about
the drugs, the nurse explains that the drugs are given preoperatively to
1. normalize metabolism and decrease the size and vascularity of the gland.
3. During the nursing assessment of a patient with Grave’s disease, the nurse notes a bounding, rapid
pulse and systolic hypertension. An additional manifestation of the disorder that the nurse would
expect to find includes
1. patchy hair loss.
4. Special equipment that the nurse places in the patient’s room before the patient returns to the
surgical unit following a thyroidectomy includes
1. a tracheostomy tray.
5. A few hours after returning to the surgical nursing unit, a patient who has undergone a subtotal
thyroidectomy develops laryngeal stridor and a cramp in the right hand. The nurse anticipates
that intervention will include
1. administration of intravenous calcium gluconate.
6. The nurse identifies a nursing diagnosis of risk for injury: corneal ulceration related to inability to
close the eyelids secondary to exophthalmos for a patient with Graves’ disease. An appropriate
nursing intervention to prevent this problem is to
1. teach the patient to sit upright as much as possible.
7. The first nursing action indicated when a patient returns to the surgical nursing unit following a
thyroidectomy is to
1. assess respiratory status for signs of obstruction.
8. A patient with hyperthyroidism is treated with radioactive iodine at a clinic. Before the patient is
discharged, the nurse instructs the patient
1. to monitor for symptoms of hypothyroidism, such as easy bruising and cold intolerance.
1
,9. After 5 years of experiencing depression, fatigue, and lethargy, an elderly woman is diagnosed
with hypothyroidism, and levothyroxine (Synthroid) is prescribed. During initiation of thyroid
replacement for the patient, it is most important for the nurse to assess
1. cardiovascular function.
10. While a 68-year-old woman is hospitalized for a fractured femur, she is diagnosed with
hypothyroidism. A drug ordered for the patient at the time of admission that the nurse recognizes
should not be administered without consulting the physician is
1. diazepam (Valium).
11. When teaching a patient with newly diagnosed hypothyroidism about management of the
condition, the nurse should
1. provide written handouts of all instructions for continued reference as the patient improves.
12. A patient with primary hyperparathyroidism has a serum calcium level of 14 mg/dl (3.5 mmol/L),
phosphorus of 1.7 mg/dl (0.55 mmol/L), creatinine of 2.2 mg/dl (194 mmol/L), and a high urine
calcium. While the patient awaits surgery, the nurse should
1. encourage the patient to drink 4000 ml of fluid daily.
13. While obtaining a nursing history from a patient diagnosed with hyperparathyroidism caused by a
parathyroid adenoma, the nurse asks the patient about a history of
1. previous head or neck x-ray examinations.
14. Following a thyroidectomy, the patient develops hypoparathyroidism. The nurse teaches the
patient that maintenance therapy for the hypoparathyroidism will include
1. calcium supplements.
15. A patient with hypoparathyroidism receives instructions from the nurse regarding symptoms of
hypo- and hypercalcemia. The nurse teaches the patient that if mild symptoms of hypocalcemia
occur, the patient should
1. breathe in and out of a paper bag to temporarily relieve the symptoms and then seek medical
assistance.
1. When teaching a patient with hypoparathyroidism about the disorder, the nurse explains that
blood calcium levels are altered because the role of parathyroid hormone is to
1. stimulate bone resorption and increase the calcium in the blood when blood calcium levels fall.
2. During assessment of a patient’s functional health patterns, a question by the nurse that addresses
thyroid function is
1. “Do you experience fatigue even if you have slept a long time?”
3. A patient has a total serum calcium level of 13.3 mg/dl (6.7 mEq/L, 3.3 mmol/L). The nurse
understands that this level of calcium normally
2
, 1. stimulates the secretion of calcitonin.
4. During a physical examination, the nurse finds that a patient’s thyroid gland cannot be palpated.
The nurse interprets this finding as
1. a normal finding.
5. A patient’s T3 and T4 levels are decreased. The nurse understands that if the cause of the low
thyroid hormone levels is a thyroid problem, further diagnostic testing would reveal
1. increased TSH levels.
1. The nurse assesses the patient with Hashimoto's thyroiditis. Which of the following symptoms
accompanies hypothyroidism?
A) Numbness and tingling in the fingers
Feedback: Symptoms of hypothyroidism include extreme fatigue, hair loss, brittle nails, dry skin, voice
huskiness or hoarseness, menstrual disturbance, and numbness and tingling of the fingers.
2. A patient is diagnosed with Graves' disease. The nurse is aware the patient may have which of the
following physical characteristics?
C) Bulging eyes
D) Fatigue
Ans: C
Feedback: Clinical manifestations of the endocrine disorder Graves' disease include exophthalmos (bulging
eyes) and fine tremor in the hands.
3. The patient has returned following a thyroidectomy. How should the patient be positioned to
promote comfort?
C) Semi-Fowler's with the head supported on two pillows
Feedback: Semi-Fowler's position with the head elevated and supported by pillows is believed to provide
the most comfort and least tension on the suture line.
4. A patient comes to the health clinic complaining of tremors and hyperexcitability. The nursing
assessment reveals exophthalmos. The patient is exhibiting signs and symptoms of which of the
following?
B) Hyperthyroidism
Feedback: Tremors, hyperexcitability, and exophthalmos are signs and symptoms of hyperthyroidism.
5. The patient has returned from surgery following a total parathyroidectomy. The nurse should
assess for which of the complications following this surgery?
A) Tetany
3
, Feedback: Care of postoperative patients having a parathyroidectomy is directed toward detecting early
signs of hypoparathyroidism and subsequent hypocalcemia and anticipating signs of tetany, seizures, and
respiratory difficulties.
8. The patient who has long-standing hypothyroidism is at particular risk to develop what additional
health problem?
C) Coronary artery disease
Feedback: Any patient who has had hypothyroidism for a long period is almost certain to have elevated
serum cholesterol levels, atherosclerosis, and coronary heart disease.
9. Patients started on thyroid replacement therapy are watched for which of the following medication
interactions?
C) Increase of the effects of anticoagulants
Feedback: Thyroid hormones may increase blood glucose levels, increase susceptibility to all hypnotic
agents, and increase the effects of anticoagulants. There is no information supporting nausea with
acetaminophen ingestion.
10. Which of the following menu items would be the best source of iodine, which supports the
function of the thyroid?
C) Table salt
Feedback: The major use of iodine in the body is by the thyroid. Table salt is a source of iodine.
11. Which of the following assessments would indicate the patient was experiencing a thyroid storm?
A) Heart rate 140 beats/min, temperature 39o C, confusion
Feedback: The following signs are suggestive of a thyroid crisis: tachycardia (heart rate more than130
beats/min), elevated temperature (more than 38.5o C), and exaggerated symptoms of hyperthyroidism.
12. The nurse teaches the patient who is prescribed corticosteroid therapy that:
C) She is at an increased risk for developing infection.
Feedback: The patient is at increased risk of infection and masking of signs of infection. The cardiovascular
effects of corticosteroid therapy may result in development of thrombophlebitis or thromboembolism. Diet
should be high protein with limited fat. Changes in appearance usually disappear when therapy is no longer
necessary.
14. Hyperthyroidism is caused by increased levels of thyroxine in blood plasma. A patient with this
endocrine dysfunction would experience:
A) Heat intolerance and systolic hypertension
Feedback: An increased metabolic rate in hyperthyroidism because of excess serum thyroxine leads to
systolic hypertension and heat intolerance. Weight loss, not gain, occurs due to the increased metabolic rate.
Diastolic blood pressure decreases because of decreased peripheral resistance. Heat intolerance and widened
4
Need to add:
Davis
Med surg success
1. When teaching a patient newly diagnosed with Graves’ disease about the disorder, the nurse
explains that it is related to
1. development of thyroid-stimulating antibodies that cause growth and overproduction of the thyroid
gland.
2. A patient with Graves’ disease is prepared for surgery with drug therapy consisting of 4 weeks of
propylthiouracil (PTU) and 10 days of iodine prior to surgery. When teaching the patient about
the drugs, the nurse explains that the drugs are given preoperatively to
1. normalize metabolism and decrease the size and vascularity of the gland.
3. During the nursing assessment of a patient with Grave’s disease, the nurse notes a bounding, rapid
pulse and systolic hypertension. An additional manifestation of the disorder that the nurse would
expect to find includes
1. patchy hair loss.
4. Special equipment that the nurse places in the patient’s room before the patient returns to the
surgical unit following a thyroidectomy includes
1. a tracheostomy tray.
5. A few hours after returning to the surgical nursing unit, a patient who has undergone a subtotal
thyroidectomy develops laryngeal stridor and a cramp in the right hand. The nurse anticipates
that intervention will include
1. administration of intravenous calcium gluconate.
6. The nurse identifies a nursing diagnosis of risk for injury: corneal ulceration related to inability to
close the eyelids secondary to exophthalmos for a patient with Graves’ disease. An appropriate
nursing intervention to prevent this problem is to
1. teach the patient to sit upright as much as possible.
7. The first nursing action indicated when a patient returns to the surgical nursing unit following a
thyroidectomy is to
1. assess respiratory status for signs of obstruction.
8. A patient with hyperthyroidism is treated with radioactive iodine at a clinic. Before the patient is
discharged, the nurse instructs the patient
1. to monitor for symptoms of hypothyroidism, such as easy bruising and cold intolerance.
1
,9. After 5 years of experiencing depression, fatigue, and lethargy, an elderly woman is diagnosed
with hypothyroidism, and levothyroxine (Synthroid) is prescribed. During initiation of thyroid
replacement for the patient, it is most important for the nurse to assess
1. cardiovascular function.
10. While a 68-year-old woman is hospitalized for a fractured femur, she is diagnosed with
hypothyroidism. A drug ordered for the patient at the time of admission that the nurse recognizes
should not be administered without consulting the physician is
1. diazepam (Valium).
11. When teaching a patient with newly diagnosed hypothyroidism about management of the
condition, the nurse should
1. provide written handouts of all instructions for continued reference as the patient improves.
12. A patient with primary hyperparathyroidism has a serum calcium level of 14 mg/dl (3.5 mmol/L),
phosphorus of 1.7 mg/dl (0.55 mmol/L), creatinine of 2.2 mg/dl (194 mmol/L), and a high urine
calcium. While the patient awaits surgery, the nurse should
1. encourage the patient to drink 4000 ml of fluid daily.
13. While obtaining a nursing history from a patient diagnosed with hyperparathyroidism caused by a
parathyroid adenoma, the nurse asks the patient about a history of
1. previous head or neck x-ray examinations.
14. Following a thyroidectomy, the patient develops hypoparathyroidism. The nurse teaches the
patient that maintenance therapy for the hypoparathyroidism will include
1. calcium supplements.
15. A patient with hypoparathyroidism receives instructions from the nurse regarding symptoms of
hypo- and hypercalcemia. The nurse teaches the patient that if mild symptoms of hypocalcemia
occur, the patient should
1. breathe in and out of a paper bag to temporarily relieve the symptoms and then seek medical
assistance.
1. When teaching a patient with hypoparathyroidism about the disorder, the nurse explains that
blood calcium levels are altered because the role of parathyroid hormone is to
1. stimulate bone resorption and increase the calcium in the blood when blood calcium levels fall.
2. During assessment of a patient’s functional health patterns, a question by the nurse that addresses
thyroid function is
1. “Do you experience fatigue even if you have slept a long time?”
3. A patient has a total serum calcium level of 13.3 mg/dl (6.7 mEq/L, 3.3 mmol/L). The nurse
understands that this level of calcium normally
2
, 1. stimulates the secretion of calcitonin.
4. During a physical examination, the nurse finds that a patient’s thyroid gland cannot be palpated.
The nurse interprets this finding as
1. a normal finding.
5. A patient’s T3 and T4 levels are decreased. The nurse understands that if the cause of the low
thyroid hormone levels is a thyroid problem, further diagnostic testing would reveal
1. increased TSH levels.
1. The nurse assesses the patient with Hashimoto's thyroiditis. Which of the following symptoms
accompanies hypothyroidism?
A) Numbness and tingling in the fingers
Feedback: Symptoms of hypothyroidism include extreme fatigue, hair loss, brittle nails, dry skin, voice
huskiness or hoarseness, menstrual disturbance, and numbness and tingling of the fingers.
2. A patient is diagnosed with Graves' disease. The nurse is aware the patient may have which of the
following physical characteristics?
C) Bulging eyes
D) Fatigue
Ans: C
Feedback: Clinical manifestations of the endocrine disorder Graves' disease include exophthalmos (bulging
eyes) and fine tremor in the hands.
3. The patient has returned following a thyroidectomy. How should the patient be positioned to
promote comfort?
C) Semi-Fowler's with the head supported on two pillows
Feedback: Semi-Fowler's position with the head elevated and supported by pillows is believed to provide
the most comfort and least tension on the suture line.
4. A patient comes to the health clinic complaining of tremors and hyperexcitability. The nursing
assessment reveals exophthalmos. The patient is exhibiting signs and symptoms of which of the
following?
B) Hyperthyroidism
Feedback: Tremors, hyperexcitability, and exophthalmos are signs and symptoms of hyperthyroidism.
5. The patient has returned from surgery following a total parathyroidectomy. The nurse should
assess for which of the complications following this surgery?
A) Tetany
3
, Feedback: Care of postoperative patients having a parathyroidectomy is directed toward detecting early
signs of hypoparathyroidism and subsequent hypocalcemia and anticipating signs of tetany, seizures, and
respiratory difficulties.
8. The patient who has long-standing hypothyroidism is at particular risk to develop what additional
health problem?
C) Coronary artery disease
Feedback: Any patient who has had hypothyroidism for a long period is almost certain to have elevated
serum cholesterol levels, atherosclerosis, and coronary heart disease.
9. Patients started on thyroid replacement therapy are watched for which of the following medication
interactions?
C) Increase of the effects of anticoagulants
Feedback: Thyroid hormones may increase blood glucose levels, increase susceptibility to all hypnotic
agents, and increase the effects of anticoagulants. There is no information supporting nausea with
acetaminophen ingestion.
10. Which of the following menu items would be the best source of iodine, which supports the
function of the thyroid?
C) Table salt
Feedback: The major use of iodine in the body is by the thyroid. Table salt is a source of iodine.
11. Which of the following assessments would indicate the patient was experiencing a thyroid storm?
A) Heart rate 140 beats/min, temperature 39o C, confusion
Feedback: The following signs are suggestive of a thyroid crisis: tachycardia (heart rate more than130
beats/min), elevated temperature (more than 38.5o C), and exaggerated symptoms of hyperthyroidism.
12. The nurse teaches the patient who is prescribed corticosteroid therapy that:
C) She is at an increased risk for developing infection.
Feedback: The patient is at increased risk of infection and masking of signs of infection. The cardiovascular
effects of corticosteroid therapy may result in development of thrombophlebitis or thromboembolism. Diet
should be high protein with limited fat. Changes in appearance usually disappear when therapy is no longer
necessary.
14. Hyperthyroidism is caused by increased levels of thyroxine in blood plasma. A patient with this
endocrine dysfunction would experience:
A) Heat intolerance and systolic hypertension
Feedback: An increased metabolic rate in hyperthyroidism because of excess serum thyroxine leads to
systolic hypertension and heat intolerance. Weight loss, not gain, occurs due to the increased metabolic rate.
Diastolic blood pressure decreases because of decreased peripheral resistance. Heat intolerance and widened
4
