Complete Test Bank Alexander’s Care of the Patient in Surgery 16th Edition Rothrock Questions & Answers with rationales (Chapter 1-30)
The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimotos thyroiditis. When assessing this patient, what sign or symptom would the nurse expect?
A)Fatigue
B) Bulging eyes
C) Palpitations
D) Flushed skin - ANSWER A
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. Bulging eyes, palpitations, and flushed skin would be signs and symptoms of hyperthyroidism.
2.
A patient has been admitted to the post-surgical unit following a thyroidectomy. To promote comfort and safety, how should the nurse best position the patient?
A) Side-lying (lateral) with one pillow under the head
B) Head of the bed elevated 30 degrees and no pillows placed under the head
C) Semi-Fowlers with the head supported on two pillows
D) Supine, with a small roll supporting the neck - ANSWER C
Feedback:
When moving and turning the patient, the nurse carefully supports the patients head and avoids tension on the sutures. The most comfortable position is the semi-
Fowlers position, with the head elevated and supported by pillows.
3. A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the patient should prioritize what question when addressing potential complications?
A) Do you feel any muscle twitches or spasms?
B) Do you feel flushed or sweaty?
C) Are you experiencing any dizziness or lightheadedness?
D) Are you having any pain that seems to be radiating from your bones? - ANSWER A
Feedback:
As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of the hands and feet and muscle twitching. This is characteristic of hypoparathyroidism. Flushing, diaphoresis, dizziness, and pain are atypical signs of the resulting hypocalcemia.
4.
The nurse is caring for a patient with a diagnosis of Addisons disease. What sign or symptom is most closely associated with this health problem?
A) Truncal obesity B) Hypertension
C) Muscle weakness
D) Moon face - ANSWER C
Feedback:
Patients with Addisons disease demonstrate muscular weakness, anorexia, gastrointestinal symptoms, fatigue, emaciation, dark pigmentation of the skin, and hypotension. Patients with Cushing syndrome demonstrate truncal obesity, moon face, acne, abdominal striae, and hypertension.
5.
The nurse is caring for a patient with Addisons disease who is scheduled for discharge. When teaching the patient about hormone replacement therapy, the nurse should address what topic?
A) The possibility of precipitous weight gain
B) The need for lifelong steroid replacement C) The need to match the daily steroid dose to immediate symptoms
D) The importance of monitoring liver function - ANSWER B
Feedback:
Because of the need for lifelong replacement of adrenal cortex hormones to prevent addisonian crises, the patient and family members receive explicit education about the rationale for replacement therapy and proper dosage. Doses are not adjusted on a short-term basis. Weight gain and hepatotoxicity are not common adverse effects.
6.
The nurse is teaching a patient that the body needs iodine for the thyroid to function. What food would be the best source of iodine for the body?
A) Eggs
B) Shellfish
C) Table salt
D) Red meat - ANSWER C
Feedback:
The major use of iodine in the body is by the thyroid. Iodized table salt is the best source of iodine.
7.
A patient is prescribed corticosteroid therapy. What would be priority information for the nurse to give the patient who is prescribed long-term corticosteroid therapy?
A) The patients diet should be low protein with ample fat.
B) The patient may experience short-term changes in cognition.
C) The patient is at an increased risk for developing infection.
D) The patient is at a decreased risk for development of thrombophlebitis and thromboembolism. - ANSWER C
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 in protein with limited fat.
The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimotos thyroiditis. When assessing this patient, what sign or symptom would the nurse expect?
A)Fatigue
B) Bulging eyes
C) Palpitations
D) Flushed skin - ANSWER A
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. Bulging eyes, palpitations, and flushed skin would be signs and symptoms of hyperthyroidism.
2.
A patient has been admitted to the post-surgical unit following a thyroidectomy. To promote comfort and safety, how should the nurse best position the patient?
A) Side-lying (lateral) with one pillow under the head
B) Head of the bed elevated 30 degrees and no pillows placed under the head
C) Semi-Fowlers with the head supported on two pillows
D) Supine, with a small roll supporting the neck - ANSWER C
Feedback:
When moving and turning the patient, the nurse carefully supports the patients head and avoids tension on the sutures. The most comfortable position is the semi-
Fowlers position, with the head elevated and supported by pillows.
3. A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the patient should prioritize what question when addressing potential complications?
A) Do you feel any muscle twitches or spasms?
B) Do you feel flushed or sweaty?
C) Are you experiencing any dizziness or lightheadedness?
D) Are you having any pain that seems to be radiating from your bones? - ANSWER A
Feedback:
As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of the hands and feet and muscle twitching. This is characteristic of hypoparathyroidism. Flushing, diaphoresis, dizziness, and pain are atypical signs of the resulting hypocalcemia.
4.
The nurse is caring for a patient with a diagnosis of Addisons disease. What sign or symptom is most closely associated with this health problem?
A) Truncal obesity B) Hypertension
C) Muscle weakness
D) Moon face - ANSWER C
Feedback:
Patients with Addisons disease demonstrate muscular weakness, anorexia, gastrointestinal symptoms, fatigue, emaciation, dark pigmentation of the skin, and hypotension. Patients with Cushing syndrome demonstrate truncal obesity, moon face, acne, abdominal striae, and hypertension.
5.
The nurse is caring for a patient with Addisons disease who is scheduled for discharge. When teaching the patient about hormone replacement therapy, the nurse should address what topic?
A) The possibility of precipitous weight gain
B) The need for lifelong steroid replacement C) The need to match the daily steroid dose to immediate symptoms
D) The importance of monitoring liver function - ANSWER B
Feedback:
Because of the need for lifelong replacement of adrenal cortex hormones to prevent addisonian crises, the patient and family members receive explicit education about the rationale for replacement therapy and proper dosage. Doses are not adjusted on a short-term basis. Weight gain and hepatotoxicity are not common adverse effects.
6.
The nurse is teaching a patient that the body needs iodine for the thyroid to function. What food would be the best source of iodine for the body?
A) Eggs
B) Shellfish
C) Table salt
D) Red meat - ANSWER C
Feedback:
The major use of iodine in the body is by the thyroid. Iodized table salt is the best source of iodine.
7.
A patient is prescribed corticosteroid therapy. What would be priority information for the nurse to give the patient who is prescribed long-term corticosteroid therapy?
A) The patients diet should be low protein with ample fat.
B) The patient may experience short-term changes in cognition.
C) The patient is at an increased risk for developing infection.
D) The patient is at a decreased risk for development of thrombophlebitis and thromboembolism. - ANSWER C
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 in protein with limited fat.
