Chapter 49: Thyroid and Parathyroid Disorders
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A patient with exophthalmos is distressed about her appearance and asks when it will go
away: What is the best response by the nurse?
a. It is not reversible:
b. It can be disguised with sunglasses and makeup:
c. It usually subsides after medication for hyperthyroidism is started:
d. It can be minimized with plastic surgery to the eyelids:
ANS: C
The “startled” appearance of the patient with exophthalmos usually subsides several
weeks after therapy for hyperthyroidism becomes effective:
DIF: Cognitive Level: Comprehension REF: p: 954 OBJ: 2
TOP: Exophthalmia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
2. A nurse taking the blood pressure of a patient who had a total thyroidectomy 2 days
earlier notes that the patient’s hand goes into a carpopedal spasm: What should the nurse
recognize this movement as an indication of?
a. Hyperkalemia, called the Allen sign
b. Hypernatremia, called the Hogan sign
c. Hypocalcemia, called the Trousseau sign
d. Hypokalemia, called the Chvostek sign
ANS: C
The carpopedal spasm is the Trousseau sign, which indicates hypercalcemia:
Chvostek sign also signals hypocalcemia:
DIF: Cognitive Level: Application REF: p: 961 OBJ: 1
TOP: Hypothyroidism KEY: Nursing Process Step: Assessment
, MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. What action should a nurse implement to address dry skin in the patient with
hypothyroidism?
a. Increase the frequency of bathing to get rid of dry skin:
b. Apply lotions and creams to help maintain moisture:
c. Increase activities to stimulate circulation in the skin:
d. Take antihistamines to prevent itching:
ANS: B
The skin requires moisturizing lotion to decrease the risk breakdown: Frequent
bathing and antihistamines will dry the skin: Exercise does little for skin perfusion:
DIF: Cognitive Level: Application REF: p: 960 OBJ: 1
TOP: Hypothyroidism KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
4. What action should a nurse implement to initiate the Chvostek sign?
a. Ask the patient to grimace and note if the facial response is symmetrical:
b. Inflate a blood pressure cuff to the systolic level and watch for a carpopedal
spasm:
c. Tap the face over the facial nerve and watch for a spasm of the facial muscle:
d. Check the pupillary response to light and determine whether the pupil
accommodates and reacts:
ANS: C
Spasm of the facial muscles is an indicator of low serum calcium levels:
DIF: Cognitive Level: Application REF: p: 956 OBJ: 1
TOP: Hypocalcemia KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
5. What symptoms should a nurse anticipate in the history of a patient with
hyperparathyroidism?
a. Fatigue, hyperactive reflexes, muscle cramps, and twitching
b. Poor muscle tone, bone pain, urinary calculi, and fractures
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A patient with exophthalmos is distressed about her appearance and asks when it will go
away: What is the best response by the nurse?
a. It is not reversible:
b. It can be disguised with sunglasses and makeup:
c. It usually subsides after medication for hyperthyroidism is started:
d. It can be minimized with plastic surgery to the eyelids:
ANS: C
The “startled” appearance of the patient with exophthalmos usually subsides several
weeks after therapy for hyperthyroidism becomes effective:
DIF: Cognitive Level: Comprehension REF: p: 954 OBJ: 2
TOP: Exophthalmia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
2. A nurse taking the blood pressure of a patient who had a total thyroidectomy 2 days
earlier notes that the patient’s hand goes into a carpopedal spasm: What should the nurse
recognize this movement as an indication of?
a. Hyperkalemia, called the Allen sign
b. Hypernatremia, called the Hogan sign
c. Hypocalcemia, called the Trousseau sign
d. Hypokalemia, called the Chvostek sign
ANS: C
The carpopedal spasm is the Trousseau sign, which indicates hypercalcemia:
Chvostek sign also signals hypocalcemia:
DIF: Cognitive Level: Application REF: p: 961 OBJ: 1
TOP: Hypothyroidism KEY: Nursing Process Step: Assessment
, MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. What action should a nurse implement to address dry skin in the patient with
hypothyroidism?
a. Increase the frequency of bathing to get rid of dry skin:
b. Apply lotions and creams to help maintain moisture:
c. Increase activities to stimulate circulation in the skin:
d. Take antihistamines to prevent itching:
ANS: B
The skin requires moisturizing lotion to decrease the risk breakdown: Frequent
bathing and antihistamines will dry the skin: Exercise does little for skin perfusion:
DIF: Cognitive Level: Application REF: p: 960 OBJ: 1
TOP: Hypothyroidism KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
4. What action should a nurse implement to initiate the Chvostek sign?
a. Ask the patient to grimace and note if the facial response is symmetrical:
b. Inflate a blood pressure cuff to the systolic level and watch for a carpopedal
spasm:
c. Tap the face over the facial nerve and watch for a spasm of the facial muscle:
d. Check the pupillary response to light and determine whether the pupil
accommodates and reacts:
ANS: C
Spasm of the facial muscles is an indicator of low serum calcium levels:
DIF: Cognitive Level: Application REF: p: 956 OBJ: 1
TOP: Hypocalcemia KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
5. What symptoms should a nurse anticipate in the history of a patient with
hyperparathyroidism?
a. Fatigue, hyperactive reflexes, muscle cramps, and twitching
b. Poor muscle tone, bone pain, urinary calculi, and fractures
