Chapter 47: Endocrine System Introduction
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A patient asks about his laboratory test, which showed a high level of thyroid-stimulating
hormone (TSH) and a low level of T4: What is the most accurate explanation?
a. “It means that you have an inconsistency in your thyroid tests, and you will need
more testing:”
b. “I am sorry: You will have to ask your physician about your laboratory results:
We are not allowed to discuss them:”
c. “The TSH is sending a message to your thyroid gland to increase production, but
your thyroid isn’t producing enough hormone:”
d. “That means that you will have to go on hormone therapy for the rest of your
life:”
ANS: C
The test determines whether the problem is in the pituitary gland or in the thyroid
gland: In this patient, the high level of TSH is coming from the pituitary gland as it
should, but the thyroid gland is not responding with adequate hormone production:
DIF: Cognitive Level: Comprehension REF: p: 917|p: 922
OBJ: 2 TOP: Thyroid Laboratory Tests
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. A patient has been given an antithyroid drug called methimazole: What appropriate
nursing implementations should be included?
a. Using special radioactive precautions for her urine for the first 24 hours
b. Monitoring her vital signs and withholding the medications if her pulse is greater
than 100 beats/min
c. Teaching her to watch for and report any signs and symptoms of hypothyroidism
or infections
, d. Keeping her on a low-calorie, low-protein diet
ANS: C
The drug targets the thyroid gland to slow its function, so signs and symptoms of
hypothyroidism or infections need to be reported: Thionamides may cause
suppression of neutrophils leading to a lowered resistance:
DIF: Cognitive Level: Application REF: p: 924 OBJ: 3 | 4
TOP: Antithyroid Medications KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
3. An older patient with hypothyroidism asks why her daily dose of thyroid hormone, which
she has taken for 15 years, has been reduced: What is nurse’s best rationale when
explaining what the decreased dose is related to?
a. Improved efficacy of the thyroid preparation
b. Age-related reduction in metabolic rate
c. Drug-related hypertrophy of the thyroid
d. Changes in your diet and activity level
ANS: B
Older patients have slower drug metabolism; consequently, the drug stays in their
systems: All patients receiving hormone replacement need to be periodically
evaluated:
DIF: Cognitive Level: Comprehension REF: p: 924 OBJ: 3
TOP: Age-Related Changes in Therapy KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
4. A patient is receiving the medication octreotide (Sandostatin) as a treatment for
acromegaly: What should the nurse explain regarding this medication?
a. It reverses the effects of acromegaly:
b. It should be given on a daily basis by injection:
c. It increases insulin secretion causing hypoglycemia:
d. It suppresses the growth hormone:
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A patient asks about his laboratory test, which showed a high level of thyroid-stimulating
hormone (TSH) and a low level of T4: What is the most accurate explanation?
a. “It means that you have an inconsistency in your thyroid tests, and you will need
more testing:”
b. “I am sorry: You will have to ask your physician about your laboratory results:
We are not allowed to discuss them:”
c. “The TSH is sending a message to your thyroid gland to increase production, but
your thyroid isn’t producing enough hormone:”
d. “That means that you will have to go on hormone therapy for the rest of your
life:”
ANS: C
The test determines whether the problem is in the pituitary gland or in the thyroid
gland: In this patient, the high level of TSH is coming from the pituitary gland as it
should, but the thyroid gland is not responding with adequate hormone production:
DIF: Cognitive Level: Comprehension REF: p: 917|p: 922
OBJ: 2 TOP: Thyroid Laboratory Tests
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. A patient has been given an antithyroid drug called methimazole: What appropriate
nursing implementations should be included?
a. Using special radioactive precautions for her urine for the first 24 hours
b. Monitoring her vital signs and withholding the medications if her pulse is greater
than 100 beats/min
c. Teaching her to watch for and report any signs and symptoms of hypothyroidism
or infections
, d. Keeping her on a low-calorie, low-protein diet
ANS: C
The drug targets the thyroid gland to slow its function, so signs and symptoms of
hypothyroidism or infections need to be reported: Thionamides may cause
suppression of neutrophils leading to a lowered resistance:
DIF: Cognitive Level: Application REF: p: 924 OBJ: 3 | 4
TOP: Antithyroid Medications KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
3. An older patient with hypothyroidism asks why her daily dose of thyroid hormone, which
she has taken for 15 years, has been reduced: What is nurse’s best rationale when
explaining what the decreased dose is related to?
a. Improved efficacy of the thyroid preparation
b. Age-related reduction in metabolic rate
c. Drug-related hypertrophy of the thyroid
d. Changes in your diet and activity level
ANS: B
Older patients have slower drug metabolism; consequently, the drug stays in their
systems: All patients receiving hormone replacement need to be periodically
evaluated:
DIF: Cognitive Level: Comprehension REF: p: 924 OBJ: 3
TOP: Age-Related Changes in Therapy KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
4. A patient is receiving the medication octreotide (Sandostatin) as a treatment for
acromegaly: What should the nurse explain regarding this medication?
a. It reverses the effects of acromegaly:
b. It should be given on a daily basis by injection:
c. It increases insulin secretion causing hypoglycemia:
d. It suppresses the growth hormone:
