HESI Case Study Thyroid Disorders
UPDATED Exam Questions and
CORRECT Answers
Patient Profile - Correct Answer- Ms. Eugena Cole is a 58-year-old African American female.
She works full time as a high school math teacher. She is currently working on a specialist
degree, taking night classes at one of the local colleges. Eugena has noticed that she is more
sluggish than normal. She doesn't have the energy for girls' nights out anymore, and for the
past 4 months, she has not attended her exercise classes. She has gained 10 pounds in the past
4 to 6 months. Her friends say she acts depressed and encouraged her to see a healthcare
provider (HCP). Eugena makes an appointment to see her healthcare provider (HCP).
Given the initial history and vital signs, what other questions should the nurse ask? - Correct
Answer- - Have you had any changes in your bowel habits? (Hypothyroidism can cause
constipation)
- Do you still feel sleepy when you wake up in the mornings despite getting a god night's
sleep? (Hypothyroidism can cause sleep disturbances)
- Have you noticed any changes in your hair or nails? (hypothyroidism can cause hair loss
and brittle nails)
Diagnostic Tests - Correct Answer- Eugena is scheduled for a radioactive iodine uptake test.
This test is used to measure the rate of iodine uptake by the thyroid gland. She is also
scheduled for a thyroid scan.
After the consent form is signed, what assessment data are most important to obtain prior to
the radioactive iodine uptake test? - Correct Answer- - Find out if the client has ever had a
reaction to a bee sting. (allergic reaction to bee stings and shell fish should be assessed)
- Ask if she takes any OTC medications such as cough syrups. (many OTC cough
medications contain some iodine.)
- Investigate the client's use of OTC multivitamin and herbal products.
Based on Eugena's history and presenting symptoms, which additional diagnostic tests does
the nurse anticipate the HCP to order? - Correct Answer- - CBC with differential (need to use
, to rule out other possible causes of Eugena's symptoms which could include anemia/
infection)
- Blood chemistries (to evaluate the Pt's electrolyte and fluid status)
- TSH and free T4 (functioning or non-functioning of the thyroid gland)
Thyroid scans are one means of evaluating the thyroid gland for presence of a nodule.
Scanning also demonstrates the size, shape, function, and position of the thyroid gland.
Radioactive iodine is administered PO or parenterally, and the uptake of the iodine by the
thyroid gland is measured. Clients with hypothyroidism will demonstrate a decreased uptake
of the radioactive iodine.
Further physical examination reveals a slightly overweight female with a BMI of 27. While
assessing her thyroid, the nurse finds a goiter. Goiter is the term for an enlarged thyroid
gland. Depending on the cause of hypothyroidism, the client may have a goiter. A goiter can
also be present with hyperthyroidism.
Eugena's lab result indicate mild anemia and a TSH that is 20 (normal is 0.5-5.0
microunits/ml). She asks, "How did I get this disease?" - Correct Answer-
Based on the results, Eugena is diagnosed with hypothyroidism. What other lab should be
monitored after the diagnosis of hypothyroidism is confirmed? - Correct Answer-
Triglycerides and cholesterol
(hypothyroidism can cause increased triglyceride and cholesterol levels, leading to coronary
atherosclerosis)
Which explanation by the nurse is accurate? - Correct Answer- An autoimmune dysfunction
causes thyroid dysfunction.
(The most common cause of hypothyroidism in adults is autoimmune thyroiditis
(Hashimoto's disease) in which the immune system attacks the thyroid. More than 95% of
patients either have primary or thyroidal hypothyroidism which refers to dysfunction of the
thyroid itself)
What symptoms are clients with hypothyroidism most likely to exhibit? - Correct Answer- -
Coarse dry skin
UPDATED Exam Questions and
CORRECT Answers
Patient Profile - Correct Answer- Ms. Eugena Cole is a 58-year-old African American female.
She works full time as a high school math teacher. She is currently working on a specialist
degree, taking night classes at one of the local colleges. Eugena has noticed that she is more
sluggish than normal. She doesn't have the energy for girls' nights out anymore, and for the
past 4 months, she has not attended her exercise classes. She has gained 10 pounds in the past
4 to 6 months. Her friends say she acts depressed and encouraged her to see a healthcare
provider (HCP). Eugena makes an appointment to see her healthcare provider (HCP).
Given the initial history and vital signs, what other questions should the nurse ask? - Correct
Answer- - Have you had any changes in your bowel habits? (Hypothyroidism can cause
constipation)
- Do you still feel sleepy when you wake up in the mornings despite getting a god night's
sleep? (Hypothyroidism can cause sleep disturbances)
- Have you noticed any changes in your hair or nails? (hypothyroidism can cause hair loss
and brittle nails)
Diagnostic Tests - Correct Answer- Eugena is scheduled for a radioactive iodine uptake test.
This test is used to measure the rate of iodine uptake by the thyroid gland. She is also
scheduled for a thyroid scan.
After the consent form is signed, what assessment data are most important to obtain prior to
the radioactive iodine uptake test? - Correct Answer- - Find out if the client has ever had a
reaction to a bee sting. (allergic reaction to bee stings and shell fish should be assessed)
- Ask if she takes any OTC medications such as cough syrups. (many OTC cough
medications contain some iodine.)
- Investigate the client's use of OTC multivitamin and herbal products.
Based on Eugena's history and presenting symptoms, which additional diagnostic tests does
the nurse anticipate the HCP to order? - Correct Answer- - CBC with differential (need to use
, to rule out other possible causes of Eugena's symptoms which could include anemia/
infection)
- Blood chemistries (to evaluate the Pt's electrolyte and fluid status)
- TSH and free T4 (functioning or non-functioning of the thyroid gland)
Thyroid scans are one means of evaluating the thyroid gland for presence of a nodule.
Scanning also demonstrates the size, shape, function, and position of the thyroid gland.
Radioactive iodine is administered PO or parenterally, and the uptake of the iodine by the
thyroid gland is measured. Clients with hypothyroidism will demonstrate a decreased uptake
of the radioactive iodine.
Further physical examination reveals a slightly overweight female with a BMI of 27. While
assessing her thyroid, the nurse finds a goiter. Goiter is the term for an enlarged thyroid
gland. Depending on the cause of hypothyroidism, the client may have a goiter. A goiter can
also be present with hyperthyroidism.
Eugena's lab result indicate mild anemia and a TSH that is 20 (normal is 0.5-5.0
microunits/ml). She asks, "How did I get this disease?" - Correct Answer-
Based on the results, Eugena is diagnosed with hypothyroidism. What other lab should be
monitored after the diagnosis of hypothyroidism is confirmed? - Correct Answer-
Triglycerides and cholesterol
(hypothyroidism can cause increased triglyceride and cholesterol levels, leading to coronary
atherosclerosis)
Which explanation by the nurse is accurate? - Correct Answer- An autoimmune dysfunction
causes thyroid dysfunction.
(The most common cause of hypothyroidism in adults is autoimmune thyroiditis
(Hashimoto's disease) in which the immune system attacks the thyroid. More than 95% of
patients either have primary or thyroidal hypothyroidism which refers to dysfunction of the
thyroid itself)
What symptoms are clients with hypothyroidism most likely to exhibit? - Correct Answer- -
Coarse dry skin
