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Nursing (Southwestern University PHINMA)
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TEST
8 The Client with Endocrine Health Problems
■ The Client with Thyrotoxicosis
■ The Client with Diabetes Mellitus
■ The Client with Pituitary Adenoma
■ The Client with Addison’s Disease
■ The Client with Cushing’s Disease
■ The Female Client with Perimenopausal or Menopausal Syndrome
■ The Client with Pheochromocytoma
■ Managing Care Quality and Safety
■ Answers, Rationales, and Test Taking Strategies
The Client with Thyrotoxicosis 5. A client with thyrotoxicosis says to the nurse,
“I am so irritable. I am having problems at work
1. The nurse is completing a health assessment because I lose my temper very easily.” Which of the
of a 42-year-old female with suspected Graves’ dis- following responses by the nurse would give the cli-
ease. The nurse should assess this client for: ent the most accurate explanation of her behavior?
■ 1. Anorexia. ■ 1. “Your behavior is caused by temporary confu-
■ 2. Tachycardia. sion brought on by your illness.”
■ 3. Weight gain. ■ 2. “Your behavior is caused by the excess thy-
■ 4. Cold skin. roid hormone in your system.”
■ 3. “Your behavior is caused by your worrying
2. When conducting a health history with a about the seriousness of your illness.”
female client with thyrotoxicosis, the nurse should
■ 4. “Your behavior is caused by the stress of try-
ask about which of the following changes in the
ing to manage a career and cope with illness.”
menstrual cycle?
■ 1. Dysmenorrhea. 6. Serum concentrations of thyroid hormones
■ 2. Metrorrhagia. and thyroid-stimulating hormone (TSH) are tests
■ 3. Oligomenorrhea. ordered for the client with thyrotoxicosis. Which
■ 4. Menorrhagia. of the following laboratory values are indicative of
thyrotoxicosis?
3. A 34-year-old female is diagnosed with hypo- ■ 1. Elevated thyroid hormone concentrations and
thyroidism. The nurse should assess the client for
normal TSH.
which of the following? Select all that apply.
■ 2. Elevated TSH and normal thyroid hormone
■ 1. Rapid pulse.
concentrations.
■ 2. Decreased energy and fatigue.
■ 3. Decreased thyroid hormone concentrations
■ 3. Weight gain of 10 lb.
and elevated TSH.
■ 4. Fine, thin hair with hair loss.
■ 4. Elevated thyroid hormone concentrations and
■ 5. Constipation.
decreased TSH.
■ 6. Menorrhagia.
4. Propylthiouracil (PTU) is prescribed for a cli- 7. The nurse should teach the client to prevent
corneal irritation from mild exophthalmos by:
ent with Graves’ disease. The nurse should teach the
■ 1. Massaging the eyes at regular intervals.
client to immediately report which of the following?
■ 2. Instilling an ophthalmic anesthetic as
■ 1. Sore throat.
ordered.
■ 2. Painful, excessive menstruation.
■ 3. Wearing dark-colored glasses.
■ 3. Constipation.
■ 4. Covering both eyes with moistened gauze
■ 4. Increased urine output.
pads.
477
Downloaded by John Wangari ()
, lOMoARcPSD|56128505
478 The Nursing Care of Adults with Medical and Surgical Health Problems
8. A client with Graves’ disease is treated with 13. A client who has undergone a subtotal thy-
radioactive iodine (RAI) in the form of sodium roidectomy is subject to complications in the first
iodide 131I. Which of the following statements by the 48 hours after surgery. The nurse should obtain and
nurse will explain to the client how the drug works? keep at the bedside equipment to:
■ 1. “The radioactive iodine stabilizes the thyroid ■ 1. Begin total parenteral nutrition.
hormone levels before a thyroidectomy.” ■ 2. Start a cutdown infusion.
■ 2. “The radioactive iodine reduces uptake of ■ 3. Administer tube feedings.
thyroxine and thereby improves your condi- ■ 4. Perform a tracheotomy.
tion.”
■ 3. “The radioactive iodine lowers the levels of
14. Which of the following symptoms might
indicate that a client was developing tetany after a
thyroid hormones by slowing your body’s
subtotal thyroidectomy?
production of them.”
■ 1. Pains in the joints of the hands and feet.
■ 4. “The radioactive iodine destroys thyroid tis-
■ 2. Tingling in the fingers.
sue so that thyroid hormones are no longer
■ 3. Bleeding on the back of the dressing.
produced.”
■ 4. Tension on the suture line.
9. After treatment with radioactive iodine (RAI) 15. Which of the following medications should
in the form of sodium iodide 131I, the nurse teaches
be available to provide emergency treatment if a cli-
the client to:
ent develops tetany after a subtotal thyroidectomy?
■ 1. Monitor for signs and symptoms of hyperthy-
■ 1. Sodium phosphate.
roidism.
■ 2. Calcium gluconate.
■ 2. Rest for 1 week to prevent complications of
■ 3. Echothiophate iodide.
the medication.
■ 4. Sodium bicarbonate.
■ 3. Take thyroxine replacement for the remainder
of the client’s life. 16. A 60-year-old female is diagnosed with hypo-
■ 4. Assess for hypertension and tachycardia thyroidism. The nurse should assess the client for
resulting from altered thyroid activity. which of the following?
■ 1. Tachycardia.
10. A client with a large goiter is scheduled for ■ 2. Weight gain.
a subtotal thyroidectomy to treat thyrotoxicosis.
■ 3. Diarrhea.
Saturated solution of potassium iodide (SSKI) is pre-
■ 4. Nausea.
scribed preoperatively for the client. The primary
reason for using this drug is that it helps: 17. Appropriate nursing diagnoses for a client
■ 1. Slow progression of exophthalmos. with hypothyroidism would include which of the
■ 2. Reduce the vascularity of the thyroid gland. following?
■ 3. Decrease the body’s ability to store thyroxine. ■ 1. Risk for injury (corneal abrasion) related to
■ 4. Increase the body’s ability to excrete thyrox- incomplete closure of the eyelid.
ine. ■ 2. Imbalanced nutrition: Less than body require-
ments related to hypermetabolism.
11. The nurse is administering a saturated solu- ■ 3. Deficient fluid volume related to diarrhea.
tion of potassium iodide (SSKI). The nurse should:
■ 4. Activity intolerance related to fatigue associ-
■ 1. Pour the solution over ice chips.
ated with the disorder.
■ 2. Mix the solution with an antacid.
■ 3. Dilute the solution with water, milk, or fruit 18. When discussing recent onset of feelings of
juice and have the client drink it with a straw. sadness and depression in a client with hypothy-
■ 4. Disguise the solution in a pureed fruit or veg- roidism, the nurse should inform the client that
etable. these feelings are:
■ 1. The effects of thyroid hormone replacement
12. The nurse asks the client to state her name as therapy and will diminish over time.
soon as she regains consciousness postoperatively
■ 2. Related to thyroid hormone replacement
after a subtotal thyroidectomy and at each assess-
therapy and will not diminish over time.
ment. The nurse does this to monitor for signs of
■ 3. A normal part of having a chronic illness.
which of the following?
■ 4. Most likely related to low thyroid hormone
■ 1. Internal hemorrhage.
levels and will improve with treatment.
■ 2. Decreasing level of consciousness.
■ 3. Laryngeal nerve damage.
■ 4. Upper airway obstruction.
Downloaded by John Wangari ()
Endo to print Lippincott's Q&A Review for Nclex-RN
Nursing (Southwestern University PHINMA)
Scan to open on Studocu
Studocu is not sponsored or endorsed by any college or university
Downloaded by John Wangari ()
, lOMoARcPSD|56128505
TEST
8 The Client with Endocrine Health Problems
■ The Client with Thyrotoxicosis
■ The Client with Diabetes Mellitus
■ The Client with Pituitary Adenoma
■ The Client with Addison’s Disease
■ The Client with Cushing’s Disease
■ The Female Client with Perimenopausal or Menopausal Syndrome
■ The Client with Pheochromocytoma
■ Managing Care Quality and Safety
■ Answers, Rationales, and Test Taking Strategies
The Client with Thyrotoxicosis 5. A client with thyrotoxicosis says to the nurse,
“I am so irritable. I am having problems at work
1. The nurse is completing a health assessment because I lose my temper very easily.” Which of the
of a 42-year-old female with suspected Graves’ dis- following responses by the nurse would give the cli-
ease. The nurse should assess this client for: ent the most accurate explanation of her behavior?
■ 1. Anorexia. ■ 1. “Your behavior is caused by temporary confu-
■ 2. Tachycardia. sion brought on by your illness.”
■ 3. Weight gain. ■ 2. “Your behavior is caused by the excess thy-
■ 4. Cold skin. roid hormone in your system.”
■ 3. “Your behavior is caused by your worrying
2. When conducting a health history with a about the seriousness of your illness.”
female client with thyrotoxicosis, the nurse should
■ 4. “Your behavior is caused by the stress of try-
ask about which of the following changes in the
ing to manage a career and cope with illness.”
menstrual cycle?
■ 1. Dysmenorrhea. 6. Serum concentrations of thyroid hormones
■ 2. Metrorrhagia. and thyroid-stimulating hormone (TSH) are tests
■ 3. Oligomenorrhea. ordered for the client with thyrotoxicosis. Which
■ 4. Menorrhagia. of the following laboratory values are indicative of
thyrotoxicosis?
3. A 34-year-old female is diagnosed with hypo- ■ 1. Elevated thyroid hormone concentrations and
thyroidism. The nurse should assess the client for
normal TSH.
which of the following? Select all that apply.
■ 2. Elevated TSH and normal thyroid hormone
■ 1. Rapid pulse.
concentrations.
■ 2. Decreased energy and fatigue.
■ 3. Decreased thyroid hormone concentrations
■ 3. Weight gain of 10 lb.
and elevated TSH.
■ 4. Fine, thin hair with hair loss.
■ 4. Elevated thyroid hormone concentrations and
■ 5. Constipation.
decreased TSH.
■ 6. Menorrhagia.
4. Propylthiouracil (PTU) is prescribed for a cli- 7. The nurse should teach the client to prevent
corneal irritation from mild exophthalmos by:
ent with Graves’ disease. The nurse should teach the
■ 1. Massaging the eyes at regular intervals.
client to immediately report which of the following?
■ 2. Instilling an ophthalmic anesthetic as
■ 1. Sore throat.
ordered.
■ 2. Painful, excessive menstruation.
■ 3. Wearing dark-colored glasses.
■ 3. Constipation.
■ 4. Covering both eyes with moistened gauze
■ 4. Increased urine output.
pads.
477
Downloaded by John Wangari ()
, lOMoARcPSD|56128505
478 The Nursing Care of Adults with Medical and Surgical Health Problems
8. A client with Graves’ disease is treated with 13. A client who has undergone a subtotal thy-
radioactive iodine (RAI) in the form of sodium roidectomy is subject to complications in the first
iodide 131I. Which of the following statements by the 48 hours after surgery. The nurse should obtain and
nurse will explain to the client how the drug works? keep at the bedside equipment to:
■ 1. “The radioactive iodine stabilizes the thyroid ■ 1. Begin total parenteral nutrition.
hormone levels before a thyroidectomy.” ■ 2. Start a cutdown infusion.
■ 2. “The radioactive iodine reduces uptake of ■ 3. Administer tube feedings.
thyroxine and thereby improves your condi- ■ 4. Perform a tracheotomy.
tion.”
■ 3. “The radioactive iodine lowers the levels of
14. Which of the following symptoms might
indicate that a client was developing tetany after a
thyroid hormones by slowing your body’s
subtotal thyroidectomy?
production of them.”
■ 1. Pains in the joints of the hands and feet.
■ 4. “The radioactive iodine destroys thyroid tis-
■ 2. Tingling in the fingers.
sue so that thyroid hormones are no longer
■ 3. Bleeding on the back of the dressing.
produced.”
■ 4. Tension on the suture line.
9. After treatment with radioactive iodine (RAI) 15. Which of the following medications should
in the form of sodium iodide 131I, the nurse teaches
be available to provide emergency treatment if a cli-
the client to:
ent develops tetany after a subtotal thyroidectomy?
■ 1. Monitor for signs and symptoms of hyperthy-
■ 1. Sodium phosphate.
roidism.
■ 2. Calcium gluconate.
■ 2. Rest for 1 week to prevent complications of
■ 3. Echothiophate iodide.
the medication.
■ 4. Sodium bicarbonate.
■ 3. Take thyroxine replacement for the remainder
of the client’s life. 16. A 60-year-old female is diagnosed with hypo-
■ 4. Assess for hypertension and tachycardia thyroidism. The nurse should assess the client for
resulting from altered thyroid activity. which of the following?
■ 1. Tachycardia.
10. A client with a large goiter is scheduled for ■ 2. Weight gain.
a subtotal thyroidectomy to treat thyrotoxicosis.
■ 3. Diarrhea.
Saturated solution of potassium iodide (SSKI) is pre-
■ 4. Nausea.
scribed preoperatively for the client. The primary
reason for using this drug is that it helps: 17. Appropriate nursing diagnoses for a client
■ 1. Slow progression of exophthalmos. with hypothyroidism would include which of the
■ 2. Reduce the vascularity of the thyroid gland. following?
■ 3. Decrease the body’s ability to store thyroxine. ■ 1. Risk for injury (corneal abrasion) related to
■ 4. Increase the body’s ability to excrete thyrox- incomplete closure of the eyelid.
ine. ■ 2. Imbalanced nutrition: Less than body require-
ments related to hypermetabolism.
11. The nurse is administering a saturated solu- ■ 3. Deficient fluid volume related to diarrhea.
tion of potassium iodide (SSKI). The nurse should:
■ 4. Activity intolerance related to fatigue associ-
■ 1. Pour the solution over ice chips.
ated with the disorder.
■ 2. Mix the solution with an antacid.
■ 3. Dilute the solution with water, milk, or fruit 18. When discussing recent onset of feelings of
juice and have the client drink it with a straw. sadness and depression in a client with hypothy-
■ 4. Disguise the solution in a pureed fruit or veg- roidism, the nurse should inform the client that
etable. these feelings are:
■ 1. The effects of thyroid hormone replacement
12. The nurse asks the client to state her name as therapy and will diminish over time.
soon as she regains consciousness postoperatively
■ 2. Related to thyroid hormone replacement
after a subtotal thyroidectomy and at each assess-
therapy and will not diminish over time.
ment. The nurse does this to monitor for signs of
■ 3. A normal part of having a chronic illness.
which of the following?
■ 4. Most likely related to low thyroid hormone
■ 1. Internal hemorrhage.
levels and will improve with treatment.
■ 2. Decreasing level of consciousness.
■ 3. Laryngeal nerve damage.
■ 4. Upper airway obstruction.
Downloaded by John Wangari ()
