NU272 HESI Case Study: Thyroid Disorders (week 4) Test with
Answers Graded A
Meet the Client - -The client works full time radioactive iodine uptake test. What are the most
as a high school math teacher. She is currently important assessments for the nurse to obtain
working on a specialist degree, taking night prior to the test? (Select all that apply. One,
classes at one of the local colleges. She noticed some, or all options may be correct.) - -Ask
that she is more sluggish than normal. She if the client has been taking any OTC
doesn't have the energy for girls' nights out medications such as cough syrups? (Many OTC
anymore, and for the past 4 months, she has not cough medications contain some iodine. There
attended her exercise classes. The client gained may not be enough to interfere with the test
10 pounds in the past 4 to 6 months. Her friends results, but the information needs to be
say she acts depressed and encouraged her to assessed.)
see a healthcare provider (HCP) so she makes
an appointment with the HCP. Investigate the client's use of over the counter
(OTC) multivitamin and herbal products.(Many
OTC multivitamins contain some iodine. There
The client's presenting vital signs: may not be enough to interfere with the test
Temperature: 96.0° F (36.0° C) results, but the information needs to be
Pulse: 52 beats/minute assessed.)
Respirations: 18 breaths/minute
Blood pressure: 140/80 mmHg Find out if the client has ever had a reaction to a
Given the initial history and vital signs, what bee sting.(Allergic reactions to bee stings and
other questions should the nurse ask? (Select all shell fish should be assessed.)
that apply. One, some, or all options may be
correct.) - -"Have you had any changes in
your bowel habits?" Based on the client's history and presenting
symptoms, which additional diagnostic tests does
"Do you still feel sleepy when you wake up in the the nurse anticipate the HCP to order?(Select all
mornings despite getting a good night's sleep?" that apply. One, some, or all options may be
correct.) - -CBC with differential. (The HCP
"Have you noticed any changes in your hair or needs to rule out other possible causes of the
nails?" client's symptoms which could include anemia or
- an infection.)
Hypothyroidism can cause
constipation.Hypothyroidism can cause sleep Blood Chemistries.(Chemistries would be needed
disturbances.Hypothyroidism can cause hair loss to evaluate the client's electrolyte and fluid
and brittle nails. status.)
TSH and free T4. (These indicate the functioning
Diagnostic Tests - -The client is scheduled or non-functioning of the thyroid gland.)
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 Based on the health care provider's (HCP)
scan. assessment and interpretation of the diagnostics,
the client is diagnosed with hypothyroidism.
Which other lab should be monitored after the
The client has signed the consent for the diagnosis of hypothyroidism is confirmed? -
1/5
, NU272 HESI Case Study: Thyroid Disorders (week 4) Test with
Answers Graded A
-Triglycerides and cholesterol. speech, fatigue and lethargy.)
Hypothyroidism can cause increased triglyceride Coarse dry skin.
and cholesterol levels, leading to coronary
atherosclerosis. Somnolence and cold intolerance.
Thyroid scans are one means of evaluating the Pharmacologic Management - -Medical
thyroid gland for presence of a nodule. Scanning treatment for hypothyroidism is based on
also demonstrates the size, shape, function, and replacement therapy. The HCP will monitor the
position of the thyroid gland. Radioactive iodine client's goiter for now. The primary medication
is administered PO or parenterally, and the used to treat hypothyroidism is levothyroxine
uptake of the iodine by the thyroid gland is sodium. The HCP prescribes 1.7 mcg/kg body
measured. Clients with hypothyroidism will weight/day. The client weights 150 lbs.
demonstrate a decreased uptake of the
radioactive iodine. - -Further physical
examination reveals a slight obesity with a BMI of What is the client'sdaily dose of medication?
27. While assessing the thyroid gland, the nurse (Enter numerical value only. If rounding is
finds a goiter. Goiter is the term for an enlarged necessary, round to the hundredth.) - -150
thyroid gland. Depending on the cause of the lbs = 68.18 kg
hypothyroidism, the client may have a goiter. A 68.18 x 1.7 mcg = 115.9
goiter can also be present with hyperthyroidism. 115.9 mcg/1000 = 0.115 mg
Lab results indicate mild anemia and a TSH that
is 20 (normal is 0.5 to 5.0 microunits/mL).
Which approach by the nurse describes the
action of the levothyroxine? - -Increases
The client asks the nurse how she got this fat, protein, carbohydrate metabolism.
disease. Which explanation by the nurse is -
accurate? - -An autoimmune dysfunction The action of levothyroxine is the same as
causes thyroid dysfunction. endogenous thyroid hormone. The drug
increases the metabolic rate (increased oxygen
The most common cause of hypothyroidism in consumption, respiration and heart rate) and
adults is autoimmune thyroiditis (Hashimoto's increases the rate of fat, protein, and
disease) in which the immune system attacks the carbohydrate metabolism. It promotes growth
thyroid. More than 95% of clients either have and maturation.
primary or thyroidal hypothyroidism which refers
to dysfunction of the thyroid itself.
Which information in the client's history would be
of concern to the nurse related to the use of
Which symptoms are the client with levothyroxine? - -The client takes a daily
hypothyroidism most likely to exhibit? (Select all calcium supplement.
that apply. One, some, or all options may be -
correct.) - -Somnolence and fatigue. Calcium should be taken at least four hours after
(Hypothyroidism generally causes an individual the Levothyroxine dose to prevent interference
to have decreased initiative, somnolence, slowed with absorption.
2/5
Answers Graded A
Meet the Client - -The client works full time radioactive iodine uptake test. What are the most
as a high school math teacher. She is currently important assessments for the nurse to obtain
working on a specialist degree, taking night prior to the test? (Select all that apply. One,
classes at one of the local colleges. She noticed some, or all options may be correct.) - -Ask
that she is more sluggish than normal. She if the client has been taking any OTC
doesn't have the energy for girls' nights out medications such as cough syrups? (Many OTC
anymore, and for the past 4 months, she has not cough medications contain some iodine. There
attended her exercise classes. The client gained may not be enough to interfere with the test
10 pounds in the past 4 to 6 months. Her friends results, but the information needs to be
say she acts depressed and encouraged her to assessed.)
see a healthcare provider (HCP) so she makes
an appointment with the HCP. Investigate the client's use of over the counter
(OTC) multivitamin and herbal products.(Many
OTC multivitamins contain some iodine. There
The client's presenting vital signs: may not be enough to interfere with the test
Temperature: 96.0° F (36.0° C) results, but the information needs to be
Pulse: 52 beats/minute assessed.)
Respirations: 18 breaths/minute
Blood pressure: 140/80 mmHg Find out if the client has ever had a reaction to a
Given the initial history and vital signs, what bee sting.(Allergic reactions to bee stings and
other questions should the nurse ask? (Select all shell fish should be assessed.)
that apply. One, some, or all options may be
correct.) - -"Have you had any changes in
your bowel habits?" Based on the client's history and presenting
symptoms, which additional diagnostic tests does
"Do you still feel sleepy when you wake up in the the nurse anticipate the HCP to order?(Select all
mornings despite getting a good night's sleep?" that apply. One, some, or all options may be
correct.) - -CBC with differential. (The HCP
"Have you noticed any changes in your hair or needs to rule out other possible causes of the
nails?" client's symptoms which could include anemia or
- an infection.)
Hypothyroidism can cause
constipation.Hypothyroidism can cause sleep Blood Chemistries.(Chemistries would be needed
disturbances.Hypothyroidism can cause hair loss to evaluate the client's electrolyte and fluid
and brittle nails. status.)
TSH and free T4. (These indicate the functioning
Diagnostic Tests - -The client is scheduled or non-functioning of the thyroid gland.)
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 Based on the health care provider's (HCP)
scan. assessment and interpretation of the diagnostics,
the client is diagnosed with hypothyroidism.
Which other lab should be monitored after the
The client has signed the consent for the diagnosis of hypothyroidism is confirmed? -
1/5
, NU272 HESI Case Study: Thyroid Disorders (week 4) Test with
Answers Graded A
-Triglycerides and cholesterol. speech, fatigue and lethargy.)
Hypothyroidism can cause increased triglyceride Coarse dry skin.
and cholesterol levels, leading to coronary
atherosclerosis. Somnolence and cold intolerance.
Thyroid scans are one means of evaluating the Pharmacologic Management - -Medical
thyroid gland for presence of a nodule. Scanning treatment for hypothyroidism is based on
also demonstrates the size, shape, function, and replacement therapy. The HCP will monitor the
position of the thyroid gland. Radioactive iodine client's goiter for now. The primary medication
is administered PO or parenterally, and the used to treat hypothyroidism is levothyroxine
uptake of the iodine by the thyroid gland is sodium. The HCP prescribes 1.7 mcg/kg body
measured. Clients with hypothyroidism will weight/day. The client weights 150 lbs.
demonstrate a decreased uptake of the
radioactive iodine. - -Further physical
examination reveals a slight obesity with a BMI of What is the client'sdaily dose of medication?
27. While assessing the thyroid gland, the nurse (Enter numerical value only. If rounding is
finds a goiter. Goiter is the term for an enlarged necessary, round to the hundredth.) - -150
thyroid gland. Depending on the cause of the lbs = 68.18 kg
hypothyroidism, the client may have a goiter. A 68.18 x 1.7 mcg = 115.9
goiter can also be present with hyperthyroidism. 115.9 mcg/1000 = 0.115 mg
Lab results indicate mild anemia and a TSH that
is 20 (normal is 0.5 to 5.0 microunits/mL).
Which approach by the nurse describes the
action of the levothyroxine? - -Increases
The client asks the nurse how she got this fat, protein, carbohydrate metabolism.
disease. Which explanation by the nurse is -
accurate? - -An autoimmune dysfunction The action of levothyroxine is the same as
causes thyroid dysfunction. endogenous thyroid hormone. The drug
increases the metabolic rate (increased oxygen
The most common cause of hypothyroidism in consumption, respiration and heart rate) and
adults is autoimmune thyroiditis (Hashimoto's increases the rate of fat, protein, and
disease) in which the immune system attacks the carbohydrate metabolism. It promotes growth
thyroid. More than 95% of clients either have and maturation.
primary or thyroidal hypothyroidism which refers
to dysfunction of the thyroid itself.
Which information in the client's history would be
of concern to the nurse related to the use of
Which symptoms are the client with levothyroxine? - -The client takes a daily
hypothyroidism most likely to exhibit? (Select all calcium supplement.
that apply. One, some, or all options may be -
correct.) - -Somnolence and fatigue. Calcium should be taken at least four hours after
(Hypothyroidism generally causes an individual the Levothyroxine dose to prevent interference
to have decreased initiative, somnolence, slowed with absorption.
2/5
