Chapter 58: Concepts of Care for Patients
with Problems of the Thyroid and
Parathyroid Glands
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A nurse plans care for a client with hypothyroidism. Which priority problem does the
nurse address first for this client?
a. Heat intolerance
b. Body image problems
c. Depression and withdrawal
d. Obesity and water retention
ANS: C
Hypothyroidism causes many problems in psychosocial functioning. Depression is the
most common reason for seeking medical attention. Memory and attention span may
be impaired. The client’s family may have great difficulty accepting and dealing with
these changes. The client is often unmotivated to participate in self-care. Lapses in
memory and attention require the nurse to ensure that the patient’s environment is
safe. Heat intolerance is seen in hyperthyroidism. Body image problems and weight
issues do not take priority over mental status and safety.
DIF: Applying TOP: Integrated Process: Nursing Process: Analysis
KEY: Thyroid disorder, Assessment MSC: Client Needs
Category: Psychological Integrity
, 2. A nurse assesses a client who is prescribed levothyroxine for hypothyroidism. Which
assessment finding alerts the nurse that drug therapy is effective?
a. Thirst is recognized and fluid intake is appropriate.
b. Weight has been the same for 3 weeks.
c. Total white blood cell count is 6000 cells/mm3 (6 109/L).
d. Heart rate is 76 beats/min and regular.
ANS: D
Hypothyroidism decreases body functioning and can result in effects such as
bradycardia, confusion, and constipation. If a client’s heart rate is bradycardic while
on thyroid hormone replacement, this is an indicator that the replacement may not be
adequate. Conversely, a heart rate above 100 beats/min may indicate that the client is
receiving too much of the thyroid hormone. Thirst, fluid intake, weight, and white
blood cell count do not represent a therapeutic response to this medication.
DIF: Analyzing TOP: Integrated Process: Nursing Process: Evaluation
KEY: Thyroid disorder, Drug therapy MSC: Client Needs
Category: Physiological Integrity: Pharmacological and Parenteral Therapies
3. A nurse cares for a client who has hypothyroidism as a result of Hashimotothyroiditis.
The client asks, “How long will I need to take this thyroid medication?” How would
the nurse respond?
a. “You will need to take the thyroid medication until the goiter is completely
gone.”
b. “Thyroiditis is cured with antibiotics. Then you won’t need thyroid
medication.”
c. “You’ll need thyroid pills for life because your thyroid won’t start working
again.”
d. “When blood tests indicate normal thyroid function, you can stop the
medication.”
ANS: C
with Problems of the Thyroid and
Parathyroid Glands
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A nurse plans care for a client with hypothyroidism. Which priority problem does the
nurse address first for this client?
a. Heat intolerance
b. Body image problems
c. Depression and withdrawal
d. Obesity and water retention
ANS: C
Hypothyroidism causes many problems in psychosocial functioning. Depression is the
most common reason for seeking medical attention. Memory and attention span may
be impaired. The client’s family may have great difficulty accepting and dealing with
these changes. The client is often unmotivated to participate in self-care. Lapses in
memory and attention require the nurse to ensure that the patient’s environment is
safe. Heat intolerance is seen in hyperthyroidism. Body image problems and weight
issues do not take priority over mental status and safety.
DIF: Applying TOP: Integrated Process: Nursing Process: Analysis
KEY: Thyroid disorder, Assessment MSC: Client Needs
Category: Psychological Integrity
, 2. A nurse assesses a client who is prescribed levothyroxine for hypothyroidism. Which
assessment finding alerts the nurse that drug therapy is effective?
a. Thirst is recognized and fluid intake is appropriate.
b. Weight has been the same for 3 weeks.
c. Total white blood cell count is 6000 cells/mm3 (6 109/L).
d. Heart rate is 76 beats/min and regular.
ANS: D
Hypothyroidism decreases body functioning and can result in effects such as
bradycardia, confusion, and constipation. If a client’s heart rate is bradycardic while
on thyroid hormone replacement, this is an indicator that the replacement may not be
adequate. Conversely, a heart rate above 100 beats/min may indicate that the client is
receiving too much of the thyroid hormone. Thirst, fluid intake, weight, and white
blood cell count do not represent a therapeutic response to this medication.
DIF: Analyzing TOP: Integrated Process: Nursing Process: Evaluation
KEY: Thyroid disorder, Drug therapy MSC: Client Needs
Category: Physiological Integrity: Pharmacological and Parenteral Therapies
3. A nurse cares for a client who has hypothyroidism as a result of Hashimotothyroiditis.
The client asks, “How long will I need to take this thyroid medication?” How would
the nurse respond?
a. “You will need to take the thyroid medication until the goiter is completely
gone.”
b. “Thyroiditis is cured with antibiotics. Then you won’t need thyroid
medication.”
c. “You’ll need thyroid pills for life because your thyroid won’t start working
again.”
d. “When blood tests indicate normal thyroid function, you can stop the
medication.”
ANS: C
