exam 3 Flashcards
(124 cards)
Why would a patient with hyperthyroidism be prescribed the drug methimazole (Tapazole)?
To limit the effect of the pituitary on the thyroid
To destroy part of the hyperactive thyroid tissue
To stimulate the pineal gland
To block the production of thyroid hormones
To block the production of thyroid hormones
Medical management for hyperthyroidism may include administration of drugs that block the
production of thyroid hormones, such as propylthiouracil or methimazole.
To which diet should a patient with Cushing syndrome adhere?
Less sodium
More calories
Less potassium
More carbohydrates
Less sodium
The diet should be lower in sodium to help decrease edema.
A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During
thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of the
potentially lethal complication of:
severe nausea and vomiting.
bradycardia.
delirium with restlessness
congestive heart failure.
congestive heart failure.
In thyroid crisis, all the signs and symptoms of hyperthyroidism are exaggerated. The patient
may develop congestive heart failure and die
The purpose of the use of radioactive iodine in the treatment of hyperthyroidism is to:
stimulate the thyroid gland.
depress the pituitary
destroy some of the thyroid tissue.
alter the stimulus from the pituitary.
destroy some of the thyroid tissue.
Radioactive iodine 131 destroys some of the hyperactive thyroid gland to produce a more
normally functioning gland.
Which precaution(s) should the nurse take when caring for a patient who is being treated with radioactive iodine 131 (RAIU)?
Initiate radioactive safety precautions
Avoid assigning any young woman to the patient
Wait three days after dose before assigning a pregnant nurse to care for this patient
Advise visitors to sit at least 10 feet away from the patient
Wait three days after dose before assigning a pregnant nurse to care for this patient
The dose is patient specific and at a very low level. No radioactive safety precautions are necessary
and pregnant nurses can be assigned 3 days after the dose. RAIU is not harmful to nonpregnant
women
What is the postoperative position for a person who has had a thyroidectomy?
Prone
Semi-Fowler
Side-lying
Supine
Semi-Fowler
Postoperative management of this patient includes keeping the bed in a semi-Fowler position, with pillows supporting the head and shoulders. There should be a suction apparatus and tracheotomy tray available for emergency use.
What extra equipment should the nurse provide at the bedside of a new postoperative thyroidectomy patient?
Large bandage scissors
Tracheotomy tray
Ventilator
Water-sealed drainage system
Tracheotomy tray
There should be a suction apparatus and tracheotomy tray available for emergency use.
As the nurse is shaving a patient who is 2 days postoperative from a thyroidectomy, the patient has a spasm of the facial muscles. What should the nurse recognize this as?
Chvostek sign
Montgomery sign
Trousseau sign
Homanssign
Chvostek sign
The spasm of facial muscles when stimulated is the Chvostek sign, an indication of hypocalcemic tetany
patient has undergone tests that indicate a deficiency of the parathyroid hormone secretion. She should be informed of which potential complication?
Osteoporosis
Lethargy
Laryngeal spasms
Kidneystones
Laryngeal spasms
Decreased parathyroid hormone levels in the blood stream cause a decreased calcium level. Severe hypocalcemia may result in laryngeal spasm, stridor, cyanosis, and increased possibility of asphyxia.
A 27-year-old patient with hypothyroidism is referred to the dietitian for dietary consultation. What should nutritional interventions include?
Frequent small meals high in carbohydrates
Calorie-restricted meals
Caffeine-rich beverages
Fluid restrictions
Calorie-restricted meals
What instructions should be included in the discharge instructions for a 47-year-old
patient with hypothyroidism?
Taking medication whenever symptoms cause discomfort
Decreasing fluid and fiber intake
Consuming foods rich in iron
Seeing the physician regularly for follow-up care
Seeing the physician regularly for follow-up care
Regular checkups are essential, because drug dosage may have to be adjusted from time to time.
Howshould the nurse administer insulin to prevent lipohypertrophy?
At room temperature
At body temperature
Straight from the refrigerator
After rolling bottle between hands to warm
At room temperature
In fact, it is now believed that insulin should be administered at room temperature, not straight
from the refrigerator, to help prevent insulin lipohypertrophy
A patient with a history of Graves disease is admitted to the unit with shortness of breath. The nurse notes the patients vital signs: T 103 F, P 160, R 24, BP 160/80. The nurse also notes distended neck veins. What does the patient most likely have?
Pulmonary embolism
Hypertensive crisis
Thyroid storm
Cushing crisis
Thyroid storm
In a thyroid crisis, all the signs and symptoms of hyperthyroidism are exaggerated. Additionally,
the patient may develop nausea, vomiting, severe tachycardia, severe hypertension, and occasionally
hyperthermia up to 41 C (106 F). Extreme restlessness, cardiac arrhythmia, and delirium may
also occur. The patient may develop heart failure and may die
What is the master gland of the endocrine system?
Thyroid
Parathyroid
Pancreas
Pituitary
Pituitary
The pituitary gland, located in the brain, is the master gland of the endocrine system. It has been called the master gland because through the negative feedback system, it exerts its control over the other endocrine glands.
What information should be obtained from the patient before an iodine-131 test?
Presence of metal in the body
Allergy to sulfa drugs
Status of possible pregnancy
Use of prescription drugs for hypertension
Status of possible pregnancy
The patient being treated for hypothyroidism should be instructed to eat well-balanced meals including intake of iodine. Which of the following foods contains iodine?
Eggs
Pork
White bread
Skinless chicken
Eggs
The hypothyroid diet should be adequate in intake of iodine, in foods such as saltwater fish, milk, and eggs; fluids should be increased to help prevent constipation.
The nurse is caring for a patient who is receiving calcium gluconate for treatment of hypoparathyroid tetany. Which assessment would indicate an adverse reaction to the drug?
Increase in heart rate
Flushing of face and neck
Drop in blood pressure
Urticaria
Drop in blood pressure
Indications of an adverse effect of calcium gluconate are dyspnea, bradycardia, and hypotension
The adrenal cortex secretes glucocorticoids. The most important is cortisol. What is it involved in? (Select all that apply
Glucose metabolism
Releasing androgens and estrogens
Providing extra reserve energy during stress
Decreasing the level of potassium in the blood stream
Increasing retention of sodium in the blood stream
Glucose metabolism
Providing extra reserve energy during stress
Cortisol is involved in glucose metabolism and provides extra reserve energy in times of stress
Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks?
Fasting blood sugar (FBS)
Oral glucose tolerance test (OGT)
Glycosylated hemoglobin (HbA1c)
Postprandial glucose test
Glycosylated hemoglobin (HbA1c)
Which test will furnish immediate feedback for a newly diagnosed diabetic who is not yet under control?
Fasting blood sugar (FBS)
Glycosylated hemoglobin (HgbA1c)
Oral glucose tolerance test (OGTT)
Clinitest
Fasting blood sugar (FBS)
Diabetics should do a fingerstick blood glucose level test before each meal and at bedtime each day until their disease is under control. The HgbA1c serum test reveals the effectiveness of diabetes therapy for the preceding 8 to 12 weeks
The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of an exercise regimen. The patient plans to enroll in a swimming class. Which adjustment should be made based on this information
Time the morning insulin injection so that the peak action will occur during swimming
Delete normal walks on swimming class days.
Delay the meal before the swimming class until the session is over.
Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin.
Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin.
Exercise can reduce insulin resistance and increase glucose uptake for as long as 72 hours, as well as reducing blood pressure and lipid levels. However, exercise can carry some risks for patients with diabetes, including hypoglycemia
What is a long-term complication of diabetes mellitus?
Diverticulitis
Renal failure
Hypothyroidism
Hyperglycemia
Renal failure
Long-term complications of diabetes include blindness, cardiovascular problems, and renal
failure.
In diabetes insipidus, a deficiency of which hormone causes clinical manifestations?
antidiuretic hormone (ADH)
follicle-stimulating hormone (FSH)
thyroid-stimulating hormone (TSH)
adrenocorticotropic hormone (ACTH)
antidiuretic hormone (ADH)
Diabetes insipidus is a transient or permanent metabolic disorder of the posterior pituitary in
which ADH is deficient.
What should the nurse caution a type I diabetic about excessive exercise?
It can increase the need for insulin and may result in hyperglycemia.
It can decrease the need for insulin and may result in hypoglycemia.
It can increase muscle bulk and may result in malabsorption of insulin.
It can decrease metabolic demand and may result in metabolic acidosis.
It can decrease the need for insulin and may result in hypoglycemia.
The patient with diabetes should exercise regularly. Exercise can reduce insulin resistance and increase glucose uptake for as long as 72 hours, as well as reducing blood pressure and lipid levels. However, exercise can carry some risks for patients with diabetes, including hypoglycemia.
