Lewis: Medical-Surgical Nursing, [THYROID Qs ONLY] Chapter 54:Advanced Endocrine and Metabolic Nursing Assessment Exam: Thyroid Disorders, Hyperthyroidism, Hypothyroidism, Graves’ Disease, Thyroidectomy, Parathyroid Dysfunction, Hypocalcemia, Tetany, Hype

Lewis: Medical-Surgical Nursing, [THYROID Qs ONLY] Chapter 54:Advanced Endocrine and Metabolic Nursing Assessment Exam: Thyroid Disorders, Hyperthyroidism, Hypothyroidism, Graves’ Disease, Thyroidectomy, Parathyroid Dysfunction, Hypocalcemia, Tetany, Hyperparathyroidism, Calcium-Phosphorus Imbalance, Myxedema Coma, Thyroid Storm, Radioactive Iodine Therapy, Levothyroxine Management, Hypermetabolism, Exophthalmos, Goiter, Hashimoto’s Thyroiditis, Cardiovascular Dysrhythmias, Hypertension, Hypotension, Electrolyte Imbalances, Acute Pancreatitis, Cholelithiasis, Biliary Obstruction, Fat-Soluble Vitamin Deficiency, Pain Management, Postoperative Care, Airway Obstruction, Nursing Interventions, Patient Education, Laboratory Interpretation Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 10. Which information will the nurse teach a patient who has been newly diagnosed with Graves' disease? a. Exercise is contraindicated to avoid increasing metabolic rate. b. Restriction of iodine intake is needed to reduce thyroid activity. c. Antithyroid medications may take several months for full effect. d. Surgery will eventually be required to remove the thyroid gland. c. Antithyroid medications may take several months for full effect. Medications used to block the synthesis of thyroid hormones may take 2 to 3 months before the full effect is seen. Large doses of iodine are used to inhibit the synthesis of thyroid hormones. Exercise using large muscle groups is encouraged to decrease the irritability and hyperactivity associated with high levels of thyroid hormones. Radioactive iodine is the most common treatment for Graves' disease, although surgery may be used. 11. A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor and a cramp in the right hand upon returning to the surgical nursing unit. Which collaborative action will the nurse anticipate next? a. Suction the patient's airway. b. Administer IV calcium gluconate. c. Plan for emergency tracheostomy. d. Prepare for endotracheal intubation. b. Administer IV calcium gluconate. The patient's clinical manifestations of stridor and cramping are consistent with tetany caused by hypocalcemia resulting from damage to the parathyroid glands during surgery. Endotracheal intubation or tracheostomy may be needed if the calcium does not resolve the stridor. Suctioning will not correct the stridor. 12. Which nursing action will be included in the plan of care for a patient with Graves' disease who has exophthalmos? a. Place cold packs on the eyes to relieve pain and swelling. b. Elevate the head of the patient's bed to reduce periorbital fluid. c. Apply alternating eye patches to protect the corneas from irritation. d. Teach the patient to blink every few seconds to lubricate the corneas. b. Elevate the head of the patient's bed to reduce periorbital fluid. The patient should sit upright as much as possible to promote fluid drainage from the periorbital area. With exophthalmos, the patient is unable to close the eyes completely to blink. Lubrication of the eyes, rather than eye patches, will protect the eyes from developing corneal scarring. The swelling of the eye is not caused by excessive blood flow to the eye, so cold packs will not be helpful. 13. A 62-yr-old patient with hyperthyroidism is to be treated with radioactive iodine (RAI). The nurse instructs the patient a. about radioactive precautions to take with all body secretions. b. that symptoms of hyperthyroidism should be relieved in about a week c. that symptoms of hypothyroidism may occur as the RAI therapy takes effect. d. to discontinue the antithyroid medications taken before the radioactive therapy. c. that symptoms of hypothyroidism may occur as the RAI therapy takes effect. There is a high incidence of postradiation hypothyroidism after RAI, and the patient should be monitored for symptoms of hypothyroidism. RAI has a delayed response, with the maximum effect not seen for 2 to 3 months, and the patient will continue to take antithyroid medications during this time. The therapeutic dose of radioactive iodine is low enough that no radiation safety precautions are needed. 14. Which nursing assessment of a 70-yr-old patient is most important to make during initiation of thyroid replacement with levothyroxine (Synthroid)? a. Fluid balance b. Apical pulse rate c. Nutritional intake d. Orientation and alertness b. Apical pulse rate In older patients, initiation of levothyroxine therapy can increase myocardial oxygen demand and cause angina or dysrhythmias. The medication also is expected to improve mental status and fluid balance and will increase metabolic rate and nutritional needs, but these changes will not result in potentially life-threatening complications.