AND ANSWERS 2026/2027
The nurse practicing in an out-patient clinic cares for a client recently
diagnosed with hyperthyroidism. Which diet-related teaching should the
nurse add to the client's plan of care? Select all that apply.
Emphasize the importance of a low-carbohydrate diet
.
Encourage the client to increase high-fiber foods in the diet
= Include meals and snacks high in protein content
3.
Teach avoidance of caffeine-containing liquids
4.
Teach the client about consumption of a high-calorie diet of 4000-
5000 calories/day
5.
Hyperthyroidism refers to sustained hyperfunctioning of the thyroid
gland due to excessive secretion thyroid hormones (T3, T4); this leads to
an increased metabolic rate.
In clients with hyperthyroidism, teaching and learning objectives to
satisfy hunger and prevent weight loss and tissue wasting include:
• Adherence to a high calorie diet (4000-5000 calories per day).
• Consumption of approximately 6 full meals and snacks per day.
These should be packed with protein (1-2 g/kg of ideal body
weight), carbohydrates, and be full of vitamins and
minerals (Option 1).
• Avoidance of high-fiber foods due to the constant
hyperstimulation of the gastrointestinal (GI) tract. High-fiber
foods may increase GI symptoms (eg, diarrhea) (Option 2).
However, high-fiber diets are recommended if the client with
hyperthyroidism has constipation.
, • Avoidance of stimulating substances (eg, caffeinated drinks:
coffee, tea, soft drinks).
• Avoidance of spicy foods as these can also increase GI
stimulation.
Educational objective:
Hyperthyroidism leads to a high metabolic rate. It is important for the
nurse to teach the client nutritional measures, including consumption of a
diet high in calories (high in protein, carbohydrates, vitamins, and
minerals) to satisfy hunger and prevent weight loss and tissue wasting.
The nurse is planning care for a client immediately following a
thyroidectomy. Which of the following nursing actions are appropriate to
include in the plan of care? Select all that apply.
Assessing frequently for facial or extremity numbness or tingling
1.
Encouraging the client to perform neck flexion and extension
frequently
2.
Ensuring that a tracheostomy insertion kit is at the bedside at all
times
Maintaining the head of the bed at 30-45 degrees
Monitoring the client's voice strength and quality
Thyroidectomy is a surgery involving partial or complete removal of the
thyroid, often to treat hyperthyroidism or thyroid cancer.
Clients undergoing a thyroidectomy require close monitoring as they are
at increased risk for airway compromise due to potential neck
swelling, hypocalcemia, and nerve damage.
Nurses planning care following a thyroidectomy promote client recovery
and monitor for and prevent complications by:
• Assessing for and immediately reporting signs of hypocalcemia
(eg, facial or extremity numbness or tingling, stridor, Trousseau
, and Chvostek signs), which may occur from parathyroid gland
trauma during surgery (Option 1)
• Assessing for stridor and new or worsening changes in voice
strength and quality (eg, hoarseness, whispering), which may
indicate laryngeal nerve damage that can result in respiratory
arrest (Option 5)
• Keeping emergency airway equipment (eg, tracheostomy kit,
suction, oxygen) at the bedside in case respiratory distress
develops (Option 3)
• Maintaining the client in semi-Fowler position, which promotes
drainage of surgical site edema around the neck and reduces the
risk of respiratory distress (Option 4)
(Option 2) Postoperatively, the client should avoid excessive neck
flexion and extension, which may strain and cause disruption of the
incision site, leading to hemorrhage. Encourage the client to maintain
neutral head and neck alignment.
Educational objective:
Following a thyroidectomy, place the client in semi-Fowler position with
a neutral head and neck position. Keep a tracheostomy kit, suction, and
oxygen at the bedside in case airway compromise develops. Monitor
frequently for signs of hypocalcemia and changes in voice strength and
quality.
The nurse cares for a client who is experiencing exophthalmos as a
complication of Graves' disease. Which nursing action(s) should be
included in the client's plan of care? Select all that apply.
Administer artificial tears to moisten the conjunctiva
If eyelids don't close during sleep, lightly tape them shut
Recommend the use of dark glasses to prevent irritation
Teach about the importance of smoking cessation
, Teach avoidance of eye movement to prevent further damage
5.
Exophthalmos is a complication of hyperthyroidism (hypermetabolic
state due to thyroid hormone overproduction) from Graves' disease.
It is defined as a protrusion of the eyeballs caused by increased orbital
tissue (connective, adipose, muscular) expansion and can
be irreversible. The exposed cornea is at risk for dryness, injury, and
infection.
Nursing care for a client with exophthalmos includes:
• Maintaining the head of the bed in a raised position to facilitate
fluid drainage from the periorbital area
• Using artificial tears or other similar products to moisten the eyes
to prevent corneal drying (causes abrasions/ulcers)
• Taping the client’s eyelids shut during sleep if they do not close on
their own
• Teaching the client the following: