PATHO FINAL 2026: Endocrine Module (Part 2) UPDATED
ACTUAL Questions and CORRECT Answers
Hyperthyroidism: Pathophysiology Review Excessive thyroid hormone secretion from thyroid gland
Causes hypermetabolism and increased sympathetic nervous system activity
Affects protein, fat, glucose metabolism
Hyperthyroidism: Etiology and Genetic Risk #1 Graves' disease autoimmune
Toxic multinodular goiter (TMNG)
Related to multiple nodules or benign tumors
Excessive thyroid replacement hormones
Grave's Disease Autoimmune disorder in which the production of autoantibodies (thyroid-stimulating
immunoglobulins [TSIs]) that attach to the thyrotropin (TRAb) receptor on the
thyroid gland greatly increases thyroid hormone production
,Hyperthyroidism: Incidence and Prevalence Common disorder
Women 30-50 years old
Toxic multinodular goiter
Large Goiters:
- Do Not palpate
- May have bruit w auscultation
- Can obstruct vascular/airway
- Observe for size/symmetry
Hyperthyroidism: Recognize Cues: Assessment History:
- Weight loss, increased appetite
- Heat intolerance
- Vision changes
Physical Assessment/Signs and Symptoms:
- Exophthalmos, eyelid retraction
- Goiter
- Pretibial myxedema coating to lower legs
Psychosocial Assessment
Laboratory assessment:
- T3, T4, TSH, TRAbs (antibodies to TSH receptor)
Other diagnostics assessment:
- RAIU-radioactive iodine uptake test
- Ultrasonography
- Electrocardiography (ECG)
Thyroid Storm A rare, life-threatening event that occurs in patients with uncontrolled
hyperthyroidism
It presents with symptoms of hyperthyroidism that are more intense than normal and
is characterized by high fever and tachycardia
Hyperthyroidism: Take Action: Interventions Nonsurgical management:
- Monitoring
- Reducing stimulation
- Promoting comfort
- Drug therapy
- RAI therapy-drug uptake >destroys some
hormone secreting cells
Surgical management:
- Partial or total thyroidectomy
• Monitor postoperatively for hemorrhage, respiratory
distress, hypocalcemia, tetany, laryngeal nerve damage
• Thyroid storm risk
• Overall-maintain euthyroid/normal thyroid
Hyperthyroidism: Definition Oversecretion of thyroid hormone
, Hyperthyroidism: Assessment 1. Increased physical activity
2. Tachycardia
3. Increased sensitivity to heat
4. Fine, soft hair
5. Enlarged thyroid
6. Nervous, jittery, irritable, talkative
7. Exophthalmos 8. Weight loss
Hyperthyroidism: Treatment 1. Antithyroid medications (e.g., propylthiouracil, methimazole)
2. Irradiation (131I PO)—short-term
3. Thyroidectomy—usually subtotal resection
Hyperthyroidism: Nursing Management 1. Promote comfort, rest, and sleep:
a. Limit activities to quiet ones (e.g., reading, knitting)
b. Provide for frequent rest
c. Restrict visitors and control choice of roommates
d. Keep room cool; advise light, cool clothing
e. Avoid stimulants (e.g., coffee)
2. Provide emotional support
a. Accept behavior
b. Use calm, unhurried manner when caring for client
c. Interpret behavior to family
3. Administer antithyroid medication (see Table 8-13)
4. Provide postthyroidectomy care:
a. Prevent strain on suture line
1) Low or semi-Fowler position
2) Support head, neck, and shoulders to prevent flexion or hyperextension; elevate
head of bed 30°
3) Tracheostomy set and suction supplies at bedside
b. Give fluids as tolerated
c. Check Chvostek and Trousseau signs
d. Offer throat lozenges, analgesics, cold steam inhalations for sore throat
e. Adjust diet to new metabolic needs
Hyperthyroidism: Chvostek Sign a) An abnormal spasm of the facial muscles elicited by light tapping on the cheek of
a client with hypocalcemia
b) Surgical removal of the thyroid gland can damage or remove the parathyroid
glands (because they are embedded in the posterior thyroid gland)
c) Parathyroidectomy causes hypocalcemia and produces symptoms of tetany,
including the Chvostek sign
ACTUAL Questions and CORRECT Answers
Hyperthyroidism: Pathophysiology Review Excessive thyroid hormone secretion from thyroid gland
Causes hypermetabolism and increased sympathetic nervous system activity
Affects protein, fat, glucose metabolism
Hyperthyroidism: Etiology and Genetic Risk #1 Graves' disease autoimmune
Toxic multinodular goiter (TMNG)
Related to multiple nodules or benign tumors
Excessive thyroid replacement hormones
Grave's Disease Autoimmune disorder in which the production of autoantibodies (thyroid-stimulating
immunoglobulins [TSIs]) that attach to the thyrotropin (TRAb) receptor on the
thyroid gland greatly increases thyroid hormone production
,Hyperthyroidism: Incidence and Prevalence Common disorder
Women 30-50 years old
Toxic multinodular goiter
Large Goiters:
- Do Not palpate
- May have bruit w auscultation
- Can obstruct vascular/airway
- Observe for size/symmetry
Hyperthyroidism: Recognize Cues: Assessment History:
- Weight loss, increased appetite
- Heat intolerance
- Vision changes
Physical Assessment/Signs and Symptoms:
- Exophthalmos, eyelid retraction
- Goiter
- Pretibial myxedema coating to lower legs
Psychosocial Assessment
Laboratory assessment:
- T3, T4, TSH, TRAbs (antibodies to TSH receptor)
Other diagnostics assessment:
- RAIU-radioactive iodine uptake test
- Ultrasonography
- Electrocardiography (ECG)
Thyroid Storm A rare, life-threatening event that occurs in patients with uncontrolled
hyperthyroidism
It presents with symptoms of hyperthyroidism that are more intense than normal and
is characterized by high fever and tachycardia
Hyperthyroidism: Take Action: Interventions Nonsurgical management:
- Monitoring
- Reducing stimulation
- Promoting comfort
- Drug therapy
- RAI therapy-drug uptake >destroys some
hormone secreting cells
Surgical management:
- Partial or total thyroidectomy
• Monitor postoperatively for hemorrhage, respiratory
distress, hypocalcemia, tetany, laryngeal nerve damage
• Thyroid storm risk
• Overall-maintain euthyroid/normal thyroid
Hyperthyroidism: Definition Oversecretion of thyroid hormone
, Hyperthyroidism: Assessment 1. Increased physical activity
2. Tachycardia
3. Increased sensitivity to heat
4. Fine, soft hair
5. Enlarged thyroid
6. Nervous, jittery, irritable, talkative
7. Exophthalmos 8. Weight loss
Hyperthyroidism: Treatment 1. Antithyroid medications (e.g., propylthiouracil, methimazole)
2. Irradiation (131I PO)—short-term
3. Thyroidectomy—usually subtotal resection
Hyperthyroidism: Nursing Management 1. Promote comfort, rest, and sleep:
a. Limit activities to quiet ones (e.g., reading, knitting)
b. Provide for frequent rest
c. Restrict visitors and control choice of roommates
d. Keep room cool; advise light, cool clothing
e. Avoid stimulants (e.g., coffee)
2. Provide emotional support
a. Accept behavior
b. Use calm, unhurried manner when caring for client
c. Interpret behavior to family
3. Administer antithyroid medication (see Table 8-13)
4. Provide postthyroidectomy care:
a. Prevent strain on suture line
1) Low or semi-Fowler position
2) Support head, neck, and shoulders to prevent flexion or hyperextension; elevate
head of bed 30°
3) Tracheostomy set and suction supplies at bedside
b. Give fluids as tolerated
c. Check Chvostek and Trousseau signs
d. Offer throat lozenges, analgesics, cold steam inhalations for sore throat
e. Adjust diet to new metabolic needs
Hyperthyroidism: Chvostek Sign a) An abnormal spasm of the facial muscles elicited by light tapping on the cheek of
a client with hypocalcemia
b) Surgical removal of the thyroid gland can damage or remove the parathyroid
glands (because they are embedded in the posterior thyroid gland)
c) Parathyroidectomy causes hypocalcemia and produces symptoms of tetany,
including the Chvostek sign
