ATI CARE OF PATIENTS WITH PROBLEMS OF THE THYROID AND
PARATHYROID GLANDS EXAM WITH QUESTIONS AND ANSWERS
(VERIFIED ANSWERS)
1. A nurse assesses a client with hyperthyroidism who is prescribed lithium
carbonate. Which assessment
finding should alert the nurse to a side effect of this therapy?
a. Blurred and double vision
b. Increased thirst and urination
c. Profuse nausea and diarrhea
d. Decreased attention and insomnia - CORRECT ANSWER ANS: B
Lithium antagonizes antidiuretic hormone and can cause symptoms of diabetes
insipidus. This manifests with
increased thirst and urination. Lithium has no effect on vision, gastric upset, or
level of consciousness.
2. A nurse assesses a client who is recovering from a total thyroidectomy and notes
the development of stridor.
Which action should the nurse take first?
a. Reassure the client that the voice change is temporary.
b. Document the finding and assess the client hourly.
c. Place the client in high-Fowlers position and apply oxygen.
d. Contact the provider and prepare for intubation. - CORRECT ANSWER ANS:
D
Stridor on exhalation is a hallmark of respiratory distress, usually caused by
obstruction resulting from edema.
,One emergency measure is to remove the surgical clips to relieve the pressure. This
might be a physician
function. The nurse should prepare to assist with emergency intubation or
tracheostomy while notifying the
provider or the Rapid Response Team. Stridor is an emergency situation; therefore,
reassuring the client,
documenting, and reassessing in an hour do not address the urgency of the
situation. Oxygen should be
applied, but this action will not keep the airway open.
3. A nurse assesses a client who is recovering from a subtotal thyroidectomy. On
the second postoperative day
the client states, I feel numbness and tingling around my mouth. What action
should the nurse take?
a. Offer mouth care.
b. Loosen the dressing.
c. Assess for Chvosteks sign.
d. Ask the client orientation questions. - CORRECT ANSWER ANS: C
Numbness and tingling around the mouth or in the fingers and toes are
manifestations of hypocalcemia, which
could progress to cause tetany and seizure activity. The nurse should assess the
client further by testing for
Chvosteks sign and Trousseaus sign. Then the nurse should notify the provider.
Mouth care, loosening the
dressing, and orientation questions do not provide important information to prevent
complications of low
calcium levels.
,4. A nurse assesses a client on the medical-surgical unit. Which statement made by
the client should alert the
nurse to the possibility of hypothyroidism?
a. My sister has thyroid problems.
b. I seem to feel the heat more than other people.
c. Food just doesnt taste good without a lot of salt.
d. I am always tired, even with 12 hours of sleep. - CORRECT ANSWER ANS:
D
Clients with hypothyroidism usually feel tired or weak despite getting many hours
of sleep. Thyroid problems
are not inherited. Heat intolerance is indicative of hyperthyroidism. Loss of taste is
not a manifestation of
hypothyroidism.
5. A nurse cares for a client who presents with bradycardia secondary to
hypothyroidism. Which medication
should the nurse anticipate being prescribed to the client?
a. Atropine sulfate
b. Levothyroxine sodium (Synthroid)
c. Propranolol (Inderal)
d. Epinephrine (Adrenalin) - CORRECT ANSWER ANS: B
The treatment for bradycardia from hypothyroidism is to treat the hypothyroidism
using levothyroxine sodium.
If the heart rate were so slow that it became an emergency, then atropine or
epinephrine might be an option for
short-term management. Propranolol is a beta blocker and would be
contraindicated for a client with
bradycardia.
, 6. A nurse plans care for a client with hypothyroidism. Which priority problem
should the nurse plan to
address first for this client?
a. Heat intolerance
b. Body image problems
c. Depression and withdrawal
d. Obesity and water retention - CORRECT ANSWER 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
clients 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 clients
environment is safe. Heat
intolerance is seen in hyperthyroidism. Body image problems and weight issues do
not take priority over
mental status and safety.
7. A nurse assesses a client who is prescribed levothyroxine (Synthroid) for
hypothyroidism. Which
assessment finding should alert the nurse that the medication 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.
d. Heart rate is 70 beats/min and regular. - CORRECT ANSWER ANS: D
PARATHYROID GLANDS EXAM WITH QUESTIONS AND ANSWERS
(VERIFIED ANSWERS)
1. A nurse assesses a client with hyperthyroidism who is prescribed lithium
carbonate. Which assessment
finding should alert the nurse to a side effect of this therapy?
a. Blurred and double vision
b. Increased thirst and urination
c. Profuse nausea and diarrhea
d. Decreased attention and insomnia - CORRECT ANSWER ANS: B
Lithium antagonizes antidiuretic hormone and can cause symptoms of diabetes
insipidus. This manifests with
increased thirst and urination. Lithium has no effect on vision, gastric upset, or
level of consciousness.
2. A nurse assesses a client who is recovering from a total thyroidectomy and notes
the development of stridor.
Which action should the nurse take first?
a. Reassure the client that the voice change is temporary.
b. Document the finding and assess the client hourly.
c. Place the client in high-Fowlers position and apply oxygen.
d. Contact the provider and prepare for intubation. - CORRECT ANSWER ANS:
D
Stridor on exhalation is a hallmark of respiratory distress, usually caused by
obstruction resulting from edema.
,One emergency measure is to remove the surgical clips to relieve the pressure. This
might be a physician
function. The nurse should prepare to assist with emergency intubation or
tracheostomy while notifying the
provider or the Rapid Response Team. Stridor is an emergency situation; therefore,
reassuring the client,
documenting, and reassessing in an hour do not address the urgency of the
situation. Oxygen should be
applied, but this action will not keep the airway open.
3. A nurse assesses a client who is recovering from a subtotal thyroidectomy. On
the second postoperative day
the client states, I feel numbness and tingling around my mouth. What action
should the nurse take?
a. Offer mouth care.
b. Loosen the dressing.
c. Assess for Chvosteks sign.
d. Ask the client orientation questions. - CORRECT ANSWER ANS: C
Numbness and tingling around the mouth or in the fingers and toes are
manifestations of hypocalcemia, which
could progress to cause tetany and seizure activity. The nurse should assess the
client further by testing for
Chvosteks sign and Trousseaus sign. Then the nurse should notify the provider.
Mouth care, loosening the
dressing, and orientation questions do not provide important information to prevent
complications of low
calcium levels.
,4. A nurse assesses a client on the medical-surgical unit. Which statement made by
the client should alert the
nurse to the possibility of hypothyroidism?
a. My sister has thyroid problems.
b. I seem to feel the heat more than other people.
c. Food just doesnt taste good without a lot of salt.
d. I am always tired, even with 12 hours of sleep. - CORRECT ANSWER ANS:
D
Clients with hypothyroidism usually feel tired or weak despite getting many hours
of sleep. Thyroid problems
are not inherited. Heat intolerance is indicative of hyperthyroidism. Loss of taste is
not a manifestation of
hypothyroidism.
5. A nurse cares for a client who presents with bradycardia secondary to
hypothyroidism. Which medication
should the nurse anticipate being prescribed to the client?
a. Atropine sulfate
b. Levothyroxine sodium (Synthroid)
c. Propranolol (Inderal)
d. Epinephrine (Adrenalin) - CORRECT ANSWER ANS: B
The treatment for bradycardia from hypothyroidism is to treat the hypothyroidism
using levothyroxine sodium.
If the heart rate were so slow that it became an emergency, then atropine or
epinephrine might be an option for
short-term management. Propranolol is a beta blocker and would be
contraindicated for a client with
bradycardia.
, 6. A nurse plans care for a client with hypothyroidism. Which priority problem
should the nurse plan to
address first for this client?
a. Heat intolerance
b. Body image problems
c. Depression and withdrawal
d. Obesity and water retention - CORRECT ANSWER 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
clients 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 clients
environment is safe. Heat
intolerance is seen in hyperthyroidism. Body image problems and weight issues do
not take priority over
mental status and safety.
7. A nurse assesses a client who is prescribed levothyroxine (Synthroid) for
hypothyroidism. Which
assessment finding should alert the nurse that the medication 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.
d. Heart rate is 70 beats/min and regular. - CORRECT ANSWER ANS: D
