NURS 317 Final Exam questions and Answers
A patient's laboratory data reveal an elevated thyroxine (T4) level. The nurse would
proceed with an examination of the _____ gland.
A. Thyroid
B. Parotid
C. Adrenal
D. Parathyroid
A. Thyroid
The thyroid gland is a highly vascular endocrine gland that secretes T4 and triiodothyronine
(T3). The other glands do not secrete T4.
A patient says that she has recently noticed a lump in the front of her neck below her
"Adam's apple" that seems to be getting bigger. During the assessment, the finding that
leads the nurse to suspect that this may not be a cancerous thyroid nodule is that the lump
(nodule):
A. Is tender.
B. Is mobile and not hard.
C. Disappears when the patient smiles.
D. Is hard and fixed to the surrounding structures.
B. Is mobile and not hard.
Painless, rapidly growing nodules may be cancerous, especially the appearance of a single
,nodule in a young person. However, cancerous nodules tend to be hard and fixed to surrounding
structures, not mobile.
The nurse suspects that a patient has hyperthyroidism, and the laboratory data indicate
that the patient's T4 and T3 hormone levels are elevated. Which of these findings would the
nurse most likely find on examination?
A. Tachycardia
B. Constipation
C. Rapid dyspnea
D. Atrophied nodular thyroid gland
A. Tachycardia
T4 and T3 are thyroid hormones that stimulate the rate of cellular metabolism, resulting in
tachycardia. With an enlarged thyroid gland as in hyperthyroidism, the nurse might expect to
find diffuse enlargement (goiter) or a nodular lump but not an atrophied gland. Dyspnea and
constipation are not findings associated with hyperthyroidism.
A patient's thyroid gland is enlarged, and the nurse is preparing to auscultate the thyroid
gland for the presence of a bruit. A bruit is a __________ sound that is heard best with the
__________ of the stethoscope.
A. Low gurgling; diaphragm
B. Loud, whooshing, blowing; bell
C. Soft, whooshing, pulsatile; bell
D. High-pitched tinkling; diaphragm
,C. Soft, whooshing, pulsatile; bell
If the thyroid gland is enlarged, then the nurse should auscultate it for the presence of a bruit,
which is a soft, pulsatile, whooshing, blowing sound heard best with the bell of the stethoscope.
A woman comes to the clinic and states, "I've been sick for so long! My eyes have gotten so
puffy, and my eyebrows and hair have become coarse and dry." The nurse will assess for
other signs and symptoms of:
A. Cachexia
B. Parkinson syndrome.
C. Myxedema.
D. Scleroderma.
C. Myxedema
Myxedema (hypothyroidism) is a deficiency of thyroid hormone that, when severe, causes a
nonpitting edema or myxedema. The patient will have a puffy edematous face, especially around
the eyes (periorbital edema); coarse facial features; dry skin; and dry, coarse hair and eyebrows.
A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn
her head. The nurse suspects damage to CN ______ and proceeds with the examination by
_____________.
A. XI; palpating the anterior and posterior triangles
B. XI; asking the patient to shrug her shoulders against resistance
C. XII; percussing the sternomastoid and submandibular neck muscles
D. XII; assessing for a positive Romberg sign
, B. XI; asking the patient to shrug her shoulders against resistance
The major neck muscles are the sternomastoid and the trapezius. They are innervated by CN XI,
the spinal accessory. The innervated muscles assist with head rotation and head flexion,
movement of the shoulders, and extension and turning of the head.
When examining a patient's CN function, the nurse remembers that the muscles in the
neck that are innervated by CN XI are the:
A. Sternomastoid and trapezius.
B. Spinal accessory and omohyoid.
C. Trapezius and sternomandibular.
D. Sternomandibular and spinal accessory.
A. Sternomastoid and trapezius
The major neck muscles are the sternomastoid and the trapezius. They are innervated by CN XI,
the spinal accessory.
The nurse is aware that the four areas in the body where lymph nodes are accessible are
the:
A. Head, breasts, groin, and abdomen.
B. Arms, breasts, inguinal area, and legs.
C. Head and neck, arms, breasts, and axillae.
D. Head and neck, arms, inguinal area, and axillae.
A patient's laboratory data reveal an elevated thyroxine (T4) level. The nurse would
proceed with an examination of the _____ gland.
A. Thyroid
B. Parotid
C. Adrenal
D. Parathyroid
A. Thyroid
The thyroid gland is a highly vascular endocrine gland that secretes T4 and triiodothyronine
(T3). The other glands do not secrete T4.
A patient says that she has recently noticed a lump in the front of her neck below her
"Adam's apple" that seems to be getting bigger. During the assessment, the finding that
leads the nurse to suspect that this may not be a cancerous thyroid nodule is that the lump
(nodule):
A. Is tender.
B. Is mobile and not hard.
C. Disappears when the patient smiles.
D. Is hard and fixed to the surrounding structures.
B. Is mobile and not hard.
Painless, rapidly growing nodules may be cancerous, especially the appearance of a single
,nodule in a young person. However, cancerous nodules tend to be hard and fixed to surrounding
structures, not mobile.
The nurse suspects that a patient has hyperthyroidism, and the laboratory data indicate
that the patient's T4 and T3 hormone levels are elevated. Which of these findings would the
nurse most likely find on examination?
A. Tachycardia
B. Constipation
C. Rapid dyspnea
D. Atrophied nodular thyroid gland
A. Tachycardia
T4 and T3 are thyroid hormones that stimulate the rate of cellular metabolism, resulting in
tachycardia. With an enlarged thyroid gland as in hyperthyroidism, the nurse might expect to
find diffuse enlargement (goiter) or a nodular lump but not an atrophied gland. Dyspnea and
constipation are not findings associated with hyperthyroidism.
A patient's thyroid gland is enlarged, and the nurse is preparing to auscultate the thyroid
gland for the presence of a bruit. A bruit is a __________ sound that is heard best with the
__________ of the stethoscope.
A. Low gurgling; diaphragm
B. Loud, whooshing, blowing; bell
C. Soft, whooshing, pulsatile; bell
D. High-pitched tinkling; diaphragm
,C. Soft, whooshing, pulsatile; bell
If the thyroid gland is enlarged, then the nurse should auscultate it for the presence of a bruit,
which is a soft, pulsatile, whooshing, blowing sound heard best with the bell of the stethoscope.
A woman comes to the clinic and states, "I've been sick for so long! My eyes have gotten so
puffy, and my eyebrows and hair have become coarse and dry." The nurse will assess for
other signs and symptoms of:
A. Cachexia
B. Parkinson syndrome.
C. Myxedema.
D. Scleroderma.
C. Myxedema
Myxedema (hypothyroidism) is a deficiency of thyroid hormone that, when severe, causes a
nonpitting edema or myxedema. The patient will have a puffy edematous face, especially around
the eyes (periorbital edema); coarse facial features; dry skin; and dry, coarse hair and eyebrows.
A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn
her head. The nurse suspects damage to CN ______ and proceeds with the examination by
_____________.
A. XI; palpating the anterior and posterior triangles
B. XI; asking the patient to shrug her shoulders against resistance
C. XII; percussing the sternomastoid and submandibular neck muscles
D. XII; assessing for a positive Romberg sign
, B. XI; asking the patient to shrug her shoulders against resistance
The major neck muscles are the sternomastoid and the trapezius. They are innervated by CN XI,
the spinal accessory. The innervated muscles assist with head rotation and head flexion,
movement of the shoulders, and extension and turning of the head.
When examining a patient's CN function, the nurse remembers that the muscles in the
neck that are innervated by CN XI are the:
A. Sternomastoid and trapezius.
B. Spinal accessory and omohyoid.
C. Trapezius and sternomandibular.
D. Sternomandibular and spinal accessory.
A. Sternomastoid and trapezius
The major neck muscles are the sternomastoid and the trapezius. They are innervated by CN XI,
the spinal accessory.
The nurse is aware that the four areas in the body where lymph nodes are accessible are
the:
A. Head, breasts, groin, and abdomen.
B. Arms, breasts, inguinal area, and legs.
C. Head and neck, arms, breasts, and axillae.
D. Head and neck, arms, inguinal area, and axillae.
