Chapter 45 Assessment and Management of Patients With
Endocrine Disorders
1. The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimoto's
thyroiditis. When assessing this patient, what sign or symptom would the nurse expect?
A) Fatigue
B) Bulging eyes C) Palpitations D) Flushed skin Ans: A
Feedback:
Symptoms of hypothyroidism include extreme fatigue, hair loss, brittle nails, dry skin,
voice huskiness or hoarseness, menstrual disturbance, and numbness and tingling of the
fingers. Bulging eyes, palpitations, and flushed skin would be signs and symptoms of
hyperthyroidism.
2. A patient has been admitted to the post-surgical unit following a thyroidectomy. To promote
comfort and safety, how should the nurse best position the patient?
A) Side-lying (lateral) with one pillow under the head
B) Head of the bed elevated 30 degrees and no pillows placed under the head
C) Semi-Fowler's with the head supported on two pillows
D) Supine, with a small roll supporting the neck
Ans: C
Feedback:
When moving and turning the patient, the nurse carefully supports the patient's head
and avoids tension on the sutures. The most comfortable position is the semi-Fowler's
position, with the head elevated and supported by pillows.
3. A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid
tissue has been removed. The nurse caring for the patient should prioritize what question
when addressing potential complications?
A) ìDo you feel any muscle twitches or spasms?î
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,B) ìDo you feel flushed or sweaty?î
C) ìAre you experiencing any dizziness or lightheadedness?î
D) ìAre you having any pain that seems to be radiating from your bones?î
Ans: A
Feedback:
As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of
the hands and feet and muscle twitching. This is characteristic of hypoparathyroidism.
Flushing, diaphoresis, dizziness, and pain are atypical signs of the resulting hypocalcemia.
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, 4. The nurse is caring for a patient with a diagnosis of Addison's disease. What sign or symptom
is most closely associated with this health problem?
A) Truncal obesity
B) Hypertension
C) Muscle weakness
D) Moon face
Ans: C
Feedback:
Patients with Addison's disease demonstrate muscular weakness, anorexia, gastrointestinal
symptoms, fatigue, emaciation, dark pigmentation of the skin, and hypotension. Patients with
Cushing syndrome demonstrate truncal obesity, ìmoonî face, acne, abdominal striae, and
hypertension.
5. The nurse is caring for a patient with Addison's disease who is scheduled for discharge.
When teaching the patient about hormone replacement therapy, the nurse should
address what topic?
A) The possibility of precipitous weight gain
B) The need for lifelong steroid replacement
C) The need to match the daily steroid dose to immediate symptoms
D) The importance of monitoring liver function
Ans: B
Feedback:
Because of the need for lifelong replacement of adrenal cortex hormones to prevent
addisonian crises, the patient and family members receive explicit education about the
rationale for replacement therapy and proper dosage. Doses are not adjusted on a short- term
basis. Weight gain and hepatotoxicity are not common adverse effects.
6. The nurse is teaching a patient that the body needs iodine for the thyroid to function.
What food would be the best source of iodine for the body? A) Eggs
B) Shellfish
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Endocrine Disorders
1. The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimoto's
thyroiditis. When assessing this patient, what sign or symptom would the nurse expect?
A) Fatigue
B) Bulging eyes C) Palpitations D) Flushed skin Ans: A
Feedback:
Symptoms of hypothyroidism include extreme fatigue, hair loss, brittle nails, dry skin,
voice huskiness or hoarseness, menstrual disturbance, and numbness and tingling of the
fingers. Bulging eyes, palpitations, and flushed skin would be signs and symptoms of
hyperthyroidism.
2. A patient has been admitted to the post-surgical unit following a thyroidectomy. To promote
comfort and safety, how should the nurse best position the patient?
A) Side-lying (lateral) with one pillow under the head
B) Head of the bed elevated 30 degrees and no pillows placed under the head
C) Semi-Fowler's with the head supported on two pillows
D) Supine, with a small roll supporting the neck
Ans: C
Feedback:
When moving and turning the patient, the nurse carefully supports the patient's head
and avoids tension on the sutures. The most comfortable position is the semi-Fowler's
position, with the head elevated and supported by pillows.
3. A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid
tissue has been removed. The nurse caring for the patient should prioritize what question
when addressing potential complications?
A) ìDo you feel any muscle twitches or spasms?î
Page 1
,B) ìDo you feel flushed or sweaty?î
C) ìAre you experiencing any dizziness or lightheadedness?î
D) ìAre you having any pain that seems to be radiating from your bones?î
Ans: A
Feedback:
As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of
the hands and feet and muscle twitching. This is characteristic of hypoparathyroidism.
Flushing, diaphoresis, dizziness, and pain are atypical signs of the resulting hypocalcemia.
Page 2
, 4. The nurse is caring for a patient with a diagnosis of Addison's disease. What sign or symptom
is most closely associated with this health problem?
A) Truncal obesity
B) Hypertension
C) Muscle weakness
D) Moon face
Ans: C
Feedback:
Patients with Addison's disease demonstrate muscular weakness, anorexia, gastrointestinal
symptoms, fatigue, emaciation, dark pigmentation of the skin, and hypotension. Patients with
Cushing syndrome demonstrate truncal obesity, ìmoonî face, acne, abdominal striae, and
hypertension.
5. The nurse is caring for a patient with Addison's disease who is scheduled for discharge.
When teaching the patient about hormone replacement therapy, the nurse should
address what topic?
A) The possibility of precipitous weight gain
B) The need for lifelong steroid replacement
C) The need to match the daily steroid dose to immediate symptoms
D) The importance of monitoring liver function
Ans: B
Feedback:
Because of the need for lifelong replacement of adrenal cortex hormones to prevent
addisonian crises, the patient and family members receive explicit education about the
rationale for replacement therapy and proper dosage. Doses are not adjusted on a short- term
basis. Weight gain and hepatotoxicity are not common adverse effects.
6. The nurse is teaching a patient that the body needs iodine for the thyroid to function.
What food would be the best source of iodine for the body? A) Eggs
B) Shellfish
Page 3
