Help
Options
Question
1. A young woman makes an appointment to see a physician at the clinic. She complains of tiredness, weight gain, muscle aches and pains, and constipation. The physician will likely order:
click to flip
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't know
Question
2. An older woman comes to the office with vague complaints of fatigue, lethargy being forgetful, lacking energy, and always being cold. She apologizes for takin up the clinic's time, because her problems don't seem too severe. Th best response would be:
Remaining cards (26)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Chapter 45 MSIII
Chapter 45 Stem Questions
| Question | Answer |
|---|---|
| 1. A young woman makes an appointment to see a physician at the clinic. She complains of tiredness, weight gain, muscle aches and pains, and constipation. The physician will likely order: | T3, T4, TSH, TRH (tests for hypothyroidism). pg 981 |
| 2. An older woman comes to the office with vague complaints of fatigue, lethargy being forgetful, lacking energy, and always being cold. She apologizes for takin up the clinic's time, because her problems don't seem too severe. Th best response would be: | Something therapeutic: signs and symptoms may be subtle in the elderly or attributed to aging process. May escape detection until severe because the symptoms are vague. pg 979 |
| 3. The hyperthyroid patient complains of fatigue, but still cannot get to sleep. The nurse suggests: | Bedtime rituals, avoid caffeine, have a restful environment, maybe sedatives. pg 985 |
| 4. A thyroid scan (123I) has been ordered for the patient. The nurse explains it as: | An isotope is given in liquid form, and patient will return to radiology 3-6 hours later. 1 week prior they will avoid iodine, birth control, weight control drugs, multivitamins, thyroid drugs and seafood. pg 981 |
| 5. The patient asks about his lab test, which showed a HIGH level of TSH and a low level of T4. You explain: | This indicates hypothryoidism. The T4 indicates that the thyroid is underactive, and the TSH level indicates that the thyroid stimulating hormone is working over time to compensate. pg 981 |
| 6. The nurse instructs the patient is scheduled to have a radioactive iodine uptake test to: | Avoid iodine, thyroid drugs, seafood, BC, weight control drugs, multivitamins, pregnancy, pregnant women and wash gloves and hands after urinating. pg 981 |
| 7. The patient with Grave's disease asks the nurse for additional information regarding the disease. The nurse responds: | It means they have an overactive thyroid, may experience goiter. Grave's is the most common type of hyperthyroidism, may experience periods of remission and exacerbation and exophthalmus. pg 982 |
| 8. The nurse assessing a 1 day post-op subtotal thyroidectomy patient notes that the color is poor, the pulse and respirations are rapid, and the patient feels warm to touch. The patient says that she is frightened.The nurse's initial implementations are: | These are signs of thyroid crisis/storm. Monitor carefully. Notify physician/charge nurse. pg 988 |
| 9. The patient has been given an antithyroid drug called propylthiouracil. Appropriate nursing implentations include: | Monitor for bleeding, signs of liver toxicity, agranulocytosis, hypothyroidism. Drowsiness precautions. Adhere to meds. pg 984 |
| 10. The patient has been diagnosed with hyperthyroidism. The nursing diagnosis that best applies is: | Decreased cardiac output, disturbed sleep pattern, hyperthemia, imbalanced nutrition <body requirements, risk for injury, disturbed sensory perception, diarrhea. pg 985-986 |
| 11. The patient, newly diagnosed with hypothyroidism, seems very anxious to begin her drug regimen. The nurse's instructions include: | Usually med therapy is life-long, levels should be monitored periodically. Notify physician if chest pain. Avoid opioids, sedatives, tranquilizers- may cause fatal myxedema coma. pg 989 |
| 12. The nurse will include in the pre-surgical teaching of a patient scheduled for a subtotal thyroidectomy that the patient will have to: | Include decreasing anxiety, expect a dressing on front of th eneck, size will depend on approach, avoid straining and support the head. Have patient repeat teaching/demonstrate. pg 986 |
| 13. On returning from surgery after undergoing a thyroidectomy, the patient is alarmed about the large tracheostomy tray on the bedside table. When she asks why it is there, the nurse replies: | In case the patient has trouble breathing, ineffective airway clearance. Respiratory distress/emergency can result from compression of the trachea or larynx spasm due to nerve damage or hypocalcemia. pg 987 |
| 14. The nurse's technique is assessing for bleeding in a patient who has had a thyroidectomy for bleeding, would be to: | Check the back of the neck and the upperback. pg 987-988 |
| 15. The patient, seeking additional information about her diagnosis of hypothyroidism, asks if this condition has been present since infacy. The nurse responds: | Hypothyroidism can start in infancy, but usually causes retardation. pg 988 |
| 16. An older patient wondered why the doctor has decreased her daily dose of thyroid hormone. The nurse's best response would be that the decreased dose is because: | She could have signs of toxicty (pulse/bp decreased, chest pain complaint) or have reached a therapeutic blood level. |
| 17. Your neighbor complains of being cold all the time. In addition, she looks depressed and very weary. You suspect that she may have a thyroid deficiency. All the following are nursing diagnoses for hypothyroidism: | Activity intolerance, imbalanced nutrition >body requirements, hypothermia, constipation, risk for impaired skin integrity, decreased cardiac output, disturbed thought process, disturbed body image, self care deficit pg 989 |
| 18. To address the nursing diagnosis risk for impaired skin integrity related to dry skin, in the patient with hypothyroidism, the nurse would: | Liberally apply lotions and creams. Reduce frequency of bathing. pg 991 |
| 19. In order to check for Chvostek's sign, the nurse will: | Look for twitching around the mouth and eyes, ask about tingling, tap the facial nerve. pg 987 and 994 |
| 20. The nurse would anticipate that the patient with hyperparathyroidism would exhibit: | Poor muscle tone, bone pain, fractures, mood swings, polyuria, HTN, decreased reflexes, weakness, lethargy, depression, anorexia,constipation, mental and personality changes, cardiac dysrhythmias, weight loss, urinary calculi, confusion, coma, n&v. pg 995 |
| 21. Your patient who is being treated for hyperparathyroidism is receiving calcitonin. The action of this hormone is to: | Lower level of calcium level in the blood by inhibiting release of calcium from bones. pg 996 and ppt. |
| 22. An appropriate nursing diagnosis for a patient with hyperparathyroidism would be: | Activity intolerance, risk for injury r/t weakness/fatigue. Impaired urinary elimination r/t calculi. Constipation. Disturbed thought process. Imbalanced nutrition <body. |
| 23. The nurse recommends the use of salt that is iodized because iodized salt: | Is the best way to obtain an adequate amount of iodine in the diet, and lack of iodine increases hyperthyroidism and goiter. pg 985 and 993 |
| 24. The patient who has hypothyroidism can live a full and normal life if he is: | Compliant with lifelong hormone replacement therapy. Teach signs/symptoms of hyperthyroidism that may occur. pg 992-993 |
| 25. The nurse explains to the patient tat the presurgical protcol of antithyroid drugs is given to (select all that apply): | Temporarily lowers levels of serum hormones, reduces risk of bleeding, lowers danger of releasing large amounts of thyroid hormones into the bloodstream during surgery. pg 983 |
| 26. The nurse caring for a hyperthyroid patient would include in the nursing care plan implementations for (select all that apply): | Monitoring pulse/bp, signs of heart failure. Alow for rest, bac rub, sedatives. Emotional rest- avoid stress. Light clothing- adjust emp. High calories, vitamins/minerals. Eye moisteners. Elevate head of bed. Perineal cleansing. Snacks. pg 985 |
| 27. The nurse makes a list of symptoms that the patient who is on methimazole (Tapazole), a thionamide drug, should report, which list includes (select all that apply): | Bleeding, jaundice, abdominal pain, feve, sore throat, malaise, weight gain, fatigue. pg 984 |
Created by:
christiealde