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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 doesn't taste good without a lot of salt
- D. I am always tired, even with 12 hours of sleep
Correct Answer: D
Rationale: Clients with hypothyroidism often feel tired or weak despite adequate sleep. Thyroid problems are not necessarily inherited, heat intolerance suggests hyperthyroidism, and loss of taste is not a typical manifestation of hypothyroidism.
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A nurse cares for a client who has hypothyroidism as a result of Hashimoto's thyroiditis. The client asks, 'How long will I need to take this thyroid medication?' How should the nurse respond?
- A. You will need to take this thyroid medication until the goiter is completely gone
- B. Thyroiditis is cured with antibodies. Then you won't need thyroid medication
- C. You'll need thyroid pills for life because your thyroid won't start working again
- D. When blood cell count is 6000 cells/mm³, you can stop the medication
Correct Answer: C
Rationale: Hashimoto's thyroiditis causes permanent thyroid damage, requiring lifelong thyroid hormone replacement. The goiter may not resolve completely, antibodies do not cure thyroiditis, and blood cell count is unrelated to thyroid medication needs.
A nurse assesses clients for potential endocrine disorders. Which client is at greatest risk for hyperparathyroidism?
- A. A 20-year-old female with pregnancy-induced hypertension
- B. A 41-year-old male receiving dialysis for end-stage kidney disease
- C. A 41-year-old male receiving dialysis for end-stage kidney disease
- D. A 27-year-old male who is prescribed home oxygen therapy
Correct Answer: B
Rationale: Clients with chronic kidney disease have impaired vitamin D activation and calcium absorption, leading to chronic hypocalcemia, which overstimulates the parathyroid glands, causing hyperparathyroidism. Pregnancy-induced hypertension and oxygen therapy do not increase this risk.
A nurse teaches a client who is prescribed an unsealed radioactive isotope. Which statements should the nurse include in this client's education?
- A. Do not share utensils, plates, or cups with anyone
- B. You can play with your grandchildren for 1 hour each day
- C. Eat foods high in vitamins such as apples, pears, and oranges
- D. Avoid contact with pregnant women and children
- E. Take a laxative 2 days after therapy to excrete the radiation
Correct Answer: A,D,E
Rationale: Clients receiving unsealed radioactive isotopes must avoid sharing utensils, contact with pregnant women and children, and take laxatives on days 2 and 3 to excrete radiation. Playing with grandchildren and eating specific fruits are not recommended due to radiation safety concerns.
A nurse plans care for a client with hyperparathyroidism. Which intervention should the nurse include in this client's plan of care?
- A. Ask the client to ambulate in the hallway twice a day
- B. Use a lift sheet to assist the client with position changes
- C. Provide the client with a soft-bristled toothbrush for oral care
- D. Instruct the unlicensed assistive personnel to strain the client's urine for stones
Correct Answer: B
Rationale: Hyperparathyroidism increases calcium resorption from bones, raising the risk of pathologic fractures. Using a lift sheet reduces the risk of bone injury during movement. Ambulation and oral care are not specific to this condition, and not all clients require urine straining.
A nurse assesses a client who is prescribed thyroid hormone replacement. Which finding indicates a therapeutic response to the medication?
- 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: D
Rationale: Hypothyroidism decreases body functioning, leading to effects like bradycardia. A heart rate of 70 beats/min and regular while on thyroid hormone replacement indicates adequate dosing. Thirst, fluid intake, weight stability, and white blood cell count are not direct indicators of therapeutic response.