Nokea
The nurse is interviewing a patient who has a possible thyroid disorder. Which of the following questions will provide the most useful information?
- A. What methods do you use to help cope with stress?
- B. Have you experienced any blurring or double vision?
- C. Do you have to get up at night to empty your bladder?
- D. Have you had any recent unplanned weight gain or loss?
Correct Answer: D
Rationale: Because thyroid function affects metabolic rate, changes in weight may indicate hyper- or hypofunction of the thyroid gland. Nocturia, visual difficulty, and changes in stress level are associated with other endocrine disorders.
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The student nurse is caring for a patient with goitre and possible hyperthyroidism. Which of the following actions by the student nurse should cause the nursing instructor to intervene?
- A. Palpates the neck to check thyroid size.
- B. Checks the blood pressure on both arms.
- C. Administers nonmedicated eye drops to the patient's eyes.
- D. Lowers the thermostat to decrease the temperature in the room.
Correct Answer: A
Rationale: Palpation can cause the release of thyroid hormones in a patient with an enlarged thyroid and should be avoided. The other actions by the student nurse are appropriate when caring for a patient with an enlarged thyroid.
The nurse is caring for a patient who is preparing for a growth hormone stimulation test. Which of the following adverse effects should the nurse monitor for during the test?
- A. Bradycardia
- B. Hypotension
- C. Hyperglycemia
- D. Tachypnea
Correct Answer: B
Rationale: During a growth hormone stimulation test, the nurse should continually assess for hypoglycemia and hypotension. There is no indication to monitor for bradycardia or tachypnea.
The nurse is caring for a patient who is undergoing a water deprivation test. Which of the following findings is most important for the nurse to communicate to the health care provider?
- A. Intense thirst
- B. 2.3 kg weight loss
- C. Orthostatic hypotension
- D. No change in urine osmolality
Correct Answer: B
Rationale: A drop in the weight of more than 2 kg indicates severe dehydration, and the test should be discontinued. The other assessment data are not unusual with this test.
The nurse is caring for a patient who was admitted with tetany. Which of the following laboratory values should the nurse monitor?
- A. Total protein
- B. Blood glucose
- C. Ionized calcium
- D. Serum phosphate
Correct Answer: C
Rationale: Tetany is associated with hypocalcemia. The other values would not be useful for this patient in relation to tetany.
During a physical examination, the nurse finds that a patient's thyroid gland cannot be palpated. Which of the following is the best action for the nurse to take?
- A. Palpate the patient's neck more deeply.
- B. Document that the thyroid was nonpalpable.
- C. Notify the health care provider immediately.
- D. Teach the patient about thyroid hormone testing.
Correct Answer: B
Rationale: The thyroid is frequently nonpalpable. The nurse should simply document the finding. There is no need to notify the health care provider immediately about a normal finding. There is no indication for TSH testing unless there is evidence of thyroid dysfunction. Deep palpation of the neck is not appropriate.