Nokea
The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as resulting in which condition?
- A. Gigantism
- B. Dwarfism
- C. Acromegaly
- D. Simmonds disease
Correct Answer: A
Rationale: When oversecretion of GH occurs before puberty, gigantism results. Dwarfism occurs when secretion of GH is insufficient during childhood. Oversecretion of GH during adulthood results in acromegaly. An absence of pituitary hormonal activity causes Simmonds disease.
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A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestation(s) of this disorder does the nurse recognize is progressing to myxedema coma? Select all that apply.
- A. Hypothermia
- B. Hypertension
- C. Hypotension
- D. Hypoventilation
- E. Hyperventilation
Correct Answer: A,C,D
Rationale: Severe hypothyroidism is called myxedema. Advanced, untreated myxedema can progress to myxedema coma. Signs of this life-threatening event are hypothermia, hypotension, and hypoventilation. Hypertension and hyperventilation indicate increased metabolic responses, which are the opposite of what the client would be experiencing.
Which of the following precautions would be most appropriate when caring for a client being treated with radioactive iodine (RAI) for a thyroid tumor?
- A. Administer prescribed corticosteroids carefully.
- B. Handle body fluids carefully.
- C. Monitor the respiratory status.
- D. Administer the prescribed medications at the same time each day.
Correct Answer: B
Rationale: The nurse handles body fluids carefully to prevent spread of contamination. Corticosteroids are not prescribed for thyroid tumor. Monitoring the respiratory status and administering prescribed medicines at the same time each day are unrelated to the care of a client receiving RAI.
What would the nurse expect the health care provider to order for a client with hypothyroidism?
- A. Levothyroxine sodium
- B. Methimazole
- C. Propranolol
- D. Propylthiouracil
Correct Answer: A
Rationale: Hypothyroidism is treated with thyroid replacement therapy, in the form of desiccated thyroid extract or a synthetic product, such as levothyroxine sodium (Synthroid) or liothyronine sodium (Cytomel). Methimazole and propylthiouracil are antithyroid agents used to treat hyperthyroidism. Propranolol is a beta blocker that can be used to treat hyperthyroidism.
Which group of clients should not receive potassium iodide?
- A. Those who are allergic to corticosteroids
- B. Those who are pregnant
- C. Those taking medications such as cough medicines
- D. Those who are allergic to seafood
Correct Answer: D
Rationale: Potassium iodide should not be administered to anyone who is allergic to seafood, which is also high in iodine. Clients who take corticosteroids or cough medicines and those who are pregnant would be appropriate candidates for potassium iodide therapy.
A client sustained a head injury when falling from a ladder. While in the hospital, the client begins voiding large amounts of clear urine and reports being very thirsty. The client states feeling weak and having experienced an 8 pound weight loss since admission. What condition does the nurse expect the client to be tested for?
- A. Diabetes insipidus (DI)
- B. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- C. Pituitary tumor
- D. Hypothyroidism
Correct Answer: A
Rationale: With diabetes insipidus, urine output may be as high as 20 L/24 hours. Urine is dilute, with a specific gravity of 1.002 or less. Limiting fluid intake does not control urine excretion. Thirst is excessive and constant. Activities are limited by the frequent need to drink and void. Weakness, dehydration, and weight loss develop. SIADH will have the opposite clinical manifestations. The client's symptoms are related to the trauma and not to a pituitary tumor. The thyroid gland does not cause these symptoms.