Chapter 58: Drugs for Thyroid Disorders

Chapter 58: Drugs for Thyroid Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient has a free T₄ level of 0.6 ng/dL and a free T₃ of 220 pg/dL. The patient asks the nurse what these laboratory values mean. How will the nurse respond?

a.	“These laboratory values indicate that you may have Graves’ disease.”
b.	“These results suggest you may have hyperthyroidism.”
c.	“We will need to obtain a total T4 and a total T3 to tell for sure.”
d.	“We will need to obtain a TSH level to better evaluate your diagnosis.”

 

 

ANS:  D

A free T₄ level of less than 0.9 ng/dL and a free T₃ of less than 230 pg/dL are consistent with hypothyroidism, but measurement of the thyroid-stimulating hormone (TSH) level is necessary to distinguish primary hypothyroidism from secondary hypothyroidism. Total T₃ and T₄ levels are not as helpful as free T₃ and T₄ levels. These laboratory values indicate hypothyroidism, not hyperthyroid conditions such as Graves’ disease.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 704-705

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation

 

2. A nurse obtaining an admission history on an adult patient notes that the patient has a heart rate of 62 beats per minute, a blood pressure of 105/62 mm Hg, and a temperature of 96.2°F. The patient appears pale and complains of always feeling cold and tired. The nurse will contact the provider to discuss tests for which condition?

a.	Cretinism
b.	Graves’ disease
c.	Hypothyroidism
d.	Plummer’s disease

 

 

ANS:  C

This patient is showing signs of hypothyroidism: a low heart rate, low temperature, pale skin, and feeling cold and tired. In adults, thyroid deficiency is called hypothyroidism. In children, thyroid deficiency is called cretinism. Graves’ disease and Plummer’s disease are conditions caused by thyroid excess.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 705

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation

 

3. The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient?

a.	Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.
b.	Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c.	No danger to the fetus exists until the third trimester.
d.	Treatment is required only if the patient is experiencing symptoms.

 

 

ANS:  B

Maternal hypothyroidism can result in permanent neuropsychologic deficits in the child. Hypothyroidism is not a normal effect of pregnancy and is a serious condition that can affect both mother and fetus. The greatest danger to the fetus occurs in the first trimester, because the thyroid does not fully develop until the second trimester. Early identification is essential. Symptoms often are vague. Treatment should begin as soon as possible, or mental retardation and other developmental problems may occur.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 706

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

4. A nurse caring for a patient notes that the patient has a temperature of 104°F and a heart rate of 110 beats per minute. The patient’s skin is warm and moist, and the patient complains that the room is too warm. The patient appears nervous and has protuberant eyes. The nurse will contact the provider to discuss:

a.	cretinism.
b.	Graves’ disease.
c.	myxedema.
d.	Plummer’s disease.

 

 

ANS:  B

The signs and symptoms in this patient are consistent with hyperthyroidism, and because the patient’s eyes are protuberant, they also are consistent with Graves’ disease. Cretinism is hypothyroidism in children. Myxedema is severe hypothyroidism. Plummer’s disease is a hyperthyroidism condition without exophthalmos.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 706

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation