Chapter 47: Thyroid and Parathyroid Disorders

Chapter 47: Thyroid and Parathyroid Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A physician ordered T₃ and T₄ tests for a young woman complaining of fatigue, weight gain, muscle aches and pains, and constipation. Which laboratory test results will help confirm the diagnosis of hypothyroidism?

a.	Both tests show decreases.
b.	Both tests show increases.
c.	The T3 test elevates, and the T4 test decreases.
d.	The level of thyroxin rises and then falls back to subnormal levels.

 

 

ANS:  A

These complaints are strongly suggestive of thyroid disorder; T₃ and T₄ laboratory diagnostic tests are the most useful.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 1038 | p. 1047

OBJ:   2                    TOP:   Thyroid Diagnostic Tests

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: Health Promotion and Maintenance

 

2. Which instruction should a nurse provide when a patient starts taking a saturated solution of potassium iodide (SSKI)?

a.	Sip medication through a straw to prevent tooth staining.
b.	Double the dose if a dose is missed.
c.	Expect excessive salivation.
d.	Take before meals.

 

 

ANS:  A

SSKI can discolor teeth if not sipped through a straw; no iodide drug should be doubled; excessive salivation is a sign of toxicity; and the medication should be taken after meals.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1040           OBJ:   1

TOP:   SSKI              KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Pharmacological Therapies

 

3. A patient with a hyperthyroid complains of fatigue but still cannot get to sleep. What is the best suggestion by the nurse?

a.	Taking “cat naps” during the day
b.	Adhering to a bedtime ritual
c.	Drinking a cup of cocoa before bedtime
d.	Performing mild prebedtime exercises

 

 

ANS:  B

Bedtime rituals such as a warm bath, reading, and listening to music cue the body for sleep. Naps during the day may make nighttime sleep difficult; exercising and drinking caffeine-filled drinks are stimulating and should be avoided by the person with insomnia.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1042           OBJ:   3

TOP:   Hyperthyroidism Insomnia               KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort

 

4. Which significant need should be included in instructions to a patient scheduled for a thyroid scan (¹²³I)?

a.	Provision of a special container to collect urine for the next 24 hours
b.	Wear a protective apron to shield him or her from radiation for the next 24 hours
c.	Request that visitors keep a distance of at least 6 feet away for the next 24 hours
d.	Wash their hands with soap and water after every voiding for the next 24 hours

 

 

ANS:  D

The patient needs to be instructed to use soap and water to wash his or her hands after each voiding for the next 24 hours. If caregivers discard the urine, gloves should be worn and then washed and removed. Caregivers should wash their hands after glove removal.

 

DIF:    Cognitive Level: Application           REF:   p. 1039           OBJ:   2

TOP:   Thyroid Diagnostic Tests                 KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Safe, Effective Care Environment: Safety and Infection Control

 

5. A patient asks about his laboratory test, which showed a high level of thyroid-stimulating hormone (TSH) and a low level of T₄. What is the most accurate explanation?

a.	“It means that you have an inconsistency in your thyroid tests, and you will need more testing.”
b.	“I am sorry. You will have to ask your physician about your laboratory results. We are not allowed to discuss them.”
c.	“The TSH is sending a message to your thyroid gland to increase production, but your thyroid isn’t producing enough hormone.”
d.	“That means that you will have to go on hormone therapy for the rest of your life.”

 

 

ANS:  C

The test determines whether the problem is in the pituitary gland or in the thyroid gland. In this patient, the high level of TSH is coming from the pituitary gland as it should, but the thyroid gland is not responding with adequate hormone production.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1036           OBJ:   2

TOP:   Thyroid Laboratory Tests                KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation