A 39-year-old female client presents to the nurse practitioner with complaints of depression, fatigue, weight gain, sensitivity to cold, and dry skin and hair. What are other expected findings in a patient with hypothyroidism?
Buffalo hump, easy bruising, and abdominal striae
Periorbital puffiness, decreased systolic blood pressure, increased diastolic blood pressure, and bradycardia
Increased systolic blood pressure, decreased diastolic blood pressure, tachycardia, and moon facies
Enlarged thyroid gland and protruding eyeballs
The Correct Answer is B
Choice A reason: Buffalo hump, easy bruising, and abdominal striae are hallmark features of Cushing's syndrome, which results from excess cortisol. These findings are not associated with hypothyroidism, which is characterized by a slowing of metabolic processes rather than hypercortisolism.
Choice B reason: Periorbital puffiness, bradycardia, and changes in blood pressure (decreased systolic and increased diastolic) are consistent with hypothyroidism. These symptoms reflect fluid retention, reduced cardiac output, and systemic vascular resistance changes due to low thyroid hormone levels. Bradycardia is a classic cardiovascular manifestation of hypothyroidism due to decreased sympathetic tone.
Choice C reason: Increased systolic blood pressure, decreased diastolic pressure, tachycardia, and moon facies are more indicative of hyperthyroidism or Cushing's syndrome. Tachycardia and widened pulse pressure are not typical in hypothyroidism, which tends to cause bradycardia and narrowed pulse pressure.
Choice D reason: An enlarged thyroid gland and protruding eyeballs (exophthalmos) are features of Graves' disease, a form of hyperthyroidism. Hypothyroidism does not typically present with these findings unless it follows treatment for Graves' disease, in which case ophthalmopathy may persist.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Disorganized speech in early childhood is not specific to schizophrenia and may be seen in developmental disorders such as autism spectrum disorder or language delay. It is not a reliable early indicator of schizophrenia.
Choice B reason: Childhood-onset schizophrenia is associated with poorer outcomes compared to adult-onset due to earlier disruption of cognitive and social development. Early intervention may help but does not necessarily lead to better prognosis.
Choice C reason: Childhood-onset schizophrenia shares many features with adult-onset, including a gradual onset and the presence of negative symptoms such as social withdrawal, flat affect, and cognitive deficits. These symptoms often precede psychotic features and are more prominent in early-onset cases.
Choice D reason: Schizophrenia is rare in children, and other diagnoses such as mood disorders, autism spectrum disorder, or trauma-related conditions should be considered first. It should not be the initial diagnosis without thorough evaluation.
Correct Answer is B
Explanation
Choice A reason: This describes osteoarthritis, not Paget’s disease. Osteoarthritis involves degeneration of joint cartilage and synovial structures, whereas Paget’s disease affects bone remodeling.
Choice B reason: Paget’s disease of bone is characterized by excessive osteoclastic bone resorption followed by disorganized osteoblastic bone formation. The newly formed bone is structurally abnormal—larger, less dense, and more vascular—making it prone to deformity and fracture. This explains the patient’s bowing and neurological symptoms due to nerve compression.
Choice C reason: This describes rheumatoid arthritis, an autoimmune condition affecting the synovium. Paget’s disease is not autoimmune and does not primarily involve joint inflammation.
Choice D reason: While PDB does involve abnormal bone remodeling, it does not lead to decreased skeletal mass. Instead, it results in structurally unsound bone that may be enlarged but weakened.
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