A 40-year-old female client has a family history of thyroid problems and is being seen by the primary health care provider for unintentional weight loss, irritability, and chest discomfort. Her probable diagnosis is hyperthyroidism, which the primary health care provider plans to confirm by laboratory testing. What additional physical assessment findings would the nurse expect to be present in this client? Select all that apply.
Hypotension
Diaphoresis
Heat intolerance
Tachycardia
Insomnia
Decreased deep tendon reflexes
Correct Answer : B,C,D,E
Choice A reason: Hypotension is not typically associated with hyperthyroidism. In fact, hyperthyroidism usually leads to an increase in metabolic rate, which can cause an increase in blood pressure rather than a decrease. Therefore, hypotension is not a consistent finding in patients with hyperthyroidism.
Choice B reason: Diaphoresis, or excessive sweating, is a common symptom of hyperthyroidism. The increased metabolic rate associated with hyperthyroidism causes the body to generate more heat, leading to excessive sweating as the body attempts to cool down. This symptom is frequently observed in patients with this condition.
Choice C reason: Heat intolerance is a hallmark symptom of hyperthyroidism. Due to the increased metabolic activity, patients with hyperthyroidism often feel excessively warm and have difficulty tolerating heat. They may seek cooler environments and prefer lighter clothing, even in colder weather, to manage their discomfort.
Choice D reason: Tachycardia, or an abnormally rapid heart rate, is a common finding in hyperthyroidism. The excess thyroid hormones stimulate the heart, leading to an increased heart rate and palpitations. This symptom is a significant indicator of hyperthyroidism and is often one of the first signs noticed by patients and healthcare providers.
Choice E reason: Insomnia is frequently seen in patients with hyperthyroidism. The increased metabolic rate and heightened nervous system activity can lead to difficulty sleeping and restlessness. Patients may report trouble falling asleep, staying asleep, or feeling rested after sleep, contributing to overall fatigue and irritability.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Cyanosis and hypertension are not typically associated with severe anemia. While anemia can lead to tissue hypoxia, cyanosis is more related to respiratory or cardiovascular problems, and hypertension is not a common consequence of anemia.
Choice B reason: Dysrhythmias and expiratory wheezing are not directly related to severe anemia. Dysrhythmias can occur in severe cases due to the heart's increased workload, but expiratory wheezing is generally associated with respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD).
Choice C reason: Pulmonary edema and fibrosis are not linked to severe anemia. These conditions are related to heart failure, lung injury, or chronic lung diseases, rather than anemia.
Choice D reason: Dyspnea and increased heart rate are expected findings in a severely anemic patient. Dyspnea, or difficulty breathing, occurs because the body is not getting enough oxygen due to the reduced number of red blood cells. The heart rate increases as a compensatory mechanism to deliver more oxygenated blood to the tissues.
Correct Answer is A
Explanation
Choice A reason: Hepatic encephalopathy is a severe complication of cirrhosis caused by elevated serum ammonia levels. When the liver is unable to effectively remove ammonia from the blood due to cirrhosis, ammonia accumulates and crosses the blood-brain barrier, leading to neurological symptoms such as confusion, altered mental status, and even coma. This condition is directly related to the liver's impaired ability to detoxify the blood, making it the most consistent complication associated with elevated serum ammonia levels.
Choice B reason: Jaundice is a common symptom of cirrhosis, but it is not directly caused by elevated serum ammonia levels. Jaundice occurs due to the liver's inability to process bilirubin, a byproduct of red blood cell breakdown, leading to its accumulation in the blood and tissues. While jaundice is a sign of liver dysfunction, it is not specifically linked to ammonia levels.
Choice C reason: Ascites is the accumulation of fluid in the abdominal cavity and is a common complication of cirrhosis. It occurs due to portal hypertension and hypoalbuminemia, which result from liver dysfunction. Although ascites is a significant complication, it is not directly caused by elevated serum ammonia levels.
Choice D reason: Peripheral neuropathies are nerve damage that can occur in various conditions, but they are not typically associated with elevated serum ammonia levels in cirrhosis. Peripheral neuropathies can result from nutritional deficiencies, metabolic disorders, or other underlying conditions, but they are not a direct consequence of ammonia accumulation.
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