A 45-year-old female patient presents with symptoms of weight loss, palpitations, and heat intolerance. Laboratory results reveal elevated T3 and T4 levels and suppressed TSH levels. Considering her clinical presentation and lab results, which of the following treatments is most appropriate for managing her hyperthyroidism?

Methimazole.

Levothyroxine.

Radioactive iodine.

Propranolol.

Answer and Explanation

The Correct Answer is C

Choice A Reason:

Methimazole is an antithyroid medication that inhibits the synthesis of thyroid hormones. It is commonly used to manage hyperthyroidism, especially in patients who are not candidates for radioactive iodine therapy or surgery. Methimazole is effective in reducing thyroid hormone levels and controlling symptoms, but it requires long-term use and regular monitoring of thyroid function tests.

Choice B Reason:

Levothyroxine is a synthetic form of thyroxine (T4) used to treat hypothyroidism, not hyperthyroidism. Administering levothyroxine to a patient with hyperthyroidism would exacerbate the condition by increasing thyroid hormone levels. Therefore, it is not an appropriate treatment for managing hyperthyroidism.

Choice C Reason:

Radioactive iodine is a widely used treatment for hyperthyroidism. It works by destroying overactive thyroid cells, thereby reducing the production of thyroid hormones. This treatment is particularly effective for patients with Graves’ disease, toxic multinodular goiter, or toxic adenoma. Radioactive iodine is a definitive treatment that can lead to a permanent resolution of hyperthyroidism, although it may result in hypothyroidism, which can be managed with levothyroxine.

Choice D Reason:

Propranolol is a beta-blocker that helps manage the symptoms of hyperthyroidism, such as palpitations, tremors, and anxiety. While it is useful for symptomatic relief, it does not address the underlying cause of hyperthyroidism. Propranolol is often used in conjunction with other treatments, such as antithyroid medications or radioactive iodine, to provide immediate symptom control.

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Correct Answer is A

Explanation

Choice A Reason:

Monitoring platelet counts and assessing for signs of bleeding is crucial for managing thrombocytopenia. Thrombocytopenia is characterized by a low platelet count, which increases the risk of bleeding. Regular monitoring helps in detecting any significant drops in platelet levels, allowing for timely interventions to prevent severe bleeding. Assessing for signs of bleeding, such as petechiae, bruising, or nosebleeds, is essential to manage the condition effectively and prevent complications.

Choice B Reason:

Administering aspirin to manage pain and prevent clot formation is not appropriate for patients with thrombocytopenia. Aspirin is an antiplatelet agent that inhibits platelet function, which can exacerbate bleeding tendencies in patients with low platelet counts. Using aspirin in this context could increase the risk of bleeding and is therefore contraindicated.

Choice C Reason:

Administering a diuretic to reduce fluid retention and swelling is not relevant for managing thrombocytopenia. Diuretics are used to manage conditions like hypertension and edema but do not address the underlying issue of low platelet counts. In fact, diuretics can lead to electrolyte imbalances, which may complicate the patient’s condition further.

Choice D Reason:

Encouraging the patient to increase physical activity to improve circulation is not a priority intervention for thrombocytopenia. While physical activity is generally beneficial for overall health, it can increase the risk of trauma and bleeding in patients with low platelet counts. It is important to avoid activities that could lead to injury and bleeding in these patients.

A. Diabetes Insipidus B. Adrenal insufficiency C. Hyperaldosteronism D. Syndrome of inappropriate Antidiuretic Hormone (SIADH)

Correct Answer is D

Explanation

Choice A Reason:

Diabetes Insipidus (DI) is characterized by excessive urination and thirst due to a deficiency of antidiuretic hormone (ADH) or a renal insensitivity to ADH. Patients with DI typically present with hypernatremia (high serum sodium) and low urine osmolality, which contrasts with the findings of low serum sodium and high urine osmolality in this patient.

Choice B Reason:

Adrenal insufficiency can cause hyponatremia and hyperkalemia due to a deficiency in aldosterone and cortisol. However, it usually presents with low serum osmolality and low urine sodium, which does not align with the patient’s laboratory results of high urine osmolality and elevated urine sodium.

Choice C Reason:

Hyperaldosteronism leads to increased sodium reabsorption and potassium excretion, resulting in hypernatremia and hypokalemia. This condition does not match the patient’s findings of hyponatremia and high urine osmolality.

Choice D Reason:

Syndrome of inappropriate Antidiuretic Hormone (SIADH) is characterized by excessive release of ADH, leading to water retention, hyponatremia, and concentrated urine. The patient’s laboratory results of low serum sodium, low serum osmolality, high urine osmolality, and elevated urine sodium are consistent with SIADH. This condition causes the kidneys to reabsorb water, diluting the blood and concentrating the urine.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 55-year-old male patient is admitted to the hospital with a diagnosis of thrombocytopenia. Upon assessment, you note petechiae on his lower extremities, and he reports fatigue and occasional nosebleeds. Which of the following interventions should be prioritized for this patient?

Correct Answer is A

Explanation

Correct Answer is D

Explanation

A patient with pheochromocytoma

A 20-year-old male patient with a known history of hemophilia A is brought to the emergency department with swelling and pain in his right knee after a minor fall. Which of the following is the most appropriate initial nursing intervention?

A 55-year-old female presents with symptoms of fatigue, muscle weakness, and depression. Laboratory results reveal elevated calcium levels and increased parathyroid hormone (PTH) levels. Which of the following is the most likely cause of her hyperparathyroidism?

A 50-year-old male patient presents with facial rounding, central obesity, and purple striae on the abdomen. Laboratory results show high levels of ACTH. What is the most likely underlying cause of his condition?

A 70-year-old patient is diagnosed with cataracts and is discussing treatment options with their healthcare provider. Which of the following is the most appropriate treatment for cataracts?

A 65-year-old patient presents to the emergency department with sudden onset of flashes of light, a shadow over the visual field, and floaters in their right eye. What is the most likely diagnosis?

A nurse is reinforcing teaching with a client who has been newly diagnosed with chronic open-angle glaucoma. Which of the following statements by the client indicates an understanding of the teaching?