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?
Adenoma of the parathyroid gland.
Thyroid carcinoma.
Vitamin D deficiency.
Chronic kidney disease.
The Correct Answer is A
Choice A Reason:
An adenoma of the parathyroid gland is the most common cause of primary hyperparathyroidism. This benign tumor leads to the overproduction of parathyroid hormone (PTH), which in turn causes elevated calcium levels in the blood. The excessive PTH secretion disrupts the normal calcium balance, leading to symptoms such as fatigue, muscle weakness, and depression. Parathyroid adenomas account for approximately 80% of primary hyperparathyroidism cases.
Choice B Reason:
Thyroid carcinoma is a type of cancer that originates in the thyroid gland, not the parathyroid glands. While thyroid carcinoma can cause various symptoms, it does not typically lead to elevated PTH levels or hyperparathyroidism. Therefore, it is not the most likely cause of the patient’s condition.
Choice C Reason:
Vitamin D deficiency can lead to secondary hyperparathyroidism, where low levels of vitamin D cause decreased calcium absorption, prompting the parathyroid glands to produce more PTH to maintain calcium levels. However, this condition is usually associated with low or normal calcium levels, not elevated calcium levels as seen in this patient. Therefore, it is not the most likely cause of her hyperparathyroidism.
Choice D Reason:
Chronic kidney disease (CKD) can also cause secondary hyperparathyroidism due to impaired kidney function, which affects calcium and phosphate balance and vitamin D metabolism. However, similar to vitamin D deficiency, CKD-related hyperparathyroidism typically presents with low or normal calcium levels rather than elevated levels. Thus, it is not the most likely cause in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Administering intravenous fluids is not the most appropriate initial action for managing hypopituitarism. While IV fluids may be necessary in cases of acute adrenal crisis or severe dehydration, they do not address the underlying hormone deficiencies caused by hypopituitarism. The primary treatment focuses on replacing the deficient hormones to restore normal physiological functions.
Choice B Reason:
Performing a transsphenoidal hypophysectomy is a surgical procedure used to remove pituitary tumors. While this may be necessary if a tumor is causing hypopituitarism, it is not the initial action for managing the condition. The first step is to stabilize the patient with hormone replacement therapy before considering surgical interventions.
Choice C Reason:
Initiating hormone replacement therapy is the most appropriate initial action for managing hypopituitarism. This condition results in the deficiency of one or more pituitary hormones, and replacing these hormones is crucial to restore normal body functions. Hormone replacement therapy may include cortisol, thyroid hormone, sex hormones, and growth hormone, depending on which hormones are deficient.
Choice D Reason:
Recommending dietary modifications alone is not sufficient to manage hypopituitarism. While a balanced diet can support overall health, it does not address the specific hormone deficiencies associated with this condition. Hormone replacement therapy is essential for managing hypopituitarism effectively.
Correct Answer is C
Explanation
Choice A Reason:
The statement “If I forget to take my eye drops, I should wait until the next time they are due” is incorrect. For chronic open-angle glaucoma, it is important to take eye drops as prescribed to maintain consistent intraocular pressure control. If a dose is missed, the patient should take it as soon as they remember, unless it is almost time for the next dose. Skipping doses can lead to fluctuations in eye pressure, which can worsen the condition.
Choice B Reason:
The statement “Every two years I will need to have my vision checked by an eye doctor” is not accurate. Patients with chronic open-angle glaucoma typically need more frequent monitoring, often every 3 to 6 months, depending on the severity of the condition and the stability of their intraocular pressure. Regular check-ups are crucial for adjusting treatment and preventing vision loss.
Choice C Reason:
The statement “I should call the clinic before taking any over-the-counter medications” indicates an understanding of the teaching. Some over-the-counter medications can affect intraocular pressure or interact with glaucoma medications. Consulting with a healthcare provider before taking new medications helps ensure that they do not interfere with glaucoma management.
Choice D Reason:
The statement “When my vision improves, I will be able to stop taking the eye drops” is incorrect. Glaucoma is a chronic condition that requires ongoing treatment to manage intraocular pressure and prevent further damage to the optic nerve. Stopping medication can lead to a rapid increase in eye pressure and potential vision loss.
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