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 A
Explanation
Choice A Reason:
Cloudiness in the lens of the eyes is the hallmark symptom of cataracts. Cataracts cause the lens to become opaque, leading to blurred vision and difficulty seeing clearly. This cloudiness can make it challenging to perform everyday tasks and is the most indicative sign of cataracts.
Choice B Reason:
Double vision in one eye can occur with cataracts, but it is not the most indicative symptom. While cataracts can cause visual disturbances, the primary symptom is the cloudiness of the lens, which directly impacts vision clarity.
Choice C Reason:
Eye pain and redness are not typical symptoms of cataracts. These symptoms are more commonly associated with other eye conditions such as infections or glaucoma. Cataracts primarily cause visual disturbances without significant pain or redness.
Choice D Reason:
Sudden loss of vision is not characteristic of cataracts. Cataracts develop gradually over time, leading to a slow progression of vision impairment. Sudden vision loss is more likely to be associated with acute conditions such as retinal detachment or vascular occlusions.
Correct Answer is B
Explanation
Choice A Reason:
A random blood glucose level of 126 mg/dL is not typically indicative of hyperglycemia. Hyperglycemia is generally defined as a blood glucose level above 180 mg/dL. A level of 126 mg/dL is closer to the threshold for diagnosing diabetes but does not necessarily indicate hyperglycemia.
Choice B Reason:
A history of poor wound healing is a common manifestation of hyperglycemia. High blood sugar levels can impair the body’s ability to heal wounds by affecting blood flow and the function of immune cells. This can lead to prolonged wound healing times and an increased risk of infections.
Choice C Reason:
Decreased urinary output is not a typical symptom of hyperglycemia. In fact, hyperglycemia often causes increased urinary output (polyuria) due to the body’s attempt to excrete excess glucose through urine. Decreased urinary output could be indicative of other conditions, such as dehydration or kidney issues.
Choice D Reason:
Clammy skin is more commonly associated with hypoglycemia (low blood sugar) rather than hyperglycemia. Hypoglycemia can cause symptoms such as sweating, shakiness, and clammy skin due to the body’s response to low blood sugar levels. Hyperglycemia, on the other hand, does not typically cause clammy skin.
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