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:
Allowing the client to keep her hearing aids in is crucial for effective communication between the nurse and the client. Hearing aids help the client understand instructions and respond appropriately, which is essential for ensuring the client’s safety and comfort before surgery. According to preoperative guidelines, patients with hearing impairments should be allowed to use their hearing aids until they are taken to the operating room. This practice helps reduce anxiety and ensures that the client can hear and understand all preoperative instructions and consent information.
Choice B Reason:
Allowing the client to consume clear liquids up to the time of surgery is generally not recommended. Preoperative fasting guidelines typically require patients to stop consuming clear liquids at least two hours before surgery to reduce the risk of aspiration during anesthesia. Therefore, this option is not appropriate for ensuring the client’s safety.
Choice C Reason:
Allowing the client to take her morning vitamins is not advisable without specific instructions from the surgical team. Some vitamins and supplements can interact with anesthesia or increase the risk of bleeding during surgery. It is essential to follow the surgical team’s guidelines regarding medication and supplement intake before surgery.
Choice D Reason:
Allowing the client to keep her tongue stud in is not recommended. All jewelry and body piercings should be removed before surgery to prevent complications such as electrical burns during the use of electrocautery devices or interference with airway management. Removing the tongue stud is necessary to ensure the client’s safety during the procedure.
Correct Answer is C
Explanation
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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