A client is experiencing tachycardia and tremors. Lab values show elevated Free T4 and low thyroid stimulating hormone (TSH). Which diagnostic study will help the practitioner differentiate Graves' disease from other forms of hyperthyroidism?

Levothyroxine replacement test

Radioactive iodine uptake (RAIU) test

Adrenocorticotropic hormone (ACTH) stimulation test

Subtotal thyroidectomy

Answer and Explanation

The Correct Answer is B

A. Levothyroxine replacement test: This test is used to assess the thyroid's response to synthetic thyroid hormone and is not used to differentiate types of hyperthyroidism.
B. Radioactive iodine uptake (RAIU) test: This test measures the thyroid gland's ability to absorb iodine, which helps differentiate Graves' disease (characterized by increased uptake) from other forms of hyperthyroidism, such as thyroiditis (which may show decreased uptake).
C. Adrenocorticotropic hormone (ACTH) stimulation test: This test is used to evaluate adrenal function and is not relevant for diagnosing or differentiating forms of hyperthyroidism.
D. Subtotal thyroidectomy: This is a surgical procedure rather than a diagnostic test and would not be used to differentiate between types of hyperthyroidism.

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Correct Answer is B

Explanation

A. Excess mineralocorticoids: Mineralocorticoids primarily affect electrolyte and fluid balance. While excess mineralocorticoids can cause hypertension and fluid retention, they are not directly responsible for hirsutism or acne.
B. Excess adrenal androgens: Cushing syndrome can lead to elevated levels of adrenal androgens, which are responsible for hirsutism (excessive hair growth) and acne due to their androgenic effects.
C. Excess thyroid hormone: Thyroid hormone imbalances can affect various body systems, but they are not directly related to the development of hirsutism or acne seen in Cushing syndrome.
D. Excess glucocorticoids: While excess glucocorticoids are characteristic of Cushing syndrome and can cause a range of symptoms, hirsutism and acne are specifically due to excess adrenal androgens rather than glucocorticoids.

A. A 40-year-old patient with Cushing syndrome and gynecomastia. B. A 58-year-old patient with Addison's disease who is exhibiting confusion. C. A 45-year-old patient with Graves' disease and exophthalmos. D. A 47-year-old patient with hypothyroidism who is asking for a warm blanket. E. A 47-year-old patient with hypothyroidism who is asking for a warm blanket.

Correct Answer is B

Explanation

A. A 40-year-old patient with Cushing syndrome and gynecomastia: While Cushing syndrome requires ongoing management and monitoring, gynecomastia alone is not an urgent concern compared to the symptoms described in option B.
B. A 58-year-old patient with Addison's disease who is exhibiting confusion: Addison's disease can lead to adrenal insufficiency, and confusion could indicate an adrenal crisis or severe electrolyte imbalance. This is a critical situation requiring immediate assessment to prevent severe complications.
C. A 45-year-old patient with Graves' disease and exophthalmos: Graves' disease with exophthalmos is significant but does not typically represent an immediate life-threatening condition compared to the symptoms associated with Addison's disease.
D. A 47-year-old patient with hypothyroidism who is asking for a warm blanket: This patient’s request for a warm blanket suggests they might be experiencing symptoms related to hypothyroidism, such as feeling cold. However, this is less urgent compared to the confusion and potential crisis in option B.

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A client is experiencing tachycardia and tremors. Lab values show elevated Free T4 and low thyroid stimulating hormone (TSH). Which diagnostic study will help the practitioner differentiate Graves' disease from other forms of hyperthyroidism?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a female client who has a diagnosis of Cushing syndrome. The client is embarrassed that she is experiencing hirsutism and severe acne. The nurse understands that these manifestations are caused by which of the following?

Correct Answer is B

Explanation

At the beginning of the shift, a nurse receives report on the following four patients. Which patient should the nurse place priority on assessing first?

Correct Answer is B

Explanation

A nurse is caring for a client who has hypokalemia, hyperglycemia, and hypertension. A diagnosis of Cushing syndrome is suspected. Which of the following tests would the nurse anticipate the health care provider will order to help confirm the diagnosis of Cushing syndrome?

A nurse is providing education to a client who has Graves' disease and who will be returning home after receiving their first dose of radioactive iodine therapy. Which of the following information should the nurse include?

A nurse is providing education to a client who has a new diagnosis of Addison's disease. The nurse determines that additional teaching is needed when the client makes which of the following statements?

A nurse is admitting a client who is experiencing an Addisonian crisis. Which of the following should the nurse anticipate an order for?

A nurse is caring for a client after a subtotal thyroidectomy. Which of the following manifestations would lead the nurse to suspect that the procedure caused damage to the client's parathyroid glands?

A nurse is preparing to administer total parental nutrition (TPN) 1800 mL to infuse over 24 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A client who has hypothyroidism will be undergoing surgery for a total knee replacement. When planning care for this client, the nurse understands which of the following to be true for people who have hypothyroidism?