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A nurse is caring for a client
Exhibits
Select the 3 interventions that the nurse should anticipate for this client.

Administer propylthiouracil (PTU).

Provide warm blankets.

Place the client on a cardiac monitor.

Place the client on a high-calorie diet.

Administer propranolol.

Administer acetaminophen.

Administer levothyroxine.

Answer and Explanation

Correct Answer : B,C,G

A. Administer propylthiouracil (PTU): PTU is used for treating hyperthyroidism by inhibiting thyroid hormone production. The client's lab results show low Free T4 and elevated TSH, indicating hypothyroidism, not hyperthyroidism. Therefore, PTU is not appropriate for this condition.
B. Provide warm blankets: The client is experiencing hypothermia (temperature 35.6°C or 96.1°F) and lethargy. Providing warm blankets helps in managing low body temperature and preventing further complications. This intervention is necessary to stabilize the client's body temperature.
C. Place the client on a cardiac monitor: The client has bradycardia (heart rate 49/min) and a slow respiratory rate (10/min), which are signs of possible cardiac involvement due to hypothyroidism. Cardiac monitoring is essential to detect and manage any potential arrhythmias or cardiac issues that may arise.
D. Place the client on a high-calorie diet: A high-calorie diet is usually recommended for managing hyperthyroidism due to increased metabolism. However, this client has hypothyroidism, characterized by reduced metabolism and low energy levels, so this intervention is not appropriate.
E. Administer propranolol: Propranolol is used to manage symptoms of hyperthyroidism, such as tachycardia and tremors. Given the client's symptoms and lab results indicating hypothyroidism, propranolol is not indicated for this condition.
F. Administer acetaminophen: Acetaminophen is used to reduce fever, but the client is hypothermic rather than febrile. Administering acetaminophen would not address the client's current issue of low body temperature.
G. Administer levothyroxine: The client has low Free T4 and elevated TSH, indicating hypothyroidism. Levothyroxine is the appropriate medication to manage hypothyroidism by supplementing thyroid hormone levels. This intervention is necessary to treat the underlying thyroid condition.
H. Prepare the client for a subtotal thyroidectomy: A subtotal thyroidectomy is a surgical option considered for severe thyroid disorders, such as thyroid cancer or uncontrollable hyperthyroidism. This client's presentation suggests hypothyroidism rather than a condition requiring surgical intervention.

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Correct Answer is B

Explanation

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.

A. Elevated adrenocorticotropic hormone (ACTH) and elevated cortisol B. Elevated adrenocorticotropic hormone (ACTH) and low cortisol C. Low adrenocorticotropic hormone (ACTH) and elevated cortisol D. Low adrenocorticotropic hormone (ACTH) and low cortisol

Correct Answer is A

Explanation

A. Elevated adrenocorticotropic hormone (ACTH) and elevated cortisol: In cases of ectopic ACTH syndrome, the tumor produces ACTH, which stimulates the adrenal glands to produce excess cortisol. Therefore, both ACTH and cortisol levels are elevated.
B. Elevated adrenocorticotropic hormone (ACTH) and low cortisol: This scenario is less likely as elevated ACTH typically results in increased cortisol production, not decreased.
C. Low adrenocorticotropic hormone (ACTH) and elevated cortisol: This is characteristic of primary adrenal insufficiency, not ectopic ACTH syndrome, where ACTH levels are usually high.
D. Low adrenocorticotropic hormone (ACTH) and low cortisol: This pattern is inconsistent with Cushing syndrome, especially due to ectopic ACTH-secreting tumors, which typically result in elevated ACTH and cortisol.

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A nurse is caring for a client Exhibits Select the 3 interventions that the nurse should anticipate for this client.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

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 caring for a client who has developed Cushing syndrome due to long-term corticosteroid therapy to treat multiple sclerosis. The nurse understands that Cushing syndrome puts the client at increased risk for which complication?

A 28-year-old female client who is in the first trimester of pregnancy is diagnosed with hyperthyroidism. Which of the following would be the preferred treatment for this client?

A nurse is providing dietary teaching for a client who has Graves' disease. Which of the following statements made by the client indicates a need for further teaching by the nurse?

A client seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be the most useful for diagnosing heart failure?

A client who takes daily hormone replacement therapy for Addison's disease is scheduled for an outpatient surgical procedure. Which of the following instructions should the nurse include when providing discharge education to the client?

A nurse is caring for a client Exhibits Select the 3 interventions that the nurse should anticipate for this client.

A client in a primary care provider's office has a new diagnosis of hypothyroidism. The nurse understands that the client should be screened for which of the following conditions common in people who have hypothyroidism?

A nurse is caring for a client
Exhibits
Select the 3 interventions that the nurse should anticipate for this client.