A nurse is caring for a patient with decreased triiodothyronine (T3) and thyroxine (T4) and elevated thyroid-stimulating hormone (TSH) levels. The nurse knows the patient is likely suffering from what?
Hyperthyroidism
Hypothyroidism
Thyroid cancer
Pituitary adenoma
The Correct Answer is B
Choice A reason: Hyperthyroidism involves elevated T3 and T4 with low TSH due to excessive thyroid hormone production. The patient’s low T3/T4 and high TSH indicate reduced thyroid activity, not overactivity, as the pituitary increases TSH to stimulate the underactive thyroid, making this choice incorrect.
Choice B reason: Hypothyroidism is characterized by low T3 and T4 levels due to underactive thyroid function, prompting the pituitary to secrete more TSH to stimulate hormone production. This matches the patient’s lab results (low T3/T4, high TSH), often seen in primary hypothyroidism, making this the correct choice.
Choice C reason: Thyroid cancer may alter thyroid function but typically doesn’t present with consistently low T3/T4 and high TSH. It’s more likely to cause nodules or abnormal growths, not this specific hormonal pattern, which aligns with hypothyroidism, making this choice less likely.
Choice D reason: Pituitary adenoma causing secondary hypothyroidism would lower TSH, T3, and T4 due to impaired pituitary function. High TSH with low T3/T4 suggests primary thyroid failure, not pituitary dysfunction, making this choice incorrect for the patient’s hormonal profile.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Glargine provides basal, not insulin, coverage; meal coverage. It maintains steady glucose control, so this is incorrect.
Choice B reason: Insulin glargine offers 24-hour basal glucose control, stabilizing blood sugar without peaks. This is its primary effect, making it the correct outcome.
Choice C reason: Glargine requires regular monitoring, not less frequent monitoring, to ensure control. This is incorrect for the therapeutic outcome.
Choice D reason: Glargine has no peak, unlike short-acting insulins, with effects lasting 24 hours. A 2–4 hour peak is incorrect, so incorrect.
Correct Answer is D
Explanation
Choice A reason: Pseudoephedrine, a decongestant, relieves nasal congestion by vasoconstriction but doesn’t address inflammation or histamine-mediated symptoms like sneezing or itching in rhinitis. It’s less effective than intranasal corticosteroids, which target the underlying allergic response, making this choice less optimal for comprehensive rhinitis treatment.
Choice B reason: Intranasal cromolyn sodium stabilizes mast cells, reducing histamine release, but it’s less effective than corticosteroids for rhinitis. Atrovent (ipratropium) is incorrectly referenced here, as it treats rhinorrhea, not inflammation. Corticosteroids like fluticasone are preferred, making this choice incorrect for optimal treatment.
Choice C reason: Propranolol, a beta-blocker, treats hypertension and cardiac conditions, not rhinitis. It has no effect on allergic inflammation, histamine, or nasal congestion. Its use in rhinitis could worsen symptoms by causing bronchoconstriction in asthmatics, making this choice inappropriate and incorrect.
Choice D reason: Fluticasone propionate, an intranasal corticosteroid, reduces inflammation, edema, and histamine effects in seasonal and perennial rhinitis. It targets the allergic cascade, decreasing nasal congestion, sneezing, and itching, making it the most effective and guideline-recommended treatment, thus the correct choice for rhinitis management.
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