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: Increasing aspirin dosage without medical guidance risks toxicity, including gastrointestinal bleeding and ulceration, as aspirin inhibits COX enzymes, reducing prostaglandin production. Prostaglandins mediate pain and inflammation, but excessive inhibition can damage the stomach lining. This approach is unsafe and not recommended for managing menstrual cramps effectively, as it may exacerbate adverse effects without ensuring better pain relief.
Choice B reason: First-generation NSAIDs, like ibuprofen, are more effective for menstrual cramps due to their stronger inhibition of COX-1 and COX-2 enzymes, which reduce prostaglandin synthesis responsible for uterine contractions and pain. Unlike aspirin, ibuprofen offers better pain relief with a more favorable dosing profile, making it a suitable alternative for dysmenorrhea management in most patients.
Choice C reason: Acetaminophen lacks significant anti-inflammatory effects, as it primarily inhibits COX enzymes in the central nervous system, not peripherally. It reduces pain and fever but does not effectively target prostaglandin-mediated inflammation in menstrual cramps. Therefore, it is less effective than NSAIDs like ibuprofen for dysmenorrhea, making it an inappropriate substitute in this context.
Choice D reason: Avoiding COX inhibitors due to Reye’s syndrome risk is unwarranted here, as Reye’s syndrome is primarily associated with aspirin use in children with viral infections. Menstrual cramps are unrelated to this condition, and COX inhibitors like NSAIDs are standard treatment. This choice is overly restrictive and not clinically justified for managing dysmenorrhea.
Correct Answer is D
Explanation
Choice A reason: Pulse oximetry of 95% is near normal and not a major concern for beta agonist administration. Tachycardia is more critical due to cardiac stimulation, so this is incorrect.
Choice B reason: A respiratory rate of 22 is slightly elevated but acceptable in respiratory conditions. Beta agonists target airways, but tachycardia is a greater risk, making this incorrect.
Choice C reason: Blood pressure of 100/60 mm Hg is low, but beta agonists primarily affect heart rate. A pre-existing tachycardia is more concerning contraindication, so this is incorrect.
Choice D reason: A heart rate of 120 beats/min is concerning, as beta agonists increase heart rate, risking arrhythmias. This requires evaluation before administration, making it the correct concern.
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