A staff nurse is teaching a client who has secondary hypothyroidism about the disease process. The client asks the nurse what causes secondary hypothyroidism. Which of the following responses should the nurse make?

"It is caused by the overproduction of T3, T4, and calcitonin by the thyroid gland."

"It is caused by the lack of production of adrenocorticotropic hormone by the pituitary gland."

"It is caused by the lack of production of thyroid stimulating hormone by the pituitary gland."

"It is caused by the lack of production of aldosterone by the adrenal gland."

Answer and Explanation

The Correct Answer is C

A. Secondary hypothyroidism is characterized by insufficient production of thyroid hormones (T3 and T4) due to inadequate stimulation from the pituitary gland, not due to overproduction. Overproduction of thyroid hormones would typically be associated with hyperthyroidism, not hypothyroidism.
B. Adrenocorticotropic hormone (ACTH) stimulates the adrenal glands to produce cortisol. A deficiency in ACTH would lead to adrenal insufficiency or Addison's disease, not secondary hypothyroidism.
Secondary hypothyroidism specifically involves a deficiency in thyroid-stimulating hormone (TSH), not ACTH.
C. Secondary hypothyroidism is caused by inadequate production of thyroid-stimulating hormone (TSH) by the pituitary gland. TSH is necessary for stimulating the thyroid gland to produce thyroid hormones (T3 and T4). When the pituitary gland does not produce enough TSH, the thyroid gland is not adequately stimulated, leading to low levels of thyroid hormones in the blood.
D. Aldosterone is a hormone produced by the adrenal glands that helps regulate sodium and potassium levels, as well as blood pressure. A deficiency in aldosterone is associated with conditions such as
Addison’s disease or primary adrenal insufficiency, not secondary hypothyroidism. Secondary
hypothyroidism specifically relates to issues with TSH production, not aldosterone.

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Correct Answer is C

Explanation

A. This statement is not accurate in the context of miotic medications. Miotic drugs do not work by blocking neural impulses to the muscles. Instead, they directly affect the eye's pupil size and fluid dynamics. This response does not correctly describe the action of miotic agents.
B. This response is incorrect because miotic medications actually constrict the pupil, not dilate it. In acute angle-closure glaucoma, dilation of the pupil would worsen the condition by further blocking the drainage angle. Miotics are used to constrict the pupil, which helps open the angle between the iris and the cornea, thereby facilitating fluid drainage.

C. Miotic medications cause the pupil to constrict (miosis), which helps in opening the narrow angle between the iris and the cornea. In acute angle-closure glaucoma, the angle is closed or narrow, preventing proper drainage of aqueous humor. By constricting the pupil, miotic medications can help to relieve this obstruction and allow better drainage of fluid, thereby reducing intraocular pressure.
D. This statement is incorrect regarding the action of miotic medications. Miotic drugs do not pull aqueous humor into the bloodstream. Their primary effect is on the pupil's size and the angle of the eye to improve drainage. Medications that reduce aqueous humor production or increase its outflow, such as carbonic anhydrase inhibitors or prostaglandin analogs, are responsible for these actions

A. Check the client's most recent potassium level B. Administer a bolus of 1,000 mL of normal saline C. Administer potassium chloride intravenously (IV) D. Administer sodium polystyrene sulfonate (Kayexalate)

Correct Answer is A

Explanation

A. Peaked T-waves and a widened QRS complex on an ECG are often signs of hyperkalemia, which is an elevated potassium level in the blood. This can be a serious complication of acute kidney injury (AKI), especially in the oliguric phase when the kidneys are unable to effectively excrete potassium.A
B. While fluid management is important in AKI, administering a bolus of normal saline is not the first priority in the presence of suspected hyperkalemia. The primary concern is to address the electrolyte imbalance.

C. Administering potassium chloride would worsen hyperkalemia and should be avoided.
D. Kayexalate is a medication used to treat hyperkalemia by exchanging sodium ions for potassium ions in the gastrointestinal tract. However, checking the potassium level is the first step in confirming the diagnosis and determining the appropriate treatment.

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A staff nurse is teaching a client who has secondary hypothyroidism about the disease process. The client asks the nurse what causes secondary hypothyroidism. Which of the following responses should the nurse make?

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Naxlex Comprehensive Predictor Exams

A miotic medication has been prescribed for a client with acute angle-closure glaucoma. The client asks the nurse about the purpose of the medication. Which response should the nurse provide to the client?

Correct Answer is C

Explanation

A client is in the oliguric phase of acute kidney injury (AKI) which was caused by massive tissue trauma. The nurse notes peaked T-waves and a widened QRS complex on the cardiac monitor. What is the first action the nurse should take?

Correct Answer is A

Explanation

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