An adult client with extreme fatigue, weight gain, cold intolerance, and bradycardia is diagnosed with hypothyroidism. Which laboratory findings is this client likely to exhibit?
Increased triiodothyronine (T3) and thyroxine (T4) and decreased thyroid stimulating hormone (TSH).
Increased triiodothyronine (T3) and thyroid stimulating hormone (TSH).
Decreased triiodothyronine (T3) and thyroxine (T4) and increased thyroid stimulating hormone (TSH).
Decreased thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4).
The Correct Answer is C
Hypothyroidism is characterized by deficient production of thyroid hormones by the thyroid gland, leading to a decrease in circulating levels of triiodothyronine (T3) and thyroxine (T4). As a compensatory mechanism, the pituitary gland releases increased amounts of thyroid stimulating hormone (TSH) in an attempt to stimulate thyroid hormone production.
A) Increased triiodothyronine (T3) and thyroxine (T4) and decreased thyroid stimulating hormone (TSH):
This pattern of laboratory findings is not consistent with hypothyroidism. Hypothyroidism is characterized by decreased levels of T3 and T4 due to impaired thyroid function, leading to increased TSH levels as a compensatory response. Therefore, this option is incorrect.
B) Increased triiodothyronine (T3) and thyroid stimulating hormone (TSH):
While TSH levels are typically increased in hypothyroidism, T3 levels are usually decreased. Therefore, the combination of increased T3 and TSH is not indicative of hypothyroidism. This option is incorrect.
C) Decreased triiodothyronine (T3) and thyroxine (T4) and increased thyroid stimulating hormone (TSH):
Correct. In hypothyroidism, there is a decrease in both T3 and T4 levels due to impaired thyroid function. As a compensatory mechanism, the pituitary gland releases increased amounts of TSH to stimulate the thyroid gland. Therefore, this pattern of laboratory findings is consistent with hypothyroidism.
D) Decreased thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4):
Decreased levels of TSH, T3, and T4 are not indicative of hypothyroidism. Hypothyroidism is characterized by elevated TSH levels and decreased T3 and T4 levels. Therefore, this option is incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Small, skin-colored, pedunculated papules in areas of skin folds and on other areas as skin tags:
This description is more characteristic of acrochordons (skin tags), which are benign skin growths often found in skin folds. Skin tags are typically not associated with acne vulgaris.
B) Hyperpigmented areas that vary in form and color and are slightly elevated from the skin:
This description may be indicative of post-inflammatory hyperpigmentation, which can occur after resolution of acne lesions. However, it does not represent the primary pathological findings observed in acne vulgaris.
C) Hyperactive sebaceous areas forming comedones, papules, pustules on the face, neck, and upper back:
Correct. Acne vulgaris is characterized by hyperactive sebaceous glands, leading to the formation of comedones (blackheads and whiteheads), papules, and pustules. These lesions commonly occur on the face, neck, and upper back due to the high density of sebaceous glands in these areas.
D) Sharply demarcated silvery scaling plaques with underlying redness on the elbows and knees:
This description is more indicative of psoriasis, a chronic autoimmune skin condition characterized by silvery scaling plaques and inflammation. Psoriasis typically affects extensor surfaces such as the elbows and knees, rather than the areas commonly affected by acne vulgaris.
Correct Answer is B
Explanation
Tumor lysis syndrome (TLS) is a potentially life-threatening oncologic emergency characterized by the rapid release of intracellular contents into the bloodstream following the destruction of cancer cells. This release can lead to metabolic disturbances, including hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia. Here's how the child's laboratory results are indicative of tumor lysis syndrome:
A) Wilm's tumor:
Wilms tumor is a type of kidney cancer that primarily affects children. However, it typically does not cause the metabolic disturbances seen in tumor lysis syndrome. Laboratory abnormalities in Wilms tumor are generally related to renal dysfunction and may include hematuria and proteinuria.
B) Tumor lysis syndrome:
Correct. Tumor lysis syndrome occurs when chemotherapy or radiation therapy causes a rapid breakdown of cancer cells, leading to the release of intracellular contents such as potassium, phosphorus, and uric acid into the bloodstream. The elevated potassium and phosphorus levels seen in the child's laboratory results are consistent with tumor lysis syndrome. Hyperkalemia (elevated potassium) and hyperphosphatemia (elevated phosphorus) are common metabolic disturbances in tumor lysis syndrome.
C) Superior vena cava syndrome:
Superior vena cava syndrome occurs when the superior vena cava, a major vein that carries blood from the upper body to the heart, becomes partially or completely obstructed. This obstruction can lead to symptoms such as facial swelling, dyspnea, and dilated neck veins. While superior vena cava syndrome may occur in cancer patients, it does not typically cause the metabolic disturbances seen in the child's laboratory results.
D) Hyperleukocytosis:
Hyperleukocytosis refers to an extremely high white blood cell count, which can occur in leukemia. While leukemia can lead to metabolic abnormalities, the child's laboratory results, particularly the elevated potassium and phosphorus levels, are more indicative of tumor lysis syndrome than hyperleukocytosis.
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