A nurse is caring for a client who reports increased anxiety, nervousness, heat intolerance, and unintentional weight loss. Blood testing reveals decreased thyroid-stimulating hormone (TSH), elevated thyroxine (T4), and elevated triiodothyronine (T3). Which of the following vital sign abnormalities does the nurse anticipate?

Decreased body temperature

Tachycardia

Hypotension

Slow respiratory rate

Answer and Explanation

The Correct Answer is B

Choice A reason: Decreased Body Temperature

Decreased body temperature is not typically associated with hyperthyroidism. In fact, hyperthyroidism often causes an increase in body temperature due to the accelerated metabolic rate. Patients with hyperthyroidism may experience heat intolerance and excessive sweating, but not a decrease in body temperature.

Choice B reason: Tachycardia

Tachycardia, or an abnormally fast heart rate, is a common symptom of hyperthyroidism. The elevated levels of thyroid hormones (T4 and T3) increase the body’s metabolism, leading to an increased heart rate. This can result in palpitations and a feeling of a racing heart, which are characteristic signs of hyperthyroidism. Therefore, tachycardia is the most likely vital sign abnormality in this scenario.

Choice C reason: Hypotension

Hypotension, or low blood pressure, is not typically associated with hyperthyroidism. Instead, hyperthyroidism can sometimes cause an increase in blood pressure due to the heightened metabolic activity and increased cardiac output4. Therefore, hypotension is not a characteristic finding in patients with elevated thyroid hormone levels.

Choice D reason: Slow Respiratory Rate

A slow respiratory rate is not commonly seen in hyperthyroidism. The condition usually leads to an increased respiratory rate due to the body’s heightened metabolic demands. Patients with hyperthyroidism may experience shortness of breath and rapid breathing, but not a slow respiratory rate.

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Correct Answer is B

Explanation

Choice A reason: Increased Thirst, Increased Urine Output, and Weight Loss

Increased thirst, increased urine output, and weight loss are symptoms commonly associated with diabetes mellitus, particularly uncontrolled diabetes. These symptoms occur due to the body’s attempt to eliminate excess glucose through urine, leading to dehydration and subsequent weight loss. However, these symptoms are not typically associated with elevated TSH levels, which indicate hypothyroidism.

Choice B reason: Fatigue, Constipation, Weight Gain

Fatigue, constipation, and weight gain are classic symptoms of hypothyroidism2. When the thyroid gland is underactive, it produces insufficient thyroid hormones, leading to a slowdown in the body’s metabolism. This results in fatigue, weight gain, and constipation, among other symptoms. Elevated TSH levels are a compensatory response by the pituitary gland to stimulate the thyroid to produce more hormones, confirming hypothyroidism.

Choice C reason: Anxiety, Unintended Weight Loss, Palpitations

Anxiety, unintended weight loss, and palpitations are symptoms typically associated with hyperthyroidism, not hypothyroidism. Hyperthyroidism occurs when the thyroid gland produces excessive thyroid hormones, leading to an accelerated metabolism. This results in symptoms such as weight loss, increased heart rate (palpitations), and anxiety. Elevated TSH levels would not be expected in hyperthyroidism; instead, TSH levels would be low due to negative feedback from high thyroid hormone levels.

Choice D reason: Shakiness, Sweating, Nausea

Shakiness, sweating, and nausea can be symptoms of various conditions, including hypoglycemia (low blood sugar), anxiety, or panic attacks. These symptoms are not specific to thyroid dysfunction and are not typically associated with elevated TSH levels. Hypothyroidism, indicated by high TSH levels, usually presents with symptoms related to a slowed metabolism, such as fatigue and weight gain, rather than shakiness and sweating.

A. Heart murmur B. Chest pain C. Varicose veins D. Palpitations E. Abdominal pain

Correct Answer is ["A","B","D"]

Explanation

Choice A reason:

Heart murmur is a common manifestation of valvular dysfunction. It occurs when there is turbulent blood flow across a damaged or abnormal heart valve. This can be due to stenosis (narrowing of the valve) or regurgitation (leakage of the valve). The murmur’s characteristics, such as timing, location, and intensity, can help in diagnosing the specific type of valvular disease. For example, a systolic murmur might indicate aortic stenosis or mitral regurgitation, while a diastolic murmur could suggest aortic regurgitation or mitral stenosis.

Choice B reason:

Chest pain is another symptom that can be associated with valvular dysfunction. This pain can result from increased workload on the heart due to inefficient blood flow through the valves. Conditions like aortic stenosis can lead to angina (chest pain) because the heart muscle may not receive enough oxygenated blood. This symptom is particularly concerning and warrants immediate medical attention to prevent complications such as myocardial infarction.

Choice C reason:

Varicose veins are not typically associated with valvular dysfunction in the heart. They are more related to issues with the veins in the legs, where the valves that prevent backflow of blood become weakened or damaged. This condition is generally referred to as chronic venous insufficiency and is not directly linked to the heart’s valvular problems.

Choice D reason:

Palpitations, or the sensation of irregular or rapid heartbeats, are common in clients with valvular dysfunction. These can occur due to arrhythmias, which are often seen in conditions like mitral valve prolapse or aortic regurgitation. The irregular heartbeats can be a result of the heart trying to compensate for the inefficient blood flow caused by the faulty valve.

Choice E reason:

Abdominal pain is not a typical manifestation of valvular dysfunction. While severe heart conditions can sometimes lead to generalized symptoms, abdominal pain is more commonly associated with gastrointestinal issues rather than heart valve problems. Therefore, it is not a primary symptom to anticipate in clients with valvular dysfunction.

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing laboratory results and notes that a client has an elevated thyroid-stimulating hormone (TSH) level. Which of the following assessment findings would the nurse expect?

Correct Answer is B

Explanation

A nurse is assessing a client who has valvular dysfunction. Which of the following manifestations should the nurse anticipate? (Select all that apply)

Correct Answer is ["A","B","D"]

Explanation

A nurse is assessing a client who has peripheral venous disease. Which of the following findings should the nurse recognize as a manifestation of venous disease?

A nurse is preparing to administer medications to a client who has pericarditis. Which of the following medications should the nurse anticipate to his client? (Select All that Apply)

A nurse is providing discharge teaching to a client who has heart failure. Which of the following lifestyle modifications should the nurse include in the discharge teaching?

A nurse is providing discharge teaching to a client who has heart failure. Which of the following lifestyle modifications should the nurse include in the discharge teaching?

A nurse is teaching a client who has peripheral venous disease about management of symptoms. Which of the following client statements indicates to the nurse an understanding of the teaching?

A nurse is providing education about insulin management to a client newly diagnosed with type 1 diabetes mellitus. Which of the following statements by the nurse about injection site selection is accurate?

The nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is critically ill. Which of the following lab findings requires immediate intervention?

The nurse is caring for a client with type 1 diabetes mellitus who has been taught the dosage of insulin.