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?
Increased thirst, increased urine output, and weight loss
Fatigue, constipation, weight gain
Anxiety, unintended weight loss, palpitations
Shakiness, sweating, nausea
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A: Fasting blood glucose of 140 mg/dL
A fasting blood glucose level of 140 mg/dL is above the normal range (70-99 mg/dL) but may indicate some improvement in beta cell function if it was previously higher. In type 2 diabetes, beta cells in the pancreas are responsible for producing insulin. When beta cells start to restore their function, they can produce more insulin, which helps lower blood glucose levels. However, a fasting blood glucose level of 140 mg/dL still indicates that the client has diabetes and needs to continue managing their condition.
Choice B: Client reports smoking cessation
Smoking cessation is a positive health behavior and can improve overall health, including cardiovascular health, which is often compromised in individuals with diabetes. However, it does not directly indicate the restoration of beta cell function. Beta cell function is specifically related to the pancreas’s ability to produce insulin, and smoking cessation, while beneficial, does not directly impact this.
Choice C: Weight gain of 5 lb
Weight gain can have various implications for a person with type 2 diabetes. While modest weight gain might indicate improved nutritional status or muscle mass, it does not directly indicate the restoration of beta cell function. In fact, weight gain can sometimes worsen insulin resistance, making it harder for beta cells to function effectively.
Correct Answer is A
Explanation
Choice A Reason:
A history of myocardial infarction (heart attack) and the need for stent placement are significant risk factors for developing atrial flutter. Atrial flutter is often associated with structural heart disease, including coronary artery disease, which can lead to myocardial infarction. The damage to the heart muscle and the changes in the heart’s electrical system following a myocardial infarction can predispose a person to atrial flutter.
Choice B Reason:
While a family history of atrial flutter can indicate a genetic predisposition to arrhythmias, it is not as strong a risk factor as having a history of myocardial infarction and stent placement. Genetic factors can play a role, but they are typically less influential compared to direct cardiac events.
Choice C Reason:
Recovering from an illness that caused vomiting and diarrhea is not a direct risk factor for atrial flutter. These conditions can lead to electrolyte imbalances, which might temporarily affect heart rhythm, but they do not typically cause atrial flutter.
Choice D Reason:
Increased stress can contribute to various health issues, including heart problems, but it is not a primary risk factor for atrial flutter. Chronic stress can exacerbate existing heart conditions, but it is not as significant a risk factor as a history of myocardial infarction.
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