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29837138-nursing-exam-review-Chapter-45

29837138-nursing-exam-review-Chapter-45 - Chapter 45...

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Chapter 45: Thyroid and Parathyroid Disorders MULTIPLE CHOICE 1. A young woman makes an appointment to see a physician at the clinic. She complains of tiredness, weight gain, muscle aches and pains, and constipation. The physician will likely order: 1. T 3 and T 4 serum level laboratory tests. 2. glucose tolerance test. 3. cerebral computed tomography (CT) scan. 4. adrenocortical stimulating test. ANS: 1 These complaints are strongly suggestive of thyroid disorder; T 3 and T 4 laboratory tests are the most useful diagnostic tests. PTS: 1 DIF: Cognitive Level: Knowledge REF: 981, Diagnostic Tests and Procedures table OBJ: 2 TOP: Thyroid Diagnostic Tests KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance 2. An older woman comes to the office with vague complaints of fatigue, lethargy, being forgetful, lacking energy, and always being cold. She apologizes for taking up the clinic’s time, because her problems don’t seem too severe. The best response would be: 1. “The symptoms are probably just due to the aging process.” 2. “Many people your age are worried about Alzheimer’s disease.” 3. “You are right to report any changes. We need to know that so that we can give you the best care.” 4. “You have good insurance, and so it’s good of you to come to the office.” ANS: 3 It is important to recognize symptoms in older adults and not ascribe signs and symptoms to the aging process. Older women are especially prone to hypothyroidism. PTS: 1 DIF: Cognitive Level: Application REF: 979 OBJ: 1 TOP: Thyroid Disorder Assessment KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 3. The hyperthyroid patient complains of fatigue, but still cannot get to sleep. The nurse suggests: 1. taking “cat naps” during the day. 2. adhering to a bedtime ritual. 3. drinking a cup of cocoa before bedtime. 4. mild pre-bedtime exercising. ANS: 2
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Bedtime rituals like a warm bath, reading, listening to music cue the body for sleep. Naps during the day may make night time sleep difficult, exercising and drinking caffeine filled drinks are stimulating and should be avoided by the person with insomnia. PTS: 1 DIF: Cognitive Level: Knowledge REF: 985 OBJ: 3 TOP: Hyperthyroidism Insomnia KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 4. A thyroid scan ( 123 I) has been ordered for the patient. The nurse explains it as: 1. “A blood test measures hormones circulating in the bloodstream.” 2. “A small needle will be used to remove a tissue sample that will be examined by a cytopathologist.” 3. “It is painless and noninvasive. An instrument is moved over the neck area and sound waves will create an image of the gland.” 4. “You will be given a liquid to drink, and then a few hours later, they will take images of your neck.” ANS: 4 It is essential to teach the patient the procedures that will be performed in order to gain his cooperation and understanding. It is his right.
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