Question

A nurse is reviewing the medical record of a client who has hyperthyroidism (Graves disease). Which of the following serum laboratory findings should the nurse expect to be below the expected reference range?

Answer 1

Correct Answers:

Thyroid stimulating hormone (TSH) level

Rationale :

🟣 TSH is decreased in hyperthyroidism due to negative feedback from high thyroid hormone levels.

🟣 Graves disease leads to excessive secretion of T3 and T4, which suppresses TSH production from the pituitary.

🟣 A low TSH helps distinguish primary hyperthyroidism from other causes of increased metabolism.

🟣 Monitoring TSH is essential in diagnosing and managing thyroid disorders.

🟣 TSH is inversely related to the activity of the thyroid gland—when T3/T4 are high, TSH is low.

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Answer 2

Correct Answers:

“I will feel shaky.”

Rationale :

🟢 Shakiness is one of the earliest and most noticeable symptoms of hypoglycemia.

🟢 It results from the body’s release of adrenaline (epinephrine) in response to low blood sugar.

🟢 Recognizing shakiness helps in early intervention to prevent more severe hypoglycemia.

🟢 Symptoms like sweating, anxiety, and palpitations often accompany shakiness.

🟢 Client education focuses on identifying and treating hypoglycemia quickly

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Answer 3

Correct Answers:

Numbness of the hands

Rationale :

🔵 Hypoparathyroidism causes low parathyroid hormone, leading to hypocalcemia.

🔵 Low calcium increases neuromuscular excitability, resulting in numbness or tingling in the hands and around the mouth.

🔵 Early signs may progress to tetany or muscle cramps if untreated.

🔵 Numbness and tingling are some of the most common and early symptoms of hypocalcemia.

🔵 Identifying these symptoms is essential to prevent severe complications like seizures.

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Answer 4

Correct Answers:

Bradycardia

Rationale :

🟠 Hypothyroidism slows the metabolic rate, leading to a decreased heart rate (bradycardia).

🟠 Clients may also have fatigue, cold intolerance, and weight gain due to low metabolism.

🟠 Bradycardia can contribute to fatigue and exercise intolerance.

🟠 Monitoring vital signs is important for assessing severity and progression.

🟠 Bradycardia is a key distinguishing feature of hypothyroidism compared to hyperthyroidism.

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Answer 5

Correct Answers:

"Unopened vials of insulin should be kept in my refrigerator."

Rationale :

🔴 Insulin is a protein that must be kept at the right temperature to maintain potency.

🔴 Refrigeration helps preserve the effectiveness and sterility of unopened insulin vials.

🔴 Exposure to heat or freezing can damage insulin, making it ineffective.

🔴 Proper storage is part of essential diabetes self-management education.

🔴 Opened vials may be stored at room temperature for a limited time, but unopened vials should stay cold.

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Answer 6

Correct Answers:

A poached egg with sliced tomatoes

Rationale :

🟡 After acute diverticulitis, a low-residue/low-fiber diet is recommended initially.

🟡 Eggs and tomatoes are easy to digest and unlikely to irritate the colon.

🟡 High-fiber foods like beans and broccoli are avoided until the bowel is fully healed.

🟡 A gentle diet supports healing and prevents further irritation or complications.

🟡 Fiber can be gradually reintroduced as recovery progresses.

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Answer 7

Correct Answers:

“My breath may have a fruity odor.”

Rationale :

🟤 Fruity breath odor occurs in diabetic ketoacidosis (DKA), a complication of severe hyperglycemia.

🟤 Ketones produced during fat breakdown are responsible for the fruity smell.

🟤 This sign is an important clinical clue for dangerously high blood sugar.

🟤 Other signs of hyperglycemia include increased thirst, urination, and blurry vision, but fruity breath is distinctive.

🟤 Recognizing this symptom means the client knows when to seek urgent care.

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Answer 8

Correct Answers:

“Maintain stable blood glucose levels.”

Rationale :

🟢 Tight blood glucose control is the primary way to prevent diabetic complications like retinopathy and neuropathy.

🟢 Chronic hyperglycemia damages blood vessels and nerves over time.

🟢 Maintaining stable blood glucose reduces the risk of blindness and nerve pain/loss.

🟢 Consistent monitoring and medication adherence are essential for control.

🟢 All other strategies depend on first achieving good glycemic control.

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Answer 9

Correct Answers:

“This test determines whether your thyroid gland is overactive, appropriately active, or underactive.”

Rationale :

🟠 TSH is a key screening test for thyroid disorders.

🟠 High TSH usually means hypothyroidism; low TSH suggests hyperthyroidism.

🟠 The test shows if the thyroid is functioning correctly in response to pituitary signaling.

🟠 Understanding TSH helps patients grasp why further testing or medication may be needed.

🟠 It helps direct treatment decisions for thyroid hormone replacement or suppression.

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Answer 10

Correct Answers:

“I should avoid injecting insulin into my thigh if I am going to go running.”

Rationale :

🔵 Injecting insulin into a muscle group that will be exercised soon after increases absorption rate.

🔵 This can cause unexpected hypoglycemia during or after exercise.

🔵 Clients are taught to use alternate sites, like the abdomen, before exercising the legs.

🔵 Understanding site rotation and timing helps prevent exercise-related lows.

🔵 Safe exercise habits are essential for diabetes self-management and safety

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QLexNursing

1 :
A nurse is reviewing the medical record of a client who has hyperthyroidism (Graves disease). Which of the following serum laboratory findings should the nurse expect to be below the expected reference range?

2 :
A nurse is reinforcing teaching with a client who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?

3 :
A nurse is collecting data from a client who has hypoparathyroidism. Which of the following findings should the nurse expect?

4 :
A nurse in a provider’s office is collecting data from a client who has hypothyroidism. Which of the following findings should the nurse expect?

5 :
A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for lispro and Lantus insulins. Which of the following statements by the client indicates an understanding of the teaching?

6 :
A nurse is assisting with menu selections for a client who has recovered from the acute phase of diverticulitis. Which of the following foods should the nurse recommend?

7 :
A nurse is reinforcing teaching about the manifestations of hyperglycemia with a client who has diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

8 :
A nurse is reinforcing teaching about preventing long-term complications of retinopathy and neuropathy with an older adult client who has diabetes mellitus. Which of the following actions is the most important for the nurse to include in the teaching?

9 :
A nurse is reinforcing teaching with a client who is scheduled for a blood test to measure her thyroid stimulating hormone (TSH) level. Which of the following statements should the nurse give?

10 :
A nurse is reinforcing teaching about exercise with a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

QLexNursing

1 : A nurse is reviewing the medical record of a client who has hyperthyroidism (Graves disease). Which of the following serum laboratory findings should the nurse expect to be below the expected reference range?

2 : A nurse is reinforcing teaching with a client who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?

3 : A nurse is collecting data from a client who has hypoparathyroidism. Which of the following findings should the nurse expect?

4 : A nurse in a provider’s office is collecting data from a client who has hypothyroidism. Which of the following findings should the nurse expect?

5 : A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for lispro and Lantus insulins. Which of the following statements by the client indicates an understanding of the teaching?

6 : A nurse is assisting with menu selections for a client who has recovered from the acute phase of diverticulitis. Which of the following foods should the nurse recommend?

7 : A nurse is reinforcing teaching about the manifestations of hyperglycemia with a client who has diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

8 : A nurse is reinforcing teaching about preventing long-term complications of retinopathy and neuropathy with an older adult client who has diabetes mellitus. Which of the following actions is the most important for the nurse to include in the teaching?

9 : A nurse is reinforcing teaching with a client who is scheduled for a blood test to measure her thyroid stimulating hormone (TSH) level. Which of the following statements should the nurse give?

10 : A nurse is reinforcing teaching about exercise with a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

1 :
A nurse is reviewing the medical record of a client who has hyperthyroidism (Graves disease). Which of the following serum laboratory findings should the nurse expect to be below the expected reference range?

2 :
A nurse is reinforcing teaching with a client who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?

3 :
A nurse is collecting data from a client who has hypoparathyroidism. Which of the following findings should the nurse expect?

4 :
A nurse in a provider’s office is collecting data from a client who has hypothyroidism. Which of the following findings should the nurse expect?

5 :
A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for lispro and Lantus insulins. Which of the following statements by the client indicates an understanding of the teaching?

6 :
A nurse is assisting with menu selections for a client who has recovered from the acute phase of diverticulitis. Which of the following foods should the nurse recommend?

7 :
A nurse is reinforcing teaching about the manifestations of hyperglycemia with a client who has diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

8 :
A nurse is reinforcing teaching about preventing long-term complications of retinopathy and neuropathy with an older adult client who has diabetes mellitus. Which of the following actions is the most important for the nurse to include in the teaching?

9 :
A nurse is reinforcing teaching with a client who is scheduled for a blood test to measure her thyroid stimulating hormone (TSH) level. Which of the following statements should the nurse give?

10 :
A nurse is reinforcing teaching about exercise with a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?