Question

A nurse is caring for a client who is 1 day postoperative following a thyroidectomy and reports severe muscle spasms of the lower extremities. Which of the following actions should the nurse take?

Answer 1

Correct Answers:

Verify the most recent calcium level.

Rationale :

🔥Muscle spasms following a thyroidectomy are indicative of hypocalcemia, a complication that may occur due to accidental removal or damage to the parathyroid glands during surgery.

🔥These glands regulate calcium levels through parathyroid hormone (PTH) secretion.

🔥 A drop in calcium can lead to neuromuscular irritability, which presents as muscle spasms, paresthesias, or even tetany.

🔥The most direct and appropriate nursing action is to verify the client's serum calcium level to determine if hypocalcemia is present and requires prompt correction with calcium supplementation.

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Answer 2

Correct Answers:

Regular Insulin

Rationale :

✍️In cases of diabetic ketoacidosis (DKA), the preferred treatment includes administration of regular insulin via IV infusion, as it has a rapid onset and predictable action.

✍️ Regular insulin helps lower blood glucose levels and reduces ketone production by enabling glucose to enter cells.

✍️ Long-acting insulins like glargine or detemir are not appropriate in the acute setting due to their prolonged action and delayed onset.

✍️ Timely IV insulin infusion is critical in reversing ketosis, correcting acidosis, and stabilizing the client.

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Answer 3

Correct Answers:

Lethargy

Rationale :

✍️ Chronic hypothyroidism leads to slowed metabolic processes, resulting in fatigue, lethargy, cold intolerance, weight gain, and bradycardia.

✍️ It is caused by insufficient thyroid hormone production, leading to decreased energy metabolism. Lethargy is a hallmark manifestation that reflects central nervous system slowing.

✍️ Symptoms such as exophthalmos and photophobia are associated with hyperthyroid states like Graves’ disease, not hypothyroidism.

✍️A goiter may also be present but is not as definitive as lethargy in long-standing hypothyroidism.

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Answer 4

Correct Answers:

Client report of numbness in his hands

Rationale :

🔹Hypoparathyroidism results in hypocalcemia due to deficient secretion of parathyroid hormone (PTH), which is critical in calcium regulation.

🔹 Low calcium levels lead to neuromuscular excitability, presenting as numbness or tingling in the hands, feet, and around the mouth.

🔹Other signs include Chvostek’s and Trousseau’s signs, tetany, and muscle cramps.

🔹These symptoms are key diagnostic indicators and must be assessed and treated immediately to prevent complications such as seizures or laryngospasm.

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Answer 5

Correct Answers:

Thyroid stimulating hormone (TSH)
Prolactin
Gonadotropin hormones
Adrenocorticotropic hormone (ACTH)

Rationale :

✅TSH

The anterior pituitary secretes thyroid-stimulating hormone (TSH), which regulates thyroid function.
Surgical removal of the anterior pituitary disrupts this hormone’s secretion, affecting the entire hypothalamic-pituitary-thyroid axis.

✅Prolactin

Produced by the anterior pituitary, prolactin is responsible for milk production and regulation of reproductive hormones.
Surgery in this region can impair lactation and reproductive hormone balance.

✅Gonadotropin hormones (FSH and LH)

These hormones are secreted by the anterior pituitary and control ovarian and testicular function.
Their deficiency can lead to amenorrhea, infertility, and decreased libido.

✅ACTH

Adrenocorticotropic hormone (ACTH) stimulates the adrenal glands to produce cortisol.
Surgical removal of the anterior pituitary can cause secondary adrenal insufficiency, requiring corticosteroid replacement.

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Answer 6

Correct Answers:

Heat intolerance

Rationale :

🔶Thyrotoxicosis, or excessive thyroid hormone levels, results in hypermetabolism.

🔶One of the most characteristic symptoms is heat intolerance, due to the body's increased basal metabolic rate and excessive thermogenesis.

🔶Other signs may include tachycardia, restlessness, weight loss, and sweating.

🔶 Recognition of this symptom helps in identifying levothyroxine overdose or unintentional thyroid hormone excess.

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Answer 7

Correct Answers:

Provide a quiet, low-stimulus environment.

Rationale :

♦️Clients with hyperthyroidism are at risk for developing a thyroid storm, an acute and life-threatening exacerbation of thyrotoxicosis.

♦️ This condition can be triggered by stress, infection, or excessive stimulation.

♦️ Providing a quiet and low-stimulus environment minimizes sympathetic nervous system activation and helps prevent crisis onset.

♦️ Other measures include avoiding aspirin, which can displace thyroid hormones from binding proteins and increase free hormone levels, worsening symptoms.

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Answer 8

Correct Answers:

4

Rationale :

✍️The prescription calls for 0.4 g, which equals 400 mg.

✍️The medication is supplied as 100 mg/5 mL.

To find the volume:

✏️Ordered → 400mg

✏️Available → 100mg

✏️Volume → 5mL

▲Multiply → 400mg ÷ 100mg × 5mL = ×5mL=20mL

Since 1 teaspoon = 5 mL, the client needs:

20 mL ÷ 5mL=

👉4 teaspoons

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Answer 9

Correct Answers:

Maintain optimal blood pressure to prevent kidney damage.
Reduce cholesterol and saturated fat intake.
Enroll in a smoking cessation program,
Increase physical activity.

Rationale :

✍️ Maintain optimal blood pressure

High blood pressure worsens diabetic nephropathy by damaging renal microvasculature. Tight BP control protects kidney function.

✍️ Reduce cholesterol and saturated fat intake

Dyslipidemia accelerates atherosclerosis, increasing cardiovascular and cerebrovascular risks in diabetes.

✍️ Enroll in a smoking cessation program

Smoking contributes to vascular damage and increases risk of complications such as neuropathy and nephropathy.

✍️ Increase physical activity

Regular exercise improves insulin sensitivity, lowers blood glucose, and promotes cardiovascular health.

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Answer 10

Correct Answers:

Check the clients voice every 2 hr.

Rationale :

🔶 Following a thyroidectomy, one of the major complications is injury to the recurrent laryngeal nerve, which may affect the client's voice and airway.

🔶Regular monitoring of the client’s voice for hoarseness, voice changes, or inability to speak can help detect early signs of nerve damage or airway compromise.

🔶This is particularly important in the first 24 hours post-op and hecking the voice assesses for laryngeal edema, which may precede airway obstruction.

🔶 Positioning the head flat or hyperextending the neck is contraindicated as it can strain the surgical site.

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RN ATI Medsurg~Quiz 8

No.

1 : A nurse is caring for a client who is 1 day postoperative following a thyroidectomy and reports severe muscle spasms of the lower extremities. Which of the following actions should the nurse take?

3 : A nurse is caring for a client who has chronic hypothyroidism. For which of the following conditions should the nurse monitor?

4 : A nurse is assessing a client who has hypoparathyroidism. Which of the following findings should the nurse expect?

5 : A patient is scheduled for surgery to remove a tumor of the anterior pituitary. Which hormone should the nurse expect to be affected by this surgery? Select all that apply.

6 : A nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect?

8 : The primary health-care provider prescribes a cough syrup 0.4 g every 4 hours. The dosage strength of the syrup is 100 mg/5 mL. The medication bottle contains a measuring spoon that measures in teaspoons and tablespoons. How many teaspoons will the nurse instruct the client to take?

9 : A nurse is preparing a teaching session about reducing the risk of complications of diabetes mellitus. Which of the following information should the nurse plan to include in the teaching? (Select all that apply.)

10 : A nurse is planning care for a client who is postoperative following a thyroidectomy. Which of the following interventions should the nurse include in the plan?

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