Question

A 40-year-old female client has a family history of "thyroid problems" and is being seen by the primary healthcare provider for unintentional weight loss, irritability, and chest discomfort. Her probable diagnosis is hyperthyroidism, which the primary healthcare provider plans to confirm by laboratory testing. What additional physical assessment findings would the nurse expect to be present in this client?Select all that apply.

Answer 1

Correct Answers:

Diaphoresis
Insomnia

Rationale :

💎 Diaphoresis occurs due to increased metabolic activity and heightened sympathetic stimulation in hyperthyroidism, leading to excessive sweating.

💎 Insomnia results from nervous system hyperactivity, making it hard for patients to rest despite fatigue.

💎 Hyperthyroidism elevates the basal metabolic rate, increasing heat production and stimulating the sympathetic nervous system.

💎 These findings align with classic systemic signs of excessive thyroid hormone activity.

💎 Recognizing these early manifestations aids in timely diagnosis and prevents thyroid storm progression.

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Answer 2

Correct Answers:

Decreased urinary output.

Rationale :

🔷 Desmopressin acetate (DDAVP) is a synthetic analog of antidiuretic hormone (ADH), reducing excessive urine production in diabetes insipidus.

🔷 A therapeutic response is a noticeable reduction in polyuria, restoring near-normal urine output.

🔷 By enhancing water reabsorption in the renal tubules, it helps correct fluid balance.

🔷 Monitoring urinary output is essential to evaluate medication effectiveness.

🔷 Adequate treatment prevents dehydration and maintains electrolyte stability.

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Answer 3

Correct Answers:

acetaminophen
propylthiouracil

Rationale :

♦ Used to reduce fever without increasing free thyroid hormone levels, unlike aspirin which can worsen thyrotoxicosis.

♦ Controls hyperthermia, preventing excessive metabolic demand.

♦ Safe for patients with thyroid storm where hepatic metabolism is intact.

♦ Propylthiouracil (PTU)

♦ Inhibits thyroid hormone synthesis and blocks peripheral conversion of T4 to T3.

♦ Essential in acute thyrotoxicosis management to rapidly reduce hormone levels.

♦ Works best in combination with beta-blockers and supportive therapy.

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Answer 4

Correct Answers:

Pendulous Abdomen

Rationale :

✳️ Cushing syndrome causes central obesity due to excess cortisol, leading to fat redistribution.

✳️ This results in a pendulous abdomen with thin extremities.

✳️ Cortisol promotes protein catabolism, causing muscle wasting in the limbs.

✳️ Fat pads often develop in the trunk, neck (buffalo hump), and face (moon face).

✳️ Recognition aids in differentiating Cushing syndrome from other endocrine disorders.

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Answer 5

Correct Answers:

monitoring blood glucose levels.
protecting patients from exposure to infection.

Rationale :

⬖ Monitoring blood glucose levels Hypercortisolism causes glucose intolerance and insulin resistance.

⬖ Frequent checks help adjust diet and therapy to prevent hyperglycemia complications.

⬖ Prevents worsening of Cushing-related diabetes.

⬖ Protecting from infection Excess cortisol suppresses the immune system, increasing infection risk.

⬖ Strict infection control measures are necessary.

⬖ Early detection of infection prevents sepsis in immunocompromised patients.

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Answer 6

Correct Answers:

Maintain a patent airway.

Rationale :

◈ Severe hypothyroidism can lead to myxedema coma, with decreased consciousness and respiratory depression.

◈ The priority is to ensure an open airway for adequate oxygenation.

◈ Hypoventilation can cause CO₂ retention and respiratory acidosis.

◈ Prompt airway management prevents cardiopulmonary arrest.

◈ Other interventions follow after stabilizing breathing and oxygen supply.

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Answer 7

Correct Answers:

Increasing serum sodium levels.

Rationale :

🔹 Addison’s disease is characterized by low cortisol and aldosterone, leading to hyponatremia due to sodium loss. Effective therapy should restore sodium levels toward normal.

🔹 Glucocorticoid and mineralocorticoid replacement therapy helps the kidneys retain sodium, correcting the electrolyte imbalance.

🔹 Monitoring serum sodium is essential to evaluate response to treatment and prevent complications such as hypotension and confusion.

🔹 Improvement in sodium levels indicates that aldosterone replacement is working to enhance sodium reabsorption in the renal tubules.

🔹 Correction of hyponatremia also improves circulatory stability and reduces the risk of adrenal crisis recurrence.

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Answer 8

Correct Answers:

Providing isotonic ﬂuids

Rationale :

💠 In acute adrenal insufficiency, severe hypotension from fluid loss is life-threatening, making volume resuscitation the priority.

💠 Isotonic saline (0.9% NaCl) rapidly expands plasma volume and restores blood pressure.

💠 Fluid therapy also helps correct hyponatremia and supports perfusion until corticosteroid therapy takes effect.

💠 Early aggressive fluid replacement prevents shock progression and organ failure.

💠 Potassium replacement or sodium restriction is not appropriate initially because the urgent problem is circulatory collapse

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Answer 9

Correct Answers:

Polyuria.

Rationale :

✳️ Diabetes insipidus (DI) is caused by inadequate antidiuretic hormone (ADH) or renal resistance to ADH, leading to inability to concentrate urine.

✳️ The hallmark is excessive dilute urine output (polyuria), often exceeding 3–20 liters/day.

✳️ This fluid loss causes polydipsia and risk of dehydration if intake doesn’t match losses.

✳️ Polyuria in DI is accompanied by low urine specific gravity (<1.005) and hypernatremia if fluids are not replaced.

✳️ Fluid overload or edema is not seen; instead, severe dehydration can develop quickly.

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Answer 10

Correct Answers:

2

Rationale :

💎 First, convert mg to mcg because the available tablet strength is in micrograms.

💎 0.25 mg×1000=250 mcg0.25 \, \text{mg} \times 1000 = 250 \, \text{mcg}0.25mg×1000=250mcg

💎 Available tablet strength = 125 mcg per tablet.

💎 Calculate:250 ÷125 =2 Tablets

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Medical Surgery Exam 2

No.

2 :
Desmopressin acetate (DDAVP) is prescribed to a patient for the treatment of diabetes insipidus. The nurse administering the medication monitors the patient for which therapeutic response

3 :
A patient with severe tachycardia. hyperthermia and agitation are admitted for acute thyrotoxicosis (thyroid storm). The nurse will anticipate the need to administer which of the following medications? Select all that apply.

4 :
A patient is being admitted with a diagnosis of Cushing syndrome. Which findings will the nurse expect during the assessment?

5 :
Important nursing intervention(s) when caring for a patient with Cushing syndrome include:

6 :
A nurse assesses a patient with hypothyroidism who is admitted with acute appendicitis. The nurse notes that the patient's level of consciousness has decreased. What action does the nurse perform?

7 :
Which finding indicates to the nurse that the current therapies are eﬀective for patient with acute adrenal insufficiency (Addison's)?

8 :
A 46-year-old female patient presents to the emergency department with acute adrenal insufficiency and the following vital signs: P 118 beats/min, R 18 breaths/min, BP 83/44 mm Hg. pulse oximetry 98%. and T 98.8 F oral. Which nursing intervention is the highest priority for this patient?

9 :
Which clinical manifestation should the nurse anticipate for a patient admitted to the hospital with diabetes insipidus?

10 :
Ordered: Synthroid 0.25 mg po Available: Synthroid 125 mcg tablets. How many tablets should be given? (tablets) :

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Medical Surgery Exam 2

No.

2 : Desmopressin acetate (DDAVP) is prescribed to a patient for the treatment of diabetes insipidus. The nurse administering the medication monitors the patient for which therapeutic response

3 : A patient with severe tachycardia. hyperthermia and agitation are admitted for acute thyrotoxicosis (thyroid storm). The nurse will anticipate the need to administer which of the following medications? Select all that apply.

4 : A patient is being admitted with a diagnosis of Cushing syndrome. Which findings will the nurse expect during the assessment?

5 : Important nursing intervention(s) when caring for a patient with Cushing syndrome include:

6 : A nurse assesses a patient with hypothyroidism who is admitted with acute appendicitis. The nurse notes that the patient's level of consciousness has decreased. What action does the nurse perform?

7 : Which finding indicates to the nurse that the current therapies are eﬀective for patient with acute adrenal insufficiency (Addison's)?

8 : A 46-year-old female patient presents to the emergency department with acute adrenal insufficiency and the following vital signs: P 118 beats/min, R 18 breaths/min, BP 83/44 mm Hg. pulse oximetry 98%. and T 98.8 F oral. Which nursing intervention is the highest priority for this patient?

9 : Which clinical manifestation should the nurse anticipate for a patient admitted to the hospital with diabetes insipidus?

10 : Ordered: Synthroid 0.25 mg po Available: Synthroid 125 mcg tablets. How many tablets should be given? (tablets) :

2 :
Desmopressin acetate (DDAVP) is prescribed to a patient for the treatment of diabetes insipidus. The nurse administering the medication monitors the patient for which therapeutic response

3 :
A patient with severe tachycardia. hyperthermia and agitation are admitted for acute thyrotoxicosis (thyroid storm). The nurse will anticipate the need to administer which of the following medications? Select all that apply.

4 :
A patient is being admitted with a diagnosis of Cushing syndrome. Which findings will the nurse expect during the assessment?

5 :
Important nursing intervention(s) when caring for a patient with Cushing syndrome include:

6 :
A nurse assesses a patient with hypothyroidism who is admitted with acute appendicitis. The nurse notes that the patient's level of consciousness has decreased. What action does the nurse perform?

7 :
Which finding indicates to the nurse that the current therapies are eﬀective for patient with acute adrenal insufficiency (Addison's)?

8 :
A 46-year-old female patient presents to the emergency department with acute adrenal insufficiency and the following vital signs: P 118 beats/min, R 18 breaths/min, BP 83/44 mm Hg. pulse oximetry 98%. and T 98.8 F oral. Which nursing intervention is the highest priority for this patient?

9 :
Which clinical manifestation should the nurse anticipate for a patient admitted to the hospital with diabetes insipidus?

10 :
Ordered: Synthroid 0.25 mg po Available: Synthroid 125 mcg tablets. How many tablets should be given? (tablets) :