Parathyroid NCLEX style questions

A nurse is assessing a client with suspected hyperthyroidism. Which clinical manifestation is most consistent with this condition?

Heat intolerance

Rationale: Heat intolerance is due to increased metabolic activity. Weight loss, tachycardia, and warm, diaphoretic skin are also associated with hyperthyroidism.

A patient with Graves disease reports vision problems. What condition should the nurse suspect?

Exophthalmos

Rationale: Exophthalmos, or protrusion of the eyeballs, is common in Graves disease due to fat deposits and fluid in the orbital tissue.

A client with hyperthyroidism is prescribed propranolol. What is the primary purpose of this medication?

Decrease symptoms of sympathetic stimulation

Rationale: Propranolol, a beta-blocker, reduces symptoms like tachycardia and hypertension caused by excessive thyroid hormone.

What lab result would the nurse expect in a client with hyperthyroidism?

Low TSH, elevated free T4

Rationale: TSH is suppressed due to the feedback mechanism, and T3/T4 levels are elevated in hyperthyroidism.

A nurse is caring for a client with severe hypothyroidism. Which assessment finding is most concerning?

Hypotension and hypoventilation

Rationale: These findings suggest myxedema coma, a medical emergency requiring immediate intervention.

A client is diagnosed with Hashimoto’s thyroiditis. Which lab finding supports this diagnosis?

Positive thyroid antibodies

Rationale: Hashimoto's is an autoimmune condition, often confirmed by detecting thyroid antibodies.

Which dietary advice is most appropriate for a client with hypothyroidism?

Avoid soy products and tofu

Rationale: Soy products can interfere with thyroid hormone absorption. Increasing iodine is not needed unless deficiency is the cause.

Which intervention is priority for a client experiencing thyroid storm?

Administer propranolol

Rationale: Reducing cardiac stimulation is a priority. Cooling measures and IV fluids are also essential but secondary.

A client has undergone a subtotal thyroidectomy. Which finding requires immediate intervention?

Numbness and tingling around the mouth

Rationale: This indicates hypocalcemia, a complication from accidental removal of parathyroid glands.

Post-thyroidectomy, which item is essential to have at the bedside?

Tracheostomy kit

Rationale: Swelling or hematoma could obstruct the airway, requiring immediate tracheostomy.

Which complication is associated with hyperparathyroidism?

Osteoporosis

Rationale: Excess PTH leads to calcium resorption from bones, resulting in osteoporosis.

A client with hyperparathyroidism is prescribed alendronate (Fosamax). What is the expected effect?

Inhibit bone resorption

Rationale: Alendronate, a bisphosphonate, prevents bone breakdown by reducing osteoclast activity.

Which sign is indicative of hypocalcemia in hypoparathyroidism?

Trousseaus sign

Rationale: Trousseaus sign is carpal spasm induced by a BP cuff, indicating hypocalcemia.

A client with hypoparathyroidism is prescribed calcium gluconate. Which precaution is most important?

Use a cardiac monitor during administration

Rationale: Rapid infusion of calcium gluconate can cause cardiac arrhythmias; monitoring is essential.

A client is admitted with suspected hypoparathyroidism. Which dietary recommendation is most appropriate?

High-calcium, low-phosphorus diet

Rationale: Increasing calcium and reducing phosphorus supports calcium homeostasis in hypoparathyroidism.

A nurse is caring for a client with a large goiter. Which symptom would indicate tracheal compression?

Hoarseness and difficulty swallowing

Rationale: A large goiter can compress the trachea or esophagus, causing hoarseness, dysphagia, or respiratory distress.

Which food should a client with hypothyroidism avoid?

Broccoli and cauliflower

Rationale: Cruciferous vegetables, such as broccoli and cauliflower, are goitrogens and can interfere with thyroid function.

A client is prescribed levothyroxine for hypothyroidism. What should the nurse include in the teaching?

Avoid calcium and iron supplements within 4 hours of taking the medication.

Rationale: Calcium and iron interfere with the absorption of levothyroxine. It is best taken on an empty stomach in the morning.

A client with hyperthyroidism is being prepared for radioactive iodine therapy (RAI). Which statement by the nurse is correct?

You may develop hypothyroidism after this therapy

Rationale: RAI often results in hypothyroidism due to the destruction of thyroid tissue.

Which finding suggests thyrotoxicosis in a client with hyperthyroidism?

Restlessness and confusion

Rationale: Thyrotoxicosis, or thyroid storm, presents with symptoms of extreme metabolic activity, including restlessness, confusion, tachycardia, and hyperthermia.

A client is recovering from a parathyroidectomy. Which lab value requires immediate attention?

Calcium 6.8 mg/dL

Rationale: This calcium level indicates hypocalcemia, which may lead to tetany and requires immediate intervention.

A client with chronic kidney disease is diagnosed with secondary hyperparathyroidism. What is the primary cause of this condition?

Increased phosphate levels

Rationale: Chronic kidney disease leads to hyperphosphatemia, which triggers PTH release as a compensatory mechanism.

A nurse is teaching a client with hypoparathyroidism about diet. Which food should the client avoid?

Spinach

Rationale: Spinach contains oxalic acid, which binds calcium and reduces its absorption.

A nurse is assessing for signs of hypocalcemia. Which test result confirms tetany?

Positive Trousseaus sign

Rationale: Trousseaus sign (carpal spasm when inflating a blood pressure cuff) is a classic indicator of hypocalcemia and tetany.

A client with hypocalcemia is receiving IV calcium gluconate. The nurse observes bradycardia and hypotension. What should the nurse do first?

Stop the infusion immediately.

Rationale: Bradycardia and hypotension are signs of calcium toxicity. The infusion must be stopped to prevent cardiac complications.