Edapt Thyroid gland disorders NR507 questions & answers

A young adult female presents with complaints of menstrual irregularities, joint pain, muscle weakness, and swelling in the neck. Assessment findings include exophthalmos and pretibial myxedema. Based on these findings, the nurse practitioner (NP) should complete a focused assessment to learn more about the client's choices related to which of the following?

Physical activity

Dietary intake

Use of vitamin supplements

Daily caffeine consumption

Dietary Intake-looking for increased or decreased iodine intake

Test for primary hypothyroidism

TSH, T3, T4

Common cause of Hypothyroidism

Hashimotos Thyroiditis

Which of the following hormone levels are elevated with primary hypothyroidism

T4, T3

Which of the following statements best describes the mechanism of action of hyperthyroid medications

Decrease synthesis of thyroid hormones

Laboratory testing includes thyroid-stimulating hormone (TSH) levels in combination with thyroxine (T4) and triiodothyronine (T3). ​

A low TSH with an elevated T3 and T4 indicates primary hyperthyroidism.

A high TSH with an elevated T3 and T4 indicates secondary hyperthyroidism.

Which of the following signs or symptoms suggest a diagnosis of hyperthyroidism? Select all that apply.

a-Exophthalmos

b-Weight loss

c-Increased appetite

d-Lack of thirst

e-Decreased urine output

f-Heat intolerance

A,B,C,F

Primary hypothyroidism

Characteristics: Dysfunction is in the thyroid gland, resulting in decreased production of thyroid hormones thyroxine (T4) and triiodothyronine (T3). The pituitary and hypothalamus function correctly, causing increased thyroid-stimulating hormone (TSH) and/or thyroid-releasing hormone (TRH).

Secondary hypothyroidism

Characteristics: Dysfunction is in the pituitary gland or hypothalamus, leading to a decreased stimulation of the thyroid gland and subsequent reduction in thyroid hormone production.

COngenital Hypothyroidism

Characteristics: Infants with congenital hypothyroidism may have low levels of thyroid hormones needed for growth and brain development. Many countries require testing of newborns to identify and treat congenital hypothyroidism early.

In a client with primary hypothyroidism, the anterior pituitary releases , and the thyroid responds by releasing insufficient amounts of thyroid hormone ____________(T3 and T4). The resulting imbalance causes the clinical manifestations of ________and ___________weight gain.

Thyroid-Stimulating Hormone (TSH)

Exopthalmos

poor sleep

An elevated thyroid-stimulating hormone (TSH) level with a low thyroxine (T4) level and a low triiodothyronine (T3) level indicates which of the following conditions?

Hypopituitarism

Hypothalamic tumor

Primary hypothyroidism

Secondary hypothyroidism

Primary Hypothyroidism

Which of the following statements demonstrate realistic client expectations of improvement? Select all that apply.

a-After starting medication, six weeks is the minimum time to expect symptom improvement.

b-If symptoms persist when euthyroid is reached, further medication changes or additions may be needed.

c-Once the thyroid function laboratory tests reach normal, medication can be stopped.

d-After starting medication, laboratory testing will be conducted in one week to check thyroid function.

e-Immediate relief from the symptoms is expected after starting the medication.

A, B

Brynn McDaniel (pronouns she/her/hers), 21 years old, presents with complaints of a 15-pound weight gain over 6 months; increasing fatigue over the same time frame; (case study)

weight up to 130, lethargic, reflexes depressed

Which of the following symptoms are consistent with hypothyroidism?

weight gain, constipation, lack of concentration

Brynns laboratory test results are consistent with

hashimotos, primary hypothyroid

which should be included in Brynns treatment plan

thyroid hormone replacement

Which of the following actions should the nurse practitioner (NP) take to manage Brynn's care? Select all that apply.

Repeat thyroid profile in two (2) weeks

Prescribe propylthiouracil 50 mg one tablet by mouth three times daily

Prescribe levothyroxine 100 mcg one tablet by mouth daily

Schedule for radioactive iodine therapy

Order thyroid panel in six (6) weeks

levothyroxine 100, thyroid panel in 6 weeks

Which of the following statements indicate that more client education is needed? Select all that apply.

a-"I can expect it to take six or more weeks before I'm normal."

b-"When my labs come back normal, I can stop the medication."

c-"I have a problem with my pituitary gland making too much hormone."

d-"My problem started with an autoimmune condition."

e-"I'll be on this medication for life."

B,C

Select the thyroid condition associated with each symptom.

Hyperthyroidism

Palpitations

Heat intolerance

Weight loss

Hypothyroidism

weight gain, cold intolerance, constipation, dry skin

Leads to Hypothyroidism

Thyroid gland removal, Hashimoto's, iodine deficiency

Leads to hyperthyroidism

graves, thyroid adenoma, levothyroxine toxicity