Question 1

The nurse is providing education to a client with a parathyroid disorder about the function of parathyroid hormone (PTH) in the body. Which statements will the nurse include in the teaching? Select all that apply.

Accepted Answer

A)   "PTH decreases intestinal calcium resorption."
B)   "PTH increases renal calcium resorption."
C)   "PTH promotes the release of calcium from the bone."
D)   "PTH directly affects calcium resorption in the small bowel."
E)   "PTH stimulates the production of vitamin D metabolite 1,25-(OH) 2D." B, C, E

Question 2

The nurse is providing education to a client about the most common causes of goiters. Which causative factor will the nurse review in the teaching?

Accepted Answer

A)   Thyroiditis
B)   Tumors
C)   Iodine deficiency
D)   Infiltrative disease C

Question 3

The nurse is teaching a community health class about thyroid disorders. Which statement about the prevalence of thyroid disorders will the nurse include in the teaching? Select all that apply.

Accepted Answer

A)   "An estimated 20 million people in the United States have some form of thyroid disease."
B)   "Women are 5-8 times more likely than men to have thyroid problems."
C)   "About one third of people who have thyroid disorders are asymptomatic."
D)   "One woman in eight will develop a thyroid disorder before the age of 18."
E)   "Up to 60% of people with thyroid disease are unaware of their condition." A, B, E

Question 4

The nurse is performing an assessment on a client with Graves disease. Which assessment manifestation does the nurse expect to assess?

Accepted Answer

A)   Dry, cold skin
B)   Orbital tissue inflammation
C)   Hair loss
D)   Weight gain

Question 5

The nurse is caring for a client diagnosed with hyperparathyroidism. Which potential causes does the nurse identify for this condition? Select all that apply.

Accepted Answer

A)   Adenomas
B)   Hypercalcemia
C)   Hypothyroidism
D)   Hyperplasia
E)   Chronic kidney disease

Question 6

The nurse is providing education about prenatal nutrition to a client who is 25 weeks pregnant. Which nutrient will the nurse review as being critical for maternal and fetal euthyroidism?

Accepted Answer

A)   Calcium
B)   Vitamin D
C)   Folic acid
D)   Iodine

Question 7

The nurse is assessing a client with primary hyperparathyroidism. Which signs and symptoms will the nurse anticipate to assess? Select all that apply.

Accepted Answer

A)   Exophthalmos
B)   Weakness
C)   Fatigue
D)   Depression
E)   Neuropathy

Question 8

The nurse is reviewing a client's medication and learns that the client has been taking prednisone. What is the nurse's understanding of the effect of prednisone on the adrenal glands?

Accepted Answer

A)   Prednisone therapy results in destruction of the adrenal medulla, thereby decreasing corticotropin releasing hormone.
B)   Prednisone therapy can lead to significant toxicity, resulting in dehydration, fever, and hyponatremia.
C)   Prednisone therapy increases cortisol and decreases adrenocorticotropic hormone via negative feedback principles.
D)   Prednisone therapy increases sodium and water resorption and potassium and hydrogen excretion.

Question 9

The nurse is assessing a client diagnosed with Cushing disease. Which findings are consistent with the client's diagnosis?

Accepted Answer

A)   Round, red face
B)   Buffalo hump
C)   Bruising
D)   Poor wound healing
E)   Hyperactivity

Question 10

The nurse is reviewing the mechanism of goiter development in a client with nontoxic multinodular goiters. Which statement best describes this process?

Accepted Answer

A)   Thyroid enlargement occurs due to several growth factors, in addition to thyroid stimulating hormone (TSH) , that cause some thyroid follicles to proliferate more than others.
B)   Overall thyroid enlargement occurs without associated hypo- or hyperthyroidism, and is not induced by cysts, inflammation, or neoplasia.
C)   Iodine deficiency causes some thyroid follicles to grow more quickly than to others, resulting in nodular changes and sequelae.
D)   TSH receptor antibodies (TRAb)  stimulate the TSH receptor to cause thyroid growth, goiter formation, and excessive secretion of thyroid hormones.

Question 11

The nurse is caring for a client with a disorder of the endocrine system. The nurse understands that the endocrine system regulates which functions? Select all that apply.

Accepted Answer

A)   Cognition
B)   Growth
C)   Reproduction
D)   Metabolism
E)   Fluid and electrolyte balance

Question 12

The nurse is reviewing the past medical history of a client diagnosed with Hashimoto thyroiditis. Which conditions does the nurse understand to be caused by thyroiditis? Select all that apply.

Accepted Answer

A)   Fatigue
B)   Weight gain
C)   Laryngitis
D)   Bacterial infection
E)   Constipation

Question 13

The nurse is caring for a client about to undergo treatment for hyperparathyroidism. Which priority intervention can the nurse anticipate while caring for this client?

Accepted Answer

A)   Educating the client regarding medication adherence
B)   Supporting the management of the client's symptoms
C)   Recommending self-care and exercise techniques
D)   Reviewing pre- and post-operative instructions

Question 14

While the nurse is collecting the client's personal history, the client states, "I've been taking prednisone for years and I hate it. I am stopping it today." How will the nurse respond?

Accepted Answer

A)   "Continuing with therapy is a personal choice."
B)   "You may no longer experience the benefits of treatment."
C)   "The side effects of prednisone are difficult for you."
D)   "Discontinuing treatment suddenly is extremely dangerous."

Question 15

The nurse is caring for a client with a hormone imbalance. Which manifestations does the nurse attribute to this condition? Select all that apply.

Accepted Answer

A)   Hypertension
B)   Anxiety
C)   Weight gain
D)   Fluid retention
E)   Contusion

Question 16

The nurse is performing an abdominal assessment on a client. The nurse understands that which endocrine gland is located in the abdomen?

Accepted Answer

A)   Pituitary
B)   Pancreas
C)   Liver
D)   Kidneys

Question 17

The nurse is reviewing the function of the thyroid with a client who has abnormal calcitonin levels. Which statement will the nurse include in the teaching?

Accepted Answer

A)   "Special cells within the thyroid secrete calcitonin."
B)   "Special cells with the thyroid absorb calcitonin."
C)   "Calcitonin is converted to a different hormone within the thyroid."
D)   "Calcitonin acts as a catalyst within the thyroid for chemical reactions."

Question 18

The nurse is providing education for a client with adrenal insufficiency about the anatomy and function of the adrenal glands. Which statements will the nurse include in the material? Select all that apply.

Accepted Answer

A)   "The outer layer of the adrenal gland is referred to as the zona reticularis."
B)   "The adrenal gland's inner layer is responsible for the production of adrenaline."
C)   "The adrenal cortex layers include the zona glomerulosa, zona fasciculata, and zona reticularis."
D)   "The zona glomerulosa is responsible for the production of aldosterone."
E)   "The adrenal gland produces cortisol, which increases gluconeogenesis."

Question 19

During a head and neck assessment, the nurse notes that the client's neck is enlarged, which is later confirmed to be due to a goiter. The client's serum thyroid levels are within normal limits. Which type of goiter does the nurse suspect?

Accepted Answer

A)   Toxic multinodular goiter
B)   Endemic goiter
C)   Nontoxic diffuse goiter
D)   Chronic autoimmune thyroiditis

Question 20

The nurse is caring for a client with thyroid dysfunction. Which statement about the normal function of the thyroid does the nurse know to be true?

Accepted Answer

A)   Thyroid releasing hormone and thyroid stimulating hormone are released by the thyroid.
B)   The functional unit of the thyroid is the thyroid follicle.
C)   Hormone secretion of the thyroid is regulated through positive feedback mechanisms.
D)   Thyroid function is regulated by the hypothalamus and amygdala.

Exam 38: Thyroid, Parathyroid, and Adrenal Disorders