HESI Case Studies – Thyroid Disorders

Which disease is the most common type of hyperthyroidism?
Graves disease.
Which factor in Ms. Pool’s history places her at risk for a thyroid problem?
Her age and gender.
Which term should the nurse use when documenting Ms. Pool’s wide-eyed appearance?
Exophthalamos.
Which additional clinical manifestations is Ms. Pool likely to exhibit? (Select all that apply.)
Tachycardia and palpitations.
Diarrhea and weight loss.
Anxiety and fatigue.
Which information in a client’s history represents a contraindication to the use of radioactive iodine?
Shellfish allergy.

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Which intervention should the nurse implement prior to the scan?
Advise the client that antidepressant use will not affect the thyroid scan.
How should the nurse describe the action of the propranolol (Inderal) to Ms. Pool?
Reduces symptoms such as palpitations and nervousness.
How many teaspoons for the medication will the nurse instruct Mrs. Pool to take for each dose of 20 mg?
1
Which instruction should the nurse include when teaching Ms. Pool about the use of PTU?
“Report the onset of a sore throat or fever to the health care provider.”
Which nursing intervention is appropriate for a client receiving RAI?
Encourage the client to drink plenty of fluids.
Before the procedure, the client should be informed of which possible long-term side effect of RAI?
Hypothyroidism.
Which statement is accurate concerning this situation?
Since Ms. Pool is legally competent, she should give her own consent.
Which assessment is most important for the nurse to complete next?
Observe neck dressing.
Which assessment finding would indicate the possible onset of thyroid storm?
Tachycardia, fever, and altered mental status.
What additional assessment technique should the nurse perform to assess for hypocalcemia?
Assess for Chvostek’s sign.
Which nursing action should be implemented immediately?
Confirm that a tracheostomy set, suction, and O2 are available at bedside.
The nurse would expect to administer which medication to treat Ms. Pool’s hypocalcemia?
Calcium gluconate.
What is the best response by the nurse?
“It sounds like that was a very frightening experience for you.”
Which response by the nurse would be the most therapeutic?
“You sound very fearful about being able to breathe.”
What is the best client care assignment for the LPN?
A client with hyperthyroidism scheduled for radiation.
Which task should the nurse assign the LPN during this time?
Take and record vital signs on the other three clients.
Which behavior indicates to the nurse that Ms. Pool understands the instructions?
Ms. Pool states that too much medication will cause her to feel like she did before surgery.
Based on the clinical manifestations and lab results, what change in medication should the nurse anticipate?
Increase her dose of levothyroxine.
Which diagnosis might be included in the plan of care?
Decreased cardiac output.
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