On the first postoperative day following a thyroidectomy, a client tolerates a full-fluid diet. This is changed to a soft diet on the second postoperative day. The client reports a sore throat when swallowing. What should the nurse do first?

1. Reorder the full-fluid diet.
2. Notify the primary healthcare provider.
3. Administer analgesics as prescribed before meals.
4. Provide saline gargles to moisten the mucous membranes.

C. Administer analgesics as prescribed before meals

A client is diagnosed with hyperthyroidism and is experiencing exophthalmia. Which measures should the nurse include when teaching this client how to manage the discomfort associated with exophthalmia? Select all the apply

1. Use tinted glasses.
2. Use warm, moist compresses.
3. Elevate the head of the bed 45 degrees.
4. Tape eyelids shut at night if they do not close.
5. Apply a petroleum-based jelly along the lower eyelid.

A. Use tinted glasses.

C. Elevate the head of the bed 45 degrees.

D. Tape eyelids shut at night if they do not close.

A nurse plans to set up emergency equipment at the bedside of a client in the immediate postoperative period after a thyroidectomy. What should the nurse include in the bedside setup?

1. Crash cart with bed board
2. Tracheostomy set and oxygen
3. Ampule of sodium bicarbonate
4. Airway and nonrebreather mask

B. Tracheostomy set and oxygen

A nurse is caring for a client with an underactive thyroid gland. Which responses should the nurse expect the client to exhibit as a result of decreased levels of triiodothyronine (T ₃) and thyroxine (T ₄)? Select all that apply.

1. Irritability
2. Tachycardia
3. Weight gain
4. Cold intolerance
5. Profuse diaphoresis

C. Weight gain

D. Cold intolerance

A nurse is assessing a client with hypothyroidism. Which clinical manifestations should the nurse expect the client to exhibit? Select all that apply.

1. Cool skin
2. Photophobia
3. Constipation
4. Periorbital edema
5. Decreased appetite

A. Cool skin

C. Constipation

D. Periorbital edema

E. Decreased appetite

A client has a history of hypothyroidism. Which skin condition should the nurse expect when performing a physical assessment?

1. Dry
2. Moist
3. Flushed
4. Smooth

A. Dry

A nurse is performing an admission health history and physical assessment of a client. The client’s face is pictured below. Which information is most important to obtain?

1. Heart rate and rhythm
2. Appetite and condition of the skin
3. Respiratory rate and depth of inhalations
4. Intolerance to heat and decrease in weight

A. Heart rate and rhythm

A client is scheduled for an adrenalectomy. What does the nurse expect that the plan of care will include?

1. Low-protein diet
2. Parenteral corticosteroids
3. Preoperative 24-hour urine specimen
4. Withholding all medications 48 hours before surgery

B. Parenteral corticosteroids

After stabilization of an acute adrenal insufficiency (addisonian crisis), intravenous medications are decreased gradually, and the client now is receiving hydrocortisone by mouth. What instruction should the nurse include when performing discharge teaching?

1. Eat a diet high in sodium.
2. Take the medication with food.
3. Maintain the same dose indefinitely.
4. Eliminate a dose if side effects occur.

B. Take the medication with food.

Which does the nurse state is a secondary cause of adrenal insufficiency?

1. Hemorrhage
2. Tuberculosis
3. Pituitary tumors
4. Metastatic cancer

C. Pituitary tumors

What are the cardiovascular manifestations observed in a client with adrenal insufficiency?

1. Fatigue
2. Salt craving
3. Weight loss
4. Hyponatremia

D. Hyponatremia

What are the primary causes of adrenal insufficiency? Select all that apply.

1. Hemorrhage
2. Tuberculosis
3. Pituitary tumors
4. Postpartum pituitary necrosis
5. Acquired immune deficiency syndrome

A. Hemorrhage

B. Tuberculosis

E. Acquired immune deficiency syndrome

Fludrocortisone is prescribed for a client with adrenal insufficiency. Which responses to the medication should the nurse teach the client to report? Select all that apply.

1. Edema
2. Rapid weight gain
3. Fatigue in the afternoon
4. Unpredictable changes in mood
5. Increased frequency of urination

A. Edema

B. Rapid weight gain

Which clinical manifestation occurs in a client with adrenal insufficiency?

1. Vitiligo
2. Moon face
3. Hypertension
4. Truncal obesity

A. Vitiligo

What is the cause of this condition in the client?

1. Hypofunction of adrenal gland
2. Hyperfunction of adrenal gland
3. Hypofunction of pituitary gland
4. Hyperfunction of pituitary gland

A. Hypofunction of adrenal gland

The nurse is reviewing the laboratory reports of four clients. Which client is likely to have hyperfunction of the adrenal gland?

1. Client 1 – Na-136 mEq/L; Ca-5.1 mg/dL; BiCarb-25 mEq/L; Cortisol-10 mg/dL
2. Client 2 – Na-130 mEq/L; Ca-6.1 mg/dL; BiCarb-33 mEq/L; Cortisol-2 mg/dL
3. Client 3 – Na-150 mEq/L; Ca-3.9 mg/dL; BiCarb-20 mEq/L; Cortisol-15 mg/dL
4. Client 4- Na-130 mEq/L; Ca-6.1 mg/dL; BiCarb-20 mEq/L; Cortisol-15 mg/dL

C. Client 3 – Na-150 mEq/L; Ca-3.9 mg/dL; BiCarb-20 mEq/L; Cortisol-15 mg/dL

The blood reports of a client suggest hyperfunctioning of the adrenal glands. Which finding supports the diagnosis?

1. Serum sodium of 130 mEq/L (130 mmol/L)
2. Serum bicarbonate of 24 mEq/L (24 mmol/L)
3. Blood urea nitrogen of 12 mg/dL (4.29 mmol/L)
4. Serum potassium of 2.8 mEq/L (2.8 mmol/L)

D. Serum potassium of 2.8 mEq/L (2.8 mmol/L)

Which glands secrete hormones that regulate metabolism of carbohydrates, proteins, and fats? Select all that apply.

1. Pancreas
2. Thyroid gland
3. Adrenal cortex
4. Adrenal medulla
5. Parathyroid gland

A. Pancreas

B. Thyroid gland

C. Adrenal cortex

Which laboratory value may indicate hyperfunction of the adrenal gland in a client?

1. Sodium: 143 mEq/L
2. Potassium: 2.9 mEq/L
3. Bicarbonate: 25 mEq/L
4. Total calcium: 10 mg/dL

B. Potassium: 2.9 mEq/L

What is the most probable cause for Conn’s syndrome in an adult client?

1. Genetic cause
2. Adrenal adenoma
3. High level of angiotensin II
4. Elevated level of plasma rennin

B. Adrenal adenoma