NCLEX Medical-Surgical: Endocrine Disorders 3 — Questions and Answers
Question 1: A client with hypothyroidism (myxedema) is at risk for myxedema coma. Which finding is most concerning?
- Heart rate of 88 and warm skin
- Hypothermia, hypotension, and decreased level of consciousness (Correct answer)
- Diarrhea and weight loss
- Restlessness and tachycardia
Correct answer: Hypothermia, hypotension, and decreased level of consciousness
Myxedema coma is marked by hypothermia, hypotension, hypoventilation, and decreased consciousness, requiring emergency care.
Question 2: Which symptom would the nurse expect in a client with hyperthyroidism (Graves' disease)?
- Weight gain and cold intolerance
- Bradycardia and constipation
- Weight loss, heat intolerance, and tachycardia (Correct answer)
- Dry skin and lethargy
Correct answer: Weight loss, heat intolerance, and tachycardia
Excess thyroid hormone speeds metabolism, producing weight loss, heat intolerance, and tachycardia.
Question 3: A client is taking levothyroxine for hypothyroidism. Which instruction is correct?
- Take it at bedtime with a heavy meal
- Take it in the morning on an empty stomach (Correct answer)
- Stop the medication once symptoms improve
- Take it with calcium supplements for absorption
Correct answer: Take it in the morning on an empty stomach
Levothyroxine is best absorbed when taken in the morning on an empty stomach, and it is a lifelong replacement therapy.
Question 4: Thyroid storm is suspected in a postoperative thyroidectomy client. Which finding supports this?
- Temperature 104°F (40°C), tachycardia, and agitation (Correct answer)
- Temperature 96°F (35.5°C) and bradycardia
- Hypotension and lethargy
- Decreased respiratory rate
Correct answer: Temperature 104°F (40°C), tachycardia, and agitation
Thyroid storm is a life-threatening surge of thyroid hormone causing high fever, severe tachycardia, and agitation.
Question 5: After a thyroidectomy, the nurse should keep which equipment at the bedside?
- Chest tube setup
- Tracheostomy tray and oxygen (Correct answer)
- Lumbar puncture kit
- Restraints
Correct answer: Tracheostomy tray and oxygen
Postoperative swelling or bleeding can compress the airway, so a tracheostomy tray and oxygen must be readily available.
Question 6: A nurse assesses a thyroidectomy client for hypocalcemia. Which sign should the nurse check?
- Positive Chvostek's and Trousseau's signs (Correct answer)
- Bounding peripheral pulses
- Hyperactive deep tendon reflex absence
- Flushed dry skin
Correct answer: Positive Chvostek's and Trousseau's signs
Accidental parathyroid injury during thyroidectomy can cause hypocalcemia, evidenced by positive Chvostek's and Trousseau's signs.
Question 7: Which dietary recommendation is appropriate for a client with hyperthyroidism before treatment?
- Low-calorie, low-protein diet
- High-calorie, high-protein diet with frequent meals (Correct answer)
- Restrict all fluids
- Increase caffeine intake for energy
Correct answer: High-calorie, high-protein diet with frequent meals
The hypermetabolic state of hyperthyroidism increases caloric needs, so a high-calorie, high-protein diet is recommended.
NCLEX Medical-Surgical: Endocrine Disorders 3
A client with hypothyroidism (myxedema) is at risk for myxedema coma.
Which finding is most concerning?