A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following laboratory values?
Free T4
Thyroid stimulating hormone (TSH)
Serum T3
Serum T4
The Correct Answer is B
Choice A reason:
In primary hypothyroidism, the thyroid gland is underactive and does not produce sufficient thyroid hormones, including Free T4. Therefore, we would not expect an elevation of Free T4 in primary hypothyroidism; instead, its levels would typically be low or normal.
Choice B reason:
Thyroid stimulating hormone (TSH) levels are elevated in primary hypothyroidism because the pituitary gland releases more TSH in an attempt to stimulate the thyroid gland to produce more thyroid hormones. This is a compensatory response to the low levels of circulating thyroid hormones, particularly thyroxine (T4).
Choice C reason:
Serum T3 levels may be low or normal in primary hypothyroidism. T3 is the active form of thyroid hormone and is usually converted from T4. If T4 levels are low, T3 levels may also be affected; however, T3 levels are not the primary diagnostic marker for hypothyroidism and do not typically show elevation in this condition.
Choice D reason:
Serum T4 levels are typically low in primary hypothyroidism because the thyroid gland is not producing enough of this hormone. An elevation of serum T4 would not be expected unless the patient is receiving treatment for hypothyroidism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Kernig's sign is associated with meningitis and is not related to the symptoms of tingling sensations that can occur after a subtotal thyroidectomy. This sign is elicited by extending the client's leg at the knee while the hip is flexed, which would not be relevant in this case.
Choice B reason:
Brudzinski's sign is another indicator of meningitis and involves involuntary flexion of the hips and knees when attempting to flex the client's neck. Similar to Kernig's sign, it is not pertinent to the postoperative symptoms of a subtotal thyroidectomy.
Choice C reason:
Chvostek's sign is a clinical sign of existing neuromuscular irritability seen in hypocalcemia, which can occur after thyroid surgery due to accidental removal or damage to the parathyroid glands. Tapping on the facial nerve triggers twitching of the facial muscles, which correlates with the tingling sensations reported by the client.
Choice D reason:
Babinski's sign is used to assess neurological function, particularly of the central nervous system, and is not related to the symptoms of hypocalcemia. It involves stroking the sole of the foot to observe the toes' movements, which would not provide information about the tingling sensations the client is experiencing.
Correct Answer is C
Explanation
Choice A reason:
A personal trainer working with a client who has HIV is at low risk for contracting the virus. HIV is not transmitted through casual contact, sweat, or saliva. The risk would increase only if there were exposure to blood or other body fluids through an open wound or mucous membrane.
Choice B reason:
An occupational therapist working with a client who has HIV also has a low risk of contracting the virus. Similar to a personal trainer, unless there is direct exposure to blood or body fluids, the transmission risk is minimal.
Choice C reason:
A phlebotomist who collects blood from clients who have HIV is at the greatest risk among the listed individuals. Phlebotomists are healthcare professionals who are frequently exposed to blood, which is a bodily fluid that can transmit HIV if proper precautions are not taken.
Choice D reason:
A nurse who collects urine samples is at a lower risk compared to a phlebotomist. HIV is not typically transmitted through urine unless it contains blood. However, the risk is still present if there is exposure to blood-contaminated urine through cuts or mucous membranes.
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