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 B
Explanation
Choice A Reason:
While performing range of motion exercises is important for maintaining joint function and preventing stiffness, it is not the first action a nurse should take. Range of motion exercises should only be performed after ensuring that there is no compromise in circulation or nerve function.
Choice B Reason:
Checking capillary refill is the correct first action. This quick test assesses the blood flow to the extremity and can indicate if there is any vascular obstruction. A delayed capillary refill time, which is more than 2 seconds, could signify compromised circulation and necessitate immediate intervention.
Choice C Reason:
Discussing cast care is important for client education and preventing complications such as skin breakdown and infection. However, it is not the first priority. The nurse should first ensure the client's physiological stability before providing education.
Choice D Reason:
Managing pain is a critical component of nursing care, especially for clients with fractures. However, the assessment of circulation takes precedence over pain management. Once it is established that there is no immediate threat to the limb's viability, pain management should be addressed promptly.
Correct Answer is D
Explanation
Choice A reason:
While a blood glucose level of 120 mg/dL is slightly above the normal range, it is not typically considered an emergency for a client with type 2 diabetes mellitus. This client would require monitoring and potential adjustment of their diabetes management plan, but it does not necessitate immediate assessment.
Choice B reason:
For a client with diabetes insipidus, an intake of 1,500 mL and an output of 1,600 mL in 24 hours is within expected parameters, considering the condition's characteristic polyuria and polydipsia. This client would need ongoing monitoring to maintain fluid balance but is not the highest priority for immediate assessment.
Choice C reason:
A heart rate of 100/min and tremors in a client with Graves' disease could indicate that their condition is not well-controlled. However, these symptoms are not as acutely concerning as those of a stroke and would be addressed after more urgent needs are met.
Choice D reason:
A client who has had a left-sided stroke and reports a severe headache and confusion is exhibiting signs of a possible acute neurological change or complication, such as increased intracranial pressure or hemorrhage. This client requires immediate assessment and intervention due to the potential for rapid deterioration and life-threatening complications.
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