A nurse is caring for a client after a subtotal thyroidectomy. Which of the following manifestations would lead the nurse to suspect that the procedure caused damage to the client's parathyroid glands?

Hypercalcemia and hyperkalemia

Muscle twitching and tingling around the mouth

Harsh, vibratory breath sounds

Hyperthermia and hypertension

Answer and Explanation

The Correct Answer is B

A. Hypercalcemia and hyperkalemia: These are not typical indicators of parathyroid damage. Hypercalcemia usually results from overactive parathyroid glands, while hyperkalemia is not a common result of parathyroid damage.
B. Muscle twitching and tingling around the mouth: These symptoms are indicative of hypoparathyroidism, a condition that can occur if the parathyroid glands are damaged during thyroid surgery. This results in hypocalcemia (low calcium levels), which causes neuromuscular symptoms like muscle twitching and tingling.
C. Harsh, vibratory breath sounds: These are not related to parathyroid damage. They may suggest respiratory issues, not problems with calcium regulation.
D. Hyperthermia and hypertension: These are not associated with parathyroid damage. They may be related to other post-surgical complications but not specifically to parathyroid gland injury.

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Correct Answer is D

Explanation

A. "I will include protein and carbohydrates in every meal": This is appropriate for a client with Graves' disease. A balanced diet with adequate protein and carbohydrates helps meet increased caloric needs due to hypermetabolism.
B. "I will avoid caffeinated beverages": This is a correct statement. Clients with Graves' disease should avoid caffeine as it can exacerbate symptoms like tremors and palpitations.
C. "I will eat a high-fiber diet": This is beneficial for maintaining gastrointestinal health. Hyperthyroidism can cause increased bowel movements, so a high-fiber diet helps prevent diarrhea.
D. "I will eat six full meals per day, with snacks in between": This indicates a need for further teaching. While frequent meals may be needed, "six full meals" can be excessive. Instead, a high-calorie, nutrient-dense diet with smaller, more frequent meals may be recommended to address increased metabolic demands without overloading the digestive system.

A. Elevated adrenocorticotropic hormone (ACTH) and elevated cortisol B. Elevated adrenocorticotropic hormone (ACTH) and low cortisol C. Low adrenocorticotropic hormone (ACTH) and elevated cortisol D. Low adrenocorticotropic hormone (ACTH) and low cortisol

Correct Answer is A

Explanation

A. Elevated adrenocorticotropic hormone (ACTH) and elevated cortisol: In cases of ectopic ACTH syndrome, the tumor produces ACTH, which stimulates the adrenal glands to produce excess cortisol. Therefore, both ACTH and cortisol levels are elevated.
B. Elevated adrenocorticotropic hormone (ACTH) and low cortisol: This scenario is less likely as elevated ACTH typically results in increased cortisol production, not decreased.
C. Low adrenocorticotropic hormone (ACTH) and elevated cortisol: This is characteristic of primary adrenal insufficiency, not ectopic ACTH syndrome, where ACTH levels are usually high.
D. Low adrenocorticotropic hormone (ACTH) and low cortisol: This pattern is inconsistent with Cushing syndrome, especially due to ectopic ACTH-secreting tumors, which typically result in elevated ACTH and cortisol.

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A nurse is caring for a client after a subtotal thyroidectomy. Which of the following manifestations would lead the nurse to suspect that the procedure caused damage to the client's parathyroid glands?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing dietary teaching for a client who has Graves' disease. Which of the following statements made by the client indicates a need for further teaching by the nurse?

Correct Answer is D

Explanation

Correct Answer is A

Explanation

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