A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus. The nurse determines that teaching has been effective when the client identifies which of the following manifestations of hypoglycemia? (Select all that apply.)

Choice A reason: This test does not detect antithyroid antibodies in your blood. Antithyroid antibodies are proteins that atack the thyroid gland and can cause autoimmune thyroid diseases, such as Hashimoto’s thyroiditis or Graves’ disease. To detect antithyroid antibodies, you need a different blood test called the thyroid peroxidase (TPO) antibody test.

Choice B reason: This test does not measure the amount of thyroid hormone that ataches to a protein in your blood. Thyroid hormone can exist in two forms in the blood: free or bound. Free thyroid hormone is not atached to any protein and can enter the cells and tissues where it is needed. Bound thyroid hormone is atached to a protein called thyroxine-binding globulin (TBG) and cannot enter the cells and tissues. To measure the amount of thyroid hormone that ataches to TBG, you need a different blood test called the total thyroxine (T4) test.

Choice C reason: This test determines whether your thyroid gland is overactive, appropriately active, or underactive. TSH is a hormone produced by the pituitary gland that stimulates the thyroid gland to make and release thyroid hormones, such as thyroxine (T4) and triiodothyronine (T3). These hormones regulate many body functions, such as metabolism, growth, and development. The TSH test measures the amount of TSH in the blood and reflects how well the thyroid gland is working. If the TSH level is high, it means that the thyroid gland is underactive (hypothyroidism) and not making enough thyroid hormones. If the TSH level is low, it means that the thyroid gland is overactive (hyperthyroidism) and making too much thyroid hormones.

Choice D reason: This test does not measure the absorption of iodine and how it relates to the thyroid gland. Iodine is a mineral that is essential for the production of thyroid hormones. The thyroid gland absorbs iodine from the food and water we consume and uses it to make T4 and T3. To measure the absorption of iodine by the thyroid gland, you need a different test called the radioactive iodine uptake (RAIU) test.

Choice A reason: Weight loss is not a symptom of Cushing’s syndrome. On the contrary, weight gain and obesity are common signs of this condition, especially in the trunk, face and upper back1.

Choice B reason: Diaphoresis, or excessive sweating, is not a symptom of Cushing’s syndrome. It can be caused by other conditions, such as hyperthyroidism, menopause or anxiety.

Choice C reason: Hyperpigmentation, or darkening of the skin, is a symptom of Cushing’s syndrome. It occurs due to increased production of melanin, the pigment that gives color to the skin. Hyperpigmentation can affect any part of the body, but it is more noticeable in areas exposed to friction or pressure, such as the elbows, knees, knuckles and armpits.

Choice D reason: Hypotension, or low blood pressure, is not a symptom of Cushing’s syndrome. In fact, high blood pressure (hypertension) is one of the common symptoms of this condition, due to the effects of cortisol on the cardiovascular system.