A staff nurse is teaching a client who has secondary hypothyroidism about the disease process. The client asks the nurse what causes secondary hypothyroidism. Which of the following responses should the nurse make?

"It is caused by the overproduction of T3, T4, and calcitonin by the thyroid gland."

"It is caused by the lack of production of adrenocorticotropic hormone by the pituitary gland."

"It is caused by the lack of production of thyroid stimulating hormone by the pituitary gland."

"It is caused by the lack of production of aldosterone by the adrenal gland."

Answer and Explanation

The Correct Answer is C

A. Secondary hypothyroidism is characterized by insufficient production of thyroid hormones (T3 and T4) due to inadequate stimulation from the pituitary gland, not due to overproduction. Overproduction of thyroid hormones would typically be associated with hyperthyroidism, not hypothyroidism.
B. Adrenocorticotropic hormone (ACTH) stimulates the adrenal glands to produce cortisol. A deficiency in ACTH would lead to adrenal insufficiency or Addison's disease, not secondary hypothyroidism.
Secondary hypothyroidism specifically involves a deficiency in thyroid-stimulating hormone (TSH), not ACTH.
C. Secondary hypothyroidism is caused by inadequate production of thyroid-stimulating hormone (TSH) by the pituitary gland. TSH is necessary for stimulating the thyroid gland to produce thyroid hormones (T3 and T4). When the pituitary gland does not produce enough TSH, the thyroid gland is not adequately stimulated, leading to low levels of thyroid hormones in the blood.
D. Aldosterone is a hormone produced by the adrenal glands that helps regulate sodium and potassium levels, as well as blood pressure. A deficiency in aldosterone is associated with conditions such as
Addison’s disease or primary adrenal insufficiency, not secondary hypothyroidism. Secondary
hypothyroidism specifically relates to issues with TSH production, not aldosterone.

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Correct Answer is C

Explanation

A. Prednisone, a corticosteroid, is more commonly associated with fluid retention rather than fluid volume deficit. Fluid volume deficit would generally be a concern with diuretics or other medications that increase urine output. Prednisone can lead to fluid retention and edema, not a deficit.
B. Prednisone is more likely to cause weight gain rather than weight loss. Corticosteroids can increase appetite and lead to fluid retention, both of which contribute to weight gain. Significant weight loss is not a typical side effect of prednisone.
C. Prednisone and other corticosteroids can cause sodium retention, which can lead to fluid retention and hypertension. Sodium retention is a common side effect of corticosteroids, and it contributes to the fluid retention and potential weight gain associated with these medications.
D. Prednisone can cause thinning of the skin rather than thickening. Long-term use of corticosteroids can lead to skin thinning, increased bruising, and easy tearing of the skin. Thickening of the skin is not a common side effect of prednisone.

A. Continue to monitor the patient B. Silence future alarms C. Place the patient on a non-rebreather mask D. Increase the oxygen to 4 liters per minute

Correct Answer is A

Explanation

A. The client is resting comfortably, denies distress, and has an oxygen saturation of 89% on 2 liters of supplemental oxygen. This is within an acceptable range for many patients with COPD. Given the client's current status, it is appropriate to continue monitoring the oxygen saturation and assess for any changes in condition.
B. While the alarm may be annoying, it is important to keep it active to alert the nurse to any significant changes in the client's oxygen saturation.
C. A non-rebreather mask delivers a higher concentration of oxygen and is typically used in more critical situations. In this case, the client's oxygen saturation is within a safe range, and there is no need to increase the oxygen delivery method.
D. Increasing the oxygen to 4 liters per minute without a clear indication of need could lead to oxygen toxicity, especially in patients with COPD. It is important to titrate oxygen therapy to the lowest level that maintains adequate oxygen saturation.

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A staff nurse is teaching a client who has secondary hypothyroidism about the disease process. The client asks the nurse what causes secondary hypothyroidism. Which of the following responses should the nurse make?

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Explanation

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Explanation

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