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 B

Explanation

A. A pneumothorax, or collapsed lung, occurs when air enters the pleural space, leading to lung collapse. While a pneumothorax can be a serious issue, it is not a typical finding associated with advanced COPD.
B. Hyperinflation is a hallmark finding of advanced COPD. It occurs when air becomes trapped in the lungs due to obstructed airways and damaged alveoli, leading to increased lung volumes and overexpansion of the lungs. On a chest X-ray, hyperinflation appears as an increased retrosternal air space, flattened diaphragm, and possibly increased lung volumes.
C. The presence of masses on a chest X-ray might suggest malignancies or other lung pathologies, but it is not a typical finding in COPD. While lung cancer can co-occur with COPD, masses themselves are not a direct indicator of COPD but rather a potential separate issue that would need further evaluation.
D. Atelectasis refers to the collapse of lung tissue due to loss of air in the alveoli, which can occur from various causes including obstruction or compression of the lung. While atelectasis can be seen in various pulmonary conditions, it is not specific to advanced COPD.

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

Correct Answer is C

Explanation

A. This would indicate adrenal insufficiency, not Cushing syndrome.
B. Elevated adrenocorticotropic hormone (ACTH) and elevated cortisol would indicate Cushing syndrome caused by pituitary adenoma, not adrenal gland hyperplasia.
C. Low adrenocorticotropic hormone (ACTH) and elevated cortisol is consistent with Cushing syndrome caused by adrenal gland hyperplasia. In this condition, the adrenal glands produce excess cortisol independently of ACTH stimulation.
D. Elevated adrenocorticotropic hormone (ACTH) and low cortisol would indicate adrenal insufficiency, not Cushing syndrome.

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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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Correct Answer is C

Explanation

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