An overweight African-American female client with a diagnosis of hypothyroidism asks the nurse why she has begun to gain body weight. Which is the best explanation the Medical Surgical nurse can provide?

"Your metabolism is slowing down."

"You should be exercising for longer periods of time."

"You could be making healthier food choices."

"You are retaining fluid."

Answer and Explanation

The Correct Answer is A

(a) "Your metabolism is slowing down.":

Hypothyroidism leads to a decrease in the production of thyroid hormones, which are critical in regulating metabolism. With lower levels of these hormones, the body's metabolic rate decreases, resulting in reduced calorie burning and subsequent weight gain. This explanation directly addresses the underlying cause of weight gain in hypothyroidism.

(b) "You should be exercising for longer periods of time.":

While exercise is beneficial for overall health and can help manage weight, it does not directly address the reason for weight gain in hypothyroidism. The primary issue is the slowed metabolism due to thyroid hormone deficiency, not a lack of exercise.

Although diet plays a role in weight management, this response does not explain the root cause of weight gain in hypothyroidism. The condition itself slows metabolism, leading to weight gain even if dietary habits remain unchanged.

(d) "You are retaining fluid.":

Fluid retention can occur in hypothyroidism but is not the primary reason for weight gain in this condition. The main cause is a decreased metabolic rate, which leads to the accumulation of body fat. Fluid retention might contribute to some weight gain, but it is not the best explanation in this context.

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Correct Answer is A

Explanation

(a) Liver Disease:

Pitting edema is commonly seen in liver disease, especially in conditions like cirrhosis. Liver disease can lead to hypoalbuminemia, where low levels of albumin in the blood cause fluid to leak into the interstitial spaces, resulting in edema. Additionally, liver disease often leads to portal hypertension, which can also contribute to the development of edema.

(b) Diabetes mellitus:

While diabetes can cause complications such as diabetic nephropathy, which may lead to fluid retention, pitting edema is not a primary symptom directly associated with diabetes mellitus. Diabetic patients may develop edema due to kidney issues, but it is not as directly associated as with liver disease.

End-stage renal disease (ESRD) can indeed cause significant fluid retention and edema, including pitting edema. The kidneys' inability to excrete excess fluid leads to its accumulation in tissues. However, the question seems to point towards liver disease, which directly leads to conditions causing pitting edema.

(d) Colon Cancer:

Colon cancer is not typically associated with pitting edema. While advanced cancer can lead to various complications, including fluid imbalances, it is not a primary cause of pitting edema. Edema related to cancer is often more localized and associated with tumor sites or treatment areas.

A. Soles of the feet B. Oral mucosa C. Ear lobes D. Conjunctivae

Correct Answer is B

Explanation

(a) Soles of the feet:

The soles of the feet are not considered the most reliable indicator of central cyanosis because peripheral areas can be affected by various factors, including temperature and circulation. Changes in color here might not accurately reflect central oxygenation status.

(b) Oral mucosa:

The oral mucosa is the most reliable indicator of central cyanosis because it reflects the oxygenation status of the central circulatory system. Cyanosis in this area indicates a significant drop in arterial oxygen saturation and is a more direct indicator of hypoxemia compared to peripheral sites.

Ear lobes, like the soles of the feet, can be influenced by peripheral circulation and environmental factors. While cyanosis can be observed here, it is not as reliable as central sites like the oral mucosa for assessing systemic oxygenation.

(d) Conjunctivae:

The conjunctivae can show signs of cyanosis, but the oral mucosa is still a more sensitive and reliable indicator for central cyanosis. The oral mucosa provides a clear and consistent site to assess oxygenation in emergency situations.

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An overweight African-American female client with a diagnosis of hypothyroidism asks the nurse why she has begun to gain body weight. Which is the best explanation the Medical Surgical nurse can provide?

Nursing Test Bank

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