A nurse is reviewing laboratory results and notes that a client has an elevated thyroid-stimulating hormone (TSH) level. Which of the following assessment findings would the nurse expect?
Increased thirst, increased urine output, and weight loss
Fatigue, constipation, weight gain
Anxiety, unintended weight loss, palpitations
Shakiness, sweating, nausea
The Correct Answer is B
Choice A reason: Increased Thirst, Increased Urine Output, and Weight Loss
Increased thirst, increased urine output, and weight loss are symptoms commonly associated with diabetes mellitus, particularly uncontrolled diabetes. These symptoms occur due to the body’s attempt to eliminate excess glucose through urine, leading to dehydration and subsequent weight loss. However, these symptoms are not typically associated with elevated TSH levels, which indicate hypothyroidism.
Choice B reason: Fatigue, Constipation, Weight Gain
Fatigue, constipation, and weight gain are classic symptoms of hypothyroidism2. When the thyroid gland is underactive, it produces insufficient thyroid hormones, leading to a slowdown in the body’s metabolism. This results in fatigue, weight gain, and constipation, among other symptoms. Elevated TSH levels are a compensatory response by the pituitary gland to stimulate the thyroid to produce more hormones, confirming hypothyroidism.
Choice C reason: Anxiety, Unintended Weight Loss, Palpitations
Anxiety, unintended weight loss, and palpitations are symptoms typically associated with hyperthyroidism, not hypothyroidism. Hyperthyroidism occurs when the thyroid gland produces excessive thyroid hormones, leading to an accelerated metabolism. This results in symptoms such as weight loss, increased heart rate (palpitations), and anxiety. Elevated TSH levels would not be expected in hyperthyroidism; instead, TSH levels would be low due to negative feedback from high thyroid hormone levels.
Choice D reason: Shakiness, Sweating, Nausea
Shakiness, sweating, and nausea can be symptoms of various conditions, including hypoglycemia (low blood sugar), anxiety, or panic attacks. These symptoms are not specific to thyroid dysfunction and are not typically associated with elevated TSH levels. Hypothyroidism, indicated by high TSH levels, usually presents with symptoms related to a slowed metabolism, such as fatigue and weight gain, rather than shakiness and sweating.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Coronary arteries do not become more elastic with age. Instead, they tend to become less elastic due to the buildup of plaque, a condition known as atherosclerosis. This buildup narrows the arteries and restricts blood flow, which can lead to coronary artery disease (CAD). The heart not receiving enough oxygen is a result of this narrowing, not increased elasticity.
Choice B Reason:
Coronary arteries decrease in diameter due to the buildup of plaque, which consists of fats, cholesterol, and other substances. This narrowing restricts the flow of blood, oxygen, and nutrients to the heart muscle, leading to symptoms such as chest pain (angina) and shortness of breath. This is the primary mechanism behind coronary artery disease.
Choice C Reason:
This choice is essentially a repetition of Choice B and is correct for the same reasons. The narrowing of the coronary arteries due to plaque buildup leads to insufficient blood flow, causing the heart muscle to receive less oxygen and nutrients.
Choice D Reason:
Manifestations of coronary artery disease are not due to the dilation of coronary arteries. Instead, they are due to the narrowing of these arteries. Increased blood flow and pressure are not typical causes of CAD symptoms. The primary issue is the restricted blood flow due to narrowed arteries.
Choice E Reason:
While it is true that the heart and coronary arteries can weaken over time, leading to poor perfusion and angina, this statement does not accurately describe the primary mechanism of coronary artery disease. The main issue in CAD is the narrowing of the arteries due to plaque buildup, which restricts blood flow to the heart muscle.
Correct Answer is C
Explanation
Choice A Reason:
While monitoring the frequency of urination is important for managing diabetes insipidus, it is not the most critical aspect of discharge teaching. Diabetes insipidus causes excessive urination, and patients should be aware of this symptom. However, understanding the importance of wearing a medical alert bracelet is more crucial for ensuring immediate and appropriate care in emergencies.
Choice B Reason:
Changes in appetite are not a primary concern for patients with diabetes insipidus. The condition primarily affects fluid balance and urine output rather than appetite. Therefore, this topic is less relevant compared to the need for a medical alert bracelet.
Choice C Reason:
The benefit of a medical alert bracelet is paramount for patients with diabetes insipidus. In case of an emergency, the bracelet can inform healthcare providers about the patient’s condition, ensuring they receive appropriate and timely treatment. This can be life-saving, especially if the patient is unable to communicate their medical history.
Choice D Reason:
Weight gain or loss can be a secondary concern for patients with diabetes insipidus, as the condition primarily affects fluid balance. While it is important to monitor weight to assess fluid status, it is not as critical as ensuring the patient understands the importance of wearing a medical alert bracelet.
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