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

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A Reason:

Hypokalemia, or low potassium levels, is not a direct cause of central diabetes insipidus. Central diabetes insipidus is primarily related to issues with the production or release of antidiuretic hormone (ADH) from the hypothalamus or pituitary gland. Hypokalemia can affect kidney function but does not typically cause central diabetes insipidus.

Choice B Reason:

Surgery, particularly brain surgery, can cause central diabetes insipidus by damaging the hypothalamus or pituitary gland. These structures are crucial for the production and release of ADH, which regulates water balance in the body. Damage to these areas during surgery can lead to a deficiency in ADH, resulting in central diabetes insipidus.

Choice C Reason:

Renal failure is not a cause of central diabetes insipidus. While renal failure affects the kidneys’ ability to filter waste and balance fluids, central diabetes insipidus is related to a deficiency in ADH production or release. Renal failure can lead to other types of diabetes insipidus, such as nephrogenic diabetes insipidus, where the kidneys do not respond properly to ADH.

Choice D Reason:

Sickle cell disease is not a direct cause of central diabetes insipidus. Sickle cell disease primarily affects red blood cells and can lead to various complications, including kidney damage. However, it does not typically cause central diabetes insipidus, which is related to issues with ADH production or release.

A. Synchronized electrical cardioversion B. Heart catheterization with percutaneous intervention C. Cardiac resynchronization therapy (CRT) D. Echocardiogram

Correct Answer is C

Explanation

Choice A reason: Synchronized Electrical Cardioversion

Synchronized electrical cardioversion is a procedure that uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle to restore a normal heart rhythm. It is typically used to treat certain types of arrhythmias, such as atrial fibrillation, atrial flutter, and supraventricular tachycardia. However, it is not the primary treatment for heart failure with arrhythmias. This procedure is more suited for acute management of arrhythmias rather than long-term regulation of heart rhythm in heart failure patients.

Choice B reason: Heart Catheterization with Percutaneous Intervention

Heart catheterization with percutaneous intervention, also known as percutaneous coronary intervention (PCI), involves using a catheter to open up blocked coronary arteries. This procedure is primarily used to treat coronary artery disease and improve blood flow to the heart muscle. While it can alleviate symptoms of heart disease and prevent heart attacks, it does not directly address the issue of arrhythmias associated with heart failure. Therefore, it is not the most appropriate choice for regulating heart rhythm in this context.

Choice C reason: Cardiac Resynchronization Therapy (CRT)

Cardiac resynchronization therapy (CRT) is a specialized treatment for heart failure patients who have developed arrhythmias. CRT involves implanting a device called a biventricular pacemaker, which sends electrical signals to both the left and right ventricles to help them contract in a more synchronized manner. This improves the efficiency of the heart’s pumping action and can significantly alleviate symptoms of heart failure, such as shortness of breath and fatigue. CRT is particularly beneficial for patients with moderate to severe heart failure and those whose heart chambers do not beat in unison. This makes CRT the most appropriate choice for regulating heart rhythm in a patient with worsening heart failure and arrhythmias.

Choice D reason: Echocardiogram

An echocardiogram is a diagnostic test that uses ultrasound waves to create images of the heart. It provides detailed information about the heart’s structure and function, including the size and shape of the heart chambers, the movement of the heart walls, and the function of the heart valves. While an echocardiogram is essential for diagnosing and monitoring heart conditions, it is not a treatment procedure. It does not regulate heart rhythm but rather helps in assessing the severity of heart failure and guiding treatment decisions.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care for a client who has diabetes insipidus (DI). Which of the following is a cause of acquired central diabetes insipidus?

Correct Answer is B

Explanation

A nurse is planning care for a client who has worsening heart failure and is experiencing arrhythmias. Which of the following procedures should the nurse anticipate the client will require to regulate the rhythm?

Correct Answer is C

Explanation

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