A 32-year-old female patient presents with symptoms of weight loss, anxiety, and heat intolerance. On examination, her thyroid is enlarged, and she has a fine tremor. Laboratory tests reveal elevated free thyroxine (T4) and suppressed thyroid-stimulating hormone (TSH) levels. A radioactive iodine uptake test shows increased uptake. What is the most likely diagnosis?
A. Hashimoto’s thyroiditis
B. Graves’ disease
C. Thyroid adenoma
D. Thyroid carcinoma
E. Thyroid storm
Explanation: Graves’ disease is characterized by hyperthyroidism, with clinical features including weight loss, anxiety, heat intolerance, goiter, and a fine tremor. Elevated free T4 and suppressed TSH levels, along with increased radioactive iodine uptake, are indicative of this autoimmune disorder.
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A 45-year-old male presents with symptoms of palpitations, sweating, and weight loss. Physical examination reveals proptosis and an enlarged thyroid. Laboratory tests show elevated levels of free thyroxine (T4) and suppressed thyroid-stimulating hormone (TSH). Which diagnostic test is most appropriate to confirm the suspected diagnosis?
A. Thyroid ultrasound
B. Fine-needle aspiration biopsy
C. Thyroid scan
D. Thyroid function tests
E. Serum antithyroid antibodies
Explanation: In Graves’ disease, a thyroid scan typically reveals diffusely increased radioactive iodine uptake due to the stimulation of the thyroid gland by TSH receptor antibodies. This diagnostic test can confirm the diagnosis.
A 28-year-old female with known Graves’ disease presents with worsening symptoms, including severe tachycardia, fever, and altered mental status. She has a history of non-compliance with antithyroid medications. What is the most likely diagnosis in this acute situation?
A. Graves’ disease exacerbation
B. Thyroid storm
C. Hypothyroidism
D. Thyroid carcinoma
E. Hashimoto’s thyroiditis
Explanation: Thyroid storm is a life-threatening condition seen in individuals with uncontrolled hyperthyroidism, often due to non-compliance with medication. It presents with severe symptoms, including tachycardia, fever, and altered mental status.
A 40-year-old male with a history of Graves’ disease presents with symptoms of muscle weakness, fatigue, and proximal muscle pain. Laboratory tests reveal elevated creatine kinase levels and positive antithyroid peroxidase antibodies. What is the most likely diagnosis in this patient?
A. Hyperthyroidism
B. Hypothyroidism
C. Grave’s ophthalmopathy
D. Thyroid carcinoma
E. Myasthenia gravis
Explanation: This patient is likely experiencing hypothyroidism, a condition that can develop as a result of the treatment for Graves’ disease, or in some cases due to autoimmune thyroiditis. Symptoms may include muscle weakness and elevated creatine kinase levels.
A 22-year-old female presents with exophthalmos, anxiety, and palpitations. Her thyroid function tests reveal elevated free thyroxine (T4) and suppressed thyroid-stimulating hormone (TSH) levels. Which treatment option is the initial therapy of choice for Graves’ disease in this patient?
A. Radioactive iodine therapy
B. Total thyroidectomy
C. Beta-blockers
D. Antithyroid medications
E. Corticosteroids
Explanation: Initial therapy for Graves’ disease often involves antithyroid medications (such as methimazole or propylthiouracil) to control hyperthyroidism. Radioactive iodine therapy and surgery (total thyroidectomy) may be considered if medical therapy fails or is contraindicated. Beta-blockers can be used for symptomatic relief, and corticosteroids may be indicated in severe cases of Graves’ ophthalmopathy.
A 30-year-old male presents with symptoms of muscle weakness, constipation, and fatigue. He has a history of Graves’ disease and was treated with radioactive iodine therapy three years ago. His current thyroid function tests reveal elevated thyroid-stimulating hormone (TSH) and low free thyroxine (T4) levels. What is the most likely diagnosis in this patient?
A. Hyperthyroidism
B. Hypothyroidism
C. Grave’s ophthalmopathy
D. Thyroid carcinoma
E. Myasthenia gravis
Explanation: This patient likely has hypothyroidism, which can result from radioactive iodine therapy for Graves’ disease. The symptoms, along with elevated TSH and low free T4 levels, are indicative of this condition.
A 35-year-old female presents with prominent bilateral exophthalmos, lid lag, and swelling of the retro-orbital tissues. She has a known history of Graves’ disease. Which of the following diagnostic tests is the most appropriate to evaluate the severity of her eye symptoms?
A. Thyroid ultrasound
B. Fine-needle aspiration biopsy
C. Thyroid scan
D. Erythrocyte sedimentation rate
E. Clinical assessmen
Explanation: The severity of eye symptoms in Graves’ ophthalmopathy is best evaluated through clinical assessment, including measurement of proptosis (exophthalmos), lid lag, and swelling of the retro-orbital tissues. Imaging studies like thyroid ultrasound or thyroid scan may be used for additional evaluation but are not the primary tools for assessing eye symptoms.
A 50-year-old female with a history of Graves’ disease is admitted with signs and symptoms of severe hyperthyroidism, including agitation, high fever, and delirium. Her vital signs are unstable. What is the immediate treatment of choice in this patient?
A. Initiation of antithyroid medications
B. Thyroidectomy
C. Propranolol administration
D. Intravenous fluids and cooling measures
E. Radioactive iodine therapy
Explanation: The patient’s presentation is consistent with thyroid storm, a life-threatening complication of Graves’ disease. Immediate treatment involves stabilizing the patient with intravenous fluids and cooling measures to reduce fever and agitation. Once stabilized, antithyroid medications and other interventions may be initiated.
A 28-year-old male presents with a painless, rapidly growing mass in the neck. A thyroid ultrasound reveals a solid nodule with microcalcifications. Fine-needle aspiration biopsy results show malignant cells. What is the most likely diagnosis in this patient?
A. Graves’ disease
B. Thyroid adenoma
C. Thyroiditis
D. Thyroid carcinoma
E. Hyperthyroidism
Explanation: The clinical presentation of a painless, rapidly growing thyroid mass with microcalcifications and positive fine-needle aspiration biopsy results is highly suggestive of thyroid carcinoma.
A 60-year-old female with a history of Graves’ disease presents with fatigue, weight gain, and cold intolerance. Her thyroid function tests reveal elevated thyroid-stimulating hormone (TSH) and low free thyroxine (T4) levels. What is the most likely diagnosis in this patient?
A. Hyperthyroidism
B. Hypothyroidism
C. Grave’s ophthalmopathy
D. Thyroid carcinoma
E. Myasthenia gravis
Explanation: The patient’s symptoms, along with elevated TSH and low free T4 levels, are indicative of hypothyroidism. This can occur as a result of treatment for Graves’ disease or due to other causes, such as autoimmune thyroiditis.
A 35-year-old female presents with a painful and tender thyroid gland. She also complains of fever, malaise, and difficulty swallowing. Laboratory tests show an elevated erythrocyte sedimentation rate (ESR). Which of the following is the most likely diagnosis in this patient?
A. Hyperthyroidism
B. Hypothyroidism
C. Thyroid adenoma
D. Hashimoto’s thyroiditis
E. Subacute thyroiditis (De Quervain’s thyroiditis)
Explanation: Subacute thyroiditis, also known as De Quervain’s thyroiditis, presents with a painful, tender thyroid gland, fever, and elevated ESR. It is a self-limiting condition often associated with viral infections.
A 50-year-old male patient presents with fatigue, weight gain, and depression. On examination, his thyroid gland is enlarged, firm, and non-tender. Laboratory tests reveal elevated thyroid-stimulating hormone (TSH) and low free thyroxine (T4) levels. What is the most likely diagnosis in this patient?
A. Hyperthyroidism
B. Hypothyroidism
C. Thyroid adenoma
D. Hashimoto’s thyroiditis
E. Subacute thyroiditis (De Quervain’s thyroiditis)
Explanation: Hashimoto’s thyroiditis is characterized by an enlarged, firm, non-tender thyroid gland. It typically presents with hypothyroidism, including symptoms of fatigue, weight gain, and depression.
A 28-year-old female presents with symptoms of palpitations, sweating, and weight loss. Physical examination reveals proptosis and an enlarged thyroid. Laboratory tests show elevated levels of free thyroxine (T4) and suppressed thyroid-stimulating hormone (TSH). What diagnostic test is most appropriate to confirm the suspected diagnosis?
A. Thyroid ultrasound
B. Fine-needle aspiration biopsy
C. Thyroid scan
D. Thyroid function tests
E. Serum antithyroid antibodies
Explanation: In the context of hyperthyroidism with symptoms suggestive of Graves’ disease, the presence of serum antithyroid antibodies, such as TSH receptor antibodies, can confirm the diagnosis.
A 42-year-old male with a history of autoimmune thyroiditis (Hashimoto’s thyroiditis) presents with fatigue, weight gain, and cold intolerance. His thyroid function tests reveal elevated thyroid-stimulating hormone (TSH) and low free thyroxine (T4) levels. What is the most likely diagnosis in this patient?
A. Hyperthyroidism
B. Hypothyroidism
C. Grave’s ophthalmopathy
D. Thyroid carcinoma
E. Myasthenia gravis
Explanation: This patient is likely experiencing hypothyroidism, which is a common consequence of Hashimoto’s thyroiditis. Symptoms include fatigue, weight gain, and cold intolerance.
A 38-year-old female presents with a diffuse, painless enlargement of her thyroid gland. Her thyroid function tests reveal elevated levels of free thyroxine (T4) and suppressed thyroid-stimulating hormone (TSH). She also has a low radioactive iodine uptake. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Thyroid adenoma D. Hashimoto’s thyroiditis E. Silent thyroiditis
Explanation: Silent thyroiditis is characterized by painless thyroid enlargement, elevated free T4, suppressed TSH, and low radioactive iodine uptake. It is a self-limiting condition and can present with transient hyperthyroidism followed by hypothyroidism.
A 40-year-old male patient presents with a painless, palpable mass in the neck. He has no symptoms of hyperthyroidism or hypothyroidism. Thyroid function tests are within the normal range. A thyroid ultrasound reveals a solitary, well-defined nodule. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Thyroiditis D. Thyroid adenoma E. Thyroid carcinoma
Explanation: In this patient, a solitary, well-defined thyroid nodule with normal thyroid function tests is suggestive of a thyroid adenoma. Thyroid adenomas are typically non-functional and do not cause hyperthyroid or hypothyroid symptoms.
A 30-year-old female presents with a rapidly growing thyroid nodule. She reports hoarseness and difficulty swallowing. Fine-needle aspiration biopsy reveals malignant cells. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Thyroiditis D. Thyroid adenoma E. Thyroid carcinoma
Explanation: Rapidly growing thyroid nodules associated with hoarseness and difficulty swallowing are concerning for thyroid carcinoma, particularly if fine-needle aspiration biopsy reveals malignant cells.
A 55-year-old male patient presents with symptoms of sweating, weight loss, and palpitations. Thyroid function tests reveal elevated levels of free thyroxine (T4) and suppressed thyroid-stimulating hormone (TSH). Which diagnostic test is most appropriate to differentiate thyroid adenoma from other causes of hyperthyroidism?
A. Thyroid ultrasound B. Fine-needle aspiration biopsy C. Thyroid scan D. Thyroid function tests E. Serum antithyroid antibodies
Explanation: A thyroid scan can help differentiate thyroid adenoma from other causes of hyperthyroidism by assessing the pattern of radioactive iodine uptake. Adenomas typically show focal and increased uptake, whereas other causes may have diffuse uptake patterns.
A 45-year-old female with a thyroid adenoma undergoes surgical removal of the nodule. Postoperatively, her thyroid function tests show a transient drop in serum thyroid hormones. What is the most likely explanation for this finding?
A. Development of hypothyroidism B. Recurrence of the adenoma C. Release of thyroid hormones from the adenoma D. Euthyroid status E. Thyroiditis
Explanation: Surgical manipulation of a thyroid adenoma can release stored thyroid hormones, leading to a transient drop in serum thyroid hormones. This is typically a self-limiting phenomenon and does not represent the development of hypothyroidism.
A 50-year-old female patient presents with a painless, solitary thyroid nodule. Fine-needle aspiration biopsy reveals colloid-filled follicles and no malignant cells. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Thyroiditis D. Thyroid adenoma E. Thyroid carcinoma
Explanation: A painless, solitary thyroid nodule with fine-needle aspiration biopsy showing colloid-filled follicles and no malignant cells is indicative of a benign thyroid adenoma. This type of adenoma is non-functional and typically does not cause thyroid hormone abnormalities or symptoms.A 35-year-old female presents with fatigue, weight gain, cold intolerance, and constipation. On physical examination, she has a diffuse thyroid enlargement (goiter). Laboratory tests reveal elevated thyroid-stimulating hormone (TSH) and low free thyroxine (T4) levels. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Grave’s ophthalmopathy D. Thyroid carcinoma E. Myasthenia gravis
Explanation: The clinical presentation of fatigue, weight gain, cold intolerance, constipation, and an enlarged thyroid (goiter) is consistent with hypothyroidism. Elevated TSH and low free T4 levels confirm the diagnosis.
A 50-year-old male patient with a history of hypothyroidism presents with symptoms of excessive sweating, heat intolerance, and palpitations. His thyroid function tests reveal low thyroid-stimulating hormone (TSH) and elevated free thyroxine (T4) levels. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Grave’s ophthalmopathy D. Thyroid carcinoma E. Myasthenia gravis
Explanation: The presence of excessive sweating, heat intolerance, palpitations, low TSH, and elevated free T4 levels suggests hyperthyroidism, which is the opposite of hypothyroidism.
A 28-year-old female patient presents with symptoms of fatigue, weight gain, and depression. On examination, her thyroid gland is enlarged, firm, and non-tender. Laboratory tests reveal elevated thyroid-stimulating hormone (TSH) and low free thyroxine (T4) levels. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Grave’s ophthalmopathy D. Thyroid carcinoma E. Myasthenia gravis
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Explanation: This patient’s symptoms, along with an enlarged, firm, non-tender thyroid gland and elevated TSH with low free T4 levels, are indicative of hypothyroidism, commonly seen in Hashimoto’s thyroiditis.
A 60-year-old male with a history of hypothyroidism presents with a neck mass that has been growing slowly over several years. A thyroid ultrasound shows a solitary nodule. Fine-needle aspiration biopsy results reveal benign colloid-filled follicles. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Thyroid adenoma D. Thyroid carcinoma E. Grave’s ophthalmopathy
Explanation: In this patient, a solitary nodule with benign colloid-filled follicles on fine-needle aspiration biopsy is consistent with a benign thyroid adenoma, which does not affect thyroid hormone levels.
A 42-year-old female patient with known hypothyroidism is non-compliant with her medication. She presents with severe fatigue, bradycardia, and confusion. Her vital signs include a heart rate of 45 beats per minute and hypothermia. What is the most likely diagnosis in this acute situation?
A. Hyperthyroidism B. Hypothyroidism C. Myxedema coma D. Thyroid carcinoma E. Grave’s ophthalmopathy
Explanation: The patient’s presentation, including severe hypothyroid symptoms, bradycardia, hypothermia, and altered mental status, is indicative of myxedema coma, a life-threatening complication of untreated or inadequately managed hypothyroidism.
A. Hyperthyroidism B. Hypothyroidism C. Grave’s ophthalmopathy D. Thyroid carcinoma E. Hashimoto’s thyroiditis
Explanation: The patient’s symptoms, along with an enlarged, firm, and non-tender thyroid gland, elevated TSH, and low free T4 levels, are characteristic of Hashimoto’s thyroiditis, an autoimmune thyroid disorder leading to hypothyroidism.
A 50-year-old male patient with a known history of Hashimoto’s thyroiditis presents with symptoms of excessive sweating, heat intolerance, and palpitations. His thyroid function tests reveal low thyroid-stimulating hormone (TSH) and elevated free thyroxine (T4) levels. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Grave’s ophthalmopathy D. Thyroid carcinoma E. Myasthenia gravis
Explanation: The presence of excessive sweating, heat intolerance, palpitations, low TSH, and elevated free T4 levels suggests hyperthyroidism, which can occasionally occur as a result of Hashimoto’s thyroiditis.
A 32-year-old female patient presents with symptoms of weight loss, anxiety, and heat intolerance. On examination, her thyroid is enlarged and has a bruit on auscultation. Laboratory tests reveal elevated free thyroxine (T4) and suppressed thyroid-stimulating hormone (TSH) levels. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Grave’s ophthalmopathy D. Thyroid carcinoma E. Hashimoto’s thyroiditis
Explanation: The clinical features, including weight loss, anxiety, heat intolerance, and a bruit over the thyroid, along with elevated free T4 and suppressed TSH levels, are indicative of hyperthyroidism, which can occur in Hashimoto’s thyroiditis.
A 60-year-old male with a history of Hashimoto’s thyroiditis presents with a painless, palpable mass in the neck. Fine-needle aspiration biopsy reveals malignant cells. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Thyroid adenoma D. Thyroid carcinoma E. Grave’s ophthalmopathy
Explanation: The presence of a painless, palpable neck mass with fine-needle aspiration biopsy revealing malignant cells is indicative of thyroid carcinoma, a potential complication in patients with Hashimoto’s thyroiditis.
A 45-year-old female with known Hashimoto’s thyroiditis is non-compliant with her medication. She presents with severe fatigue, bradycardia, and confusion. Her vital signs include a heart rate of 45 beats per minute and hypothermia. What is the most likely diagnosis in this acute situation?
A. Hyperthyroidism B. Hypothyroidism C. Myxedema coma D. Thyroid carcinoma E. Grave’s ophthalmopathy
Explanation: The patient’s presentation, including severe hypothyroid symptoms, bradycardia, hypothermia, and altered mental status, is indicative of myxedema coma, a life-threatening complication of untreated or inadequately managed hypothyroidism, such as in Hashimoto’s thyroiditis.
A. Hyperthyroidism B. Hypothyroidism C. Thyroiditis D. Thyroid adenoma E. Thyroid carcinoma
Explanation: The clinical presentation of a rapidly growing neck mass with hoarseness, difficulty swallowing, and fine-needle aspiration biopsy revealing malignant cells is indicative of thyroid carcinoma.
A 30-year-old male patient with a family history of thyroid cancer presents with a palpable nodule in his thyroid gland. Laboratory tests show elevated thyroid-stimulating hormone (TSH) and normal free thyroxine (T4) levels. What is the most appropriate diagnostic test to evaluate this patient’s thyroid nodule?
A. Thyroid ultrasound B. Fine-needle aspiration biopsy C. Thyroid scan D. Thyroid function tests E. Serum antithyroid antibodies
Explanation: Thyroid ultrasound is the initial test of choice to evaluate thyroid nodules and can help determine the characteristics and size of the nodule. Fine-needle aspiration biopsy is performed when the nodule appears suspicious on ultrasound.
A 35-year-old male patient presents with a painless, solitary thyroid nodule. Fine-needle aspiration biopsy results show colloid-filled follicles and no malignant cells. What is the most likely diagnosis in this patient?
A. Hyperthyroidism B. Hypothyroidism C. Thyroid adenoma D. Thyroid carcinoma E. Grave’s ophthalmopathy
Explanation: A painless, solitary thyroid nodule with fine-needle aspiration biopsy showing colloid-filled follicles and no malignant cells is indicative of a benign thyroid adenoma, which does not affect thyroid hormone levels.
A 55-year-old female patient with a history of thyroid cancer presents with symptoms of recurrent hoarseness, difficulty breathing, and a sensation of a “lump” in the throat. A physical examination reveals a painless, firm neck mass. What is the most likely diagnosis in this patient?
A. Thyroid adenoma B. Recurrent thyroid carcinoma C. Hyperthyroidism D. Hypothyroidism E. Grave’s ophthalmopathy
Explanation: The recurrence of symptoms and physical examination findings, including a firm neck mass and airway compression symptoms, are indicative of recurrent thyroid carcinoma in a patient with a history of thyroid cancer.
A 40-year-old male patient presents with a family history of thyroid cancer. He has no symptoms of thyroid dysfunction. On examination, there are no palpable neck masses. Laboratory tests show normal thyroid function. What is the most appropriate screening test for this patient?
A. Thyroid ultrasound B. Fine-needle aspiration biopsy C. Thyroid scan D. Thyroid function tests E. Serum antithyroid antibodies
Explanation: In individuals with a family history of thyroid cancer, screening with thyroid ultrasound can help identify thyroid nodules at an early stage and evaluate their characteristics. Fine-needle aspiration biopsy may be considered if nodules appear suspicious on ultrasound.
A. Osteoporosis B. Renal failure C. Hypertension D. Hypoparathyroidism E. Anemia
Explanation: Hypoparathyroidism is a common complication of thyroidectomy, as the parathyroid glands are located near the thyroid and may be inadvertently damaged or removed during the surgery, leading to calcium regulation problems.
A 50-year-old male patient is scheduled for a total thyroidectomy due to thyroid cancer. Which preoperative intervention is essential to reduce the risk of complications in the postoperative period?
A. Encouraging the patient to consume a high-fat diet B. Administering thyroid hormone replacement therapy C. Administering antithyroid medications D. Monitoring serum creatinine levels E. Preoperative sedation
Explanation: Administering thyroid hormone replacement therapy before thyroidectomy helps normalize thyroid hormone levels, reducing the risk of postoperative complications such as myxedema coma or thyroid storm.
A 45-year-old female patient is scheduled for a thyroidectomy due to a large goiter causing compressive symptoms. During the preoperative evaluation, the nurse assesses that the patient is taking an anticoagulant medication. What action should be taken before surgery?
A. Stop the anticoagulant medication immediately. B. Continue the anticoagulant medication as prescribed. C. Administer an additional dose of anticoagulant. D. Request a higher dose of anesthesia. E. Switch to a different type of anticoagulant.
Explanation: It is generally recommended to continue anticoagulant medication before surgery, with the guidance of a healthcare provider, to reduce the risk of thromboembolic events. However, the surgeon may need to adjust the patient’s anticoagulation regimen or provide alternative measures to minimize bleeding during the procedure.
A 60-year-old male patient undergoes a total thyroidectomy for thyroid cancer. In the immediate postoperative period, the nurse should prioritize assessment for which of the following complications?
A. Hypertension B. Bradycardia C. Diarrhea D. Hyperventilation E. Laryngeal nerve damage
Explanation: Laryngeal nerve damage is a potential complication following thyroidectomy that can lead to hoarseness or loss of voice. Prompt assessment and intervention are crucial to prevent long-term issues.
A 55-year-old female patient undergoes a thyroidectomy for hyperthyroidism due to Graves’ disease. Postoperatively, she experiences muscle spasms, tingling, and numbness in her extremities. What is the most likely cause of these symptoms?
A. Hypothyroidism B. Hyperthyroidism C. Hypoparathyroidism D. Thyroid storm E. Thyroid hormone overdose
Explanation: Muscle spasms, tingling, and numbness in the extremities are indicative of hypocalcemia, which commonly occurs due to hypoparathyroidism after thyroidectomy. The parathyroid glands play a key role in calcium regulation, and their damage can lead to calcium imbalances.
A 45-year-old male patient is scheduled for a subtotal thyroidectomy due to a toxic thyroid nodule. Which of the following statements by the patient indicates a need for further education regarding the procedure?
A. “I will avoid turning my head quickly after surgery.” B. “I might need to take thyroid hormone replacement medication after the surgery.” C. “I will keep the incision site clean and dry.” D. “I should consume iodine-rich foods before the surgery.” E. “I understand that my voice may be temporarily affected.”
Explanation: Consuming iodine-rich foods before thyroid surgery is typically not recommended. High levels of iodine can interfere with the surgical procedure and may not be necessary for most patients. The other statements are correct and reflect appropriate post-thyroidectomy education.
A 30-year-old female patient is scheduled for a thyroidectomy due to a large multinodular goiter. What position should the nurse instruct the patient to maintain during the early postoperative period to reduce the risk of bleeding?
A. Supine position B. Lateral recumbent position C. Trendelenburg position D. High Fowler’s position E. Prone position
Explanation: Maintaining the patient in a high Fowler’s position with the head of the bed elevated at a 30-45 degree angle helps reduce the risk of bleeding, pressure on the incision site, and respiratory distress in the early postoperative period.
A 40-year-old male patient undergoes a thyroidectomy and experiences stridor, increased respiratory distress, and a feeling of impending suffocation. What is the most appropriate nursing intervention?
A. Administering analgesics B. Encouraging deep breathing exercises C. Keeping the patient supine D. Administering oxygen E. Administering sedatives
Explanation: Stridor, increased respiratory distress, and a sensation of impending suffocation are signs of airway compromise. Administering oxygen is essential to improve oxygenation and provide immediate relief. Sedatives may worsen the situation, so they should not be administered without consulting a healthcare provider.
A 35-year-old female patient undergoes a total thyroidectomy for thyroid cancer. In the immediate postoperative period, the nurse should prioritize assessment for which of the following complications?
A. Bradycardia B. Hypertension C. Fever D. Laryngeal nerve damage E. Hypoparathyroidism
Explanation: Laryngeal nerve damage is a potential complication following thyroidectomy that can lead to hoarseness or loss of voice. Prompt assessment and intervention are crucial to prevent long-term issues.
A 55-year-old male patient undergoes a thyroidectomy for a suspicious thyroid nodule. Postoperatively, he experiences tingling and numbness in his extremities, muscle spasms, and a positive Chvostek sign. What is the most likely cause of these symptoms?
A. Hypothyroidism B. Hyperthyroidism C. Hypoparathyroidism D. Thyroid storm E. Thyroid hormone overdose
Explanation: Tingling, numbness, muscle spasms, and a positive Chvostek sign are indicative of hypocalcemia, which commonly occurs due to hypoparathyroidism after thyroidectomy. The parathyroid glands play a key role in calcium regulation, and their damage can lead to calcium imbalances.
A. Hypothyroidism B. Hypoparathyroidism C. Grave’s ophthalmopathy D. Thyroid adenoma E. Thyroid storm
Explanation: The clinical presentation of fever, profuse sweating, tachycardia, confusion, along with significantly elevated free T4 and suppressed TSH levels, is indicative of thyroid storm, a severe and life-threatening complication of hyperthyroidism.
A 30-year-old male with a history of hyperthyroidism presents to the emergency room with agitation, fever, severe sweating, and tachycardia. Laboratory tests reveal elevated levels of free thyroxine (T4) and suppressed thyroid-stimulating hormone (TSH). What is the initial nursing priority for this patient?
A. Administer antipyretics B. Administer antithyroid medications C. Administer intravenous fluids D. Administer sedatives E. Administer pain relievers
Explanation: In the initial management of thyroid storm, fluid resuscitation is a priority to address dehydration and support hemodynamic stability before other treatments like antithyroid medications or antipyretics are considered.
A 35-year-old female is admitted with symptoms of palpitations, sweating, heat intolerance, and agitation. She has a known history of Grave’s disease. What diagnostic test is most appropriate to confirm the diagnosis of thyroid storm in this patient?
A. Thyroid ultrasound B. Fine-needle aspiration biopsy C. Thyroid scan D. Thyroid function tests E. Serum antithyroid antibodies
Explanation: Thyroid function tests, including free thyroxine (T4) and thyroid-stimulating hormone (TSH) levels, are essential for confirming the diagnosis of thyroid storm by identifying significantly elevated free T4 and suppressed TSH levels.
A 40-year-old male presents with fever, tachycardia, confusion, and profuse sweating. He has a known history of hyperthyroidism but has been non-compliant with antithyroid medications. Which of the following medications is the first-line treatment for thyroid storm?
A. Levothyroxine B. Propranolol C. Methimazole D. Prednisone E. Aspirin
Explanation: Propranolol is the first-line treatment for thyroid storm as it helps control the hyperadrenergic symptoms and tachycardia. It should be initiated promptly and followed by antithyroid medications like methimazole.
A 50-year-old female with a history of hyperthyroidism is admitted with thyroid storm. While administering antithyroid medications, the nurse should be cautious about which potential adverse effect associated with these medications?
A. Hypertension B. Hypokalemia C. Hyperglycemia D. Hypocalcemia E. Thrombocytopenia
Explanation: Antithyroid medications, such as methimazole and propylthiouracil, can cause adverse effects, including the rare but serious side effect of thrombocytopenia. Monitoring for signs of bleeding and bruising is important during their use.