NATIONAL AND STATE NURSING EXAM- MCQ _MG_00105
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1. Electrolyte imbalance seen in hypoparathyroidism is:
a. Hypocalcemia
b. Hypercalcemia
c. Hypernatremia
d. Hyperkalemia
Answer: a. Hypocalcemia
Description:The electrolyte imbalance seen in hypoparathyroidism is hypocalcemia, which refers to low levels of calcium in the blood. Hypoparathyroidism is a condition characterized by decreased or absent production of parathyroid hormone (PTH) by the parathyroid glands. PTH plays a crucial role in maintaining calcium balance in the body. In hypoparathyroidism, there is insufficient production of PTH, leading to decreased calcium absorption from the intestines and decreased release of calcium from the bones. As a result, serum calcium levels are decreased, causing hypocalcemia. Therefore, the correct answer is option a: hypocalcemia. Hypercalcemia (high calcium levels), hypernatremia (high sodium levels), and hyperkalemia (high potassium levels) are not typically associated with hypoparathyroidism.
2. Congenital hypothyroidism is:
a. Graves disease
b. Cretinism
c. Myxedema
d. Acromegaly
Answer: b. Cretinism
Description:Congenital hypothyroidism refers to a condition present at birth where the thyroid gland does not produce enough thyroid hormones. It is also known as cretinism. This condition can lead to developmental and growth delays if left untreated. Graves disease, myxedema, and acromegaly are unrelated conditions that involve abnormalities in thyroid function or other hormonal imbalances.
3. Cretinism/myxedema develops due to:
a. Hypothyroidism
b. Hyperthyroidism
c. Hypopituitarism
d. Hyperpituitarism
Answer: a. Hypothyroidism
Description:Cretinism and myxedema are both conditions that are caused by hypothyroidism, which is a deficiency of thyroid hormone. Hypothyroidism can be caused by a number of things, including iodine deficiency, autoimmune diseases, and certain medications. Cretinism is a type of hypothyroidism that occurs in children. It can lead to a number of developmental delays, including mental retardation, short stature, and delayed bone maturation. Myxedema is a type of hypothyroidism that occurs in adults. It can lead to a number of symptoms, including fatigue, weight gain, dry skin, and hair loss. Both cretinism and myxedema can be treated with thyroid hormone replacement therapy. With early diagnosis and treatment, most people with hypothyroidism can live normal, healthy lives. The other options are incorrect. Hyperthyroidism is an excess of thyroid hormone, while hypopituitarism and hyperpituitarism are conditions that affect the pituitary gland.
4. Nursing management of a client with hyperthyroidism is:
a. Provide cool environment
b. Provide restful environment
c. Both a and b
d. Provide small meals
Answer: c. Both a and b
Description:Cretinism and myxedema are both conditions that are caused by hypothyroidism, which is a deficiency of thyroid hormone. Hypothyroidism can be caused by a number of things, including iodine deficiency, autoimmune diseases, and certain medications. Cretinism is a type of hypothyroidism that occurs in children. It can lead to a number of developmental delays, including mental retardation, short stature, and delayed bone maturation. Myxedema is a type of hypothyroidism that occurs in adults. It can lead to a number of symptoms, including fatigue, weight gain, dry skin, and hair loss. Both cretinism and myxedema can be treated with thyroid hormone replacement therapy. With early diagnosis and treatment, most people with hypothyroidism can live normal, healthy lives. The other options are incorrect. Hyperthyroidism is an excess of thyroid hormone, while hypopituitarism and hyperpituitarism are conditions that affect the pituitary gland.
5. Hyperthyroidism leads to:
a. Weight loss
b. Sweating
c. Irritability
d. All of these
Answer: d. All of these
Description:Hyperthyroidism is a condition where the thyroid gland produces too much thyroid hormone. This can lead to a number of symptoms, including: Weight loss Sweating Irritability Increased heart rate Difficulty sleeping Tremors Fatigue Hair loss Bulging eyes Goiter (enlarged thyroid gland) If hyperthyroidism is not treated, it can lead to serious health problems, such as heart disease, osteoporosis, and eye problems. However, with early diagnosis and treatment, most people with hyperthyroidism can live normal, healthy lives. The other options are incorrect because they are not the only symptoms of hyperthyroidism. For example, some people with hyperthyroidism may not lose weight, or they may have other symptoms, such as anxiety or depression.
6. All of the following are clinical manifestations of thyroid storm: EXCEPT:
a. High fever
b. Tachycardia
c. Hypertension
d. Sever constipation
Answer: d. Sever constipation
Description:Thyroid storm, also known as thyrotoxic crisis, is a severe and life-threatening complication of hyperthyroidism. It is characterized by an exaggerated response of the body to high levels of thyroid hormones. Clinical manifestations of thyroid storm include high fever, tachycardia (rapid heart rate), and hypertension (high blood pressure). These symptoms reflect the increased metabolic rate and overstimulation of the sympathetic nervous system. However, severe constipation is not typically associated with thyroid storm. Instead, individuals with hyperthyroidism may experience diarrhea or frequent bowel movements due to the increased gut motility. Therefore, the correct answer is option d: severe constipation.
7. Which of the following is the priority nursing care for a client with severe hyperthyroidism?
a. Asses for emotional trauma
b. Encourage range of motion exercise
c. Provide diversionary activity
d. Provide a calm and non-stimulating environment
Answer: d. Provide a calm and non-stimulating environment
Description:Distractible over activity and exaggerated sensitivity to noise are characteristic feature of hyperthyroidism. A calm environment important to reduce activity.
8. Drug of choice for hyperthyroidism is:
a. Propylthiouracils (PTU)
b. Methimazole
c. Levothyroxine sodium
d. Both a and b
Answer: d. Both a and b
Description:Propylthiouracil (PTU) and methimazole are the two main drugs used to treat hyperthyroidism. They work by blocking the production of thyroid hormone in the thyroid gland. PTU is generally preferred in the first trimester of pregnancy, while methimazole is preferred in other situations. Levothyroxine sodium is a synthetic thyroid hormone that is used to treat hypothyroidism. It is not a drug of choice for hyperthyroidism, but it may be used in conjunction with PTU or methimazole to help restore thyroid function to normal. The other options are incorrect. Methimazole and PTU are the only drugs that are specifically used to treat hyperthyroidism. Levothyroxine sodium is used to treat hypothyroidism.
9. Which of the following complication is most likely to develop if hyperthyroidism remains untreated?
a. Respiratory failure
b. Cerebos vascular accident
c. Heart failure
d. Pulmonary embolism
Answer: c. Heart failure
Description:Some of the most serious complications of hyperthyroidism involve the heart. These include a rapid heart rate, a heart rhythm disorder called atrial fibrillation and congestive heart failure.
10. Exophthalmos of the eyes is a characteristic sign of:
a. Grave’s disease
b. Cushing’s disease
c. Myxedema
d. Cretinism
Answer: a. Grave’s disease
Description:Exophthalmos, or protruding eyes, is a characteristic sign of Graves' disease. In Graves' disease, the immune system mistakenly attacks the thyroid gland, causing it to produce an excess amount of thyroid hormone. This hormonal imbalance can lead to various symptoms, including eye problems such as exophthalmos. The swelling and inflammation behind the eyes cause them to protrude forward. Therefore, the correct answer is option a: Grave's disease. Cushing's disease, myxedema, and cretinism are unrelated conditions and do not typically present with exophthalmos.
11. Which of the following nursing interventions is essential for client with exophthalmos?
a. Administer artificial tears
b. Encourage the client to wear spectacle
c. Promote bed rest
d. Monitor pulse rate q4h
Answer: d. Monitor pulse rate q4h
Description:Exophthalmos (protrusion of the eyes) may be so severe that the eyelids cannot close. The most essential measure is to keep the eyes moist. Hence, artificial tears is to keep the eyes moist so that abrasions do not occur.
12. Electrolyte imbalance seen in hyperthyroidism is:
a. Hypocalcemia
b. Hypercalcemia
c. Hypernatremia
d. Hyperkalemia
Answer: b. Hypercalcemia
Description:Causes of Hypocalcemia: • Hypoparathyroidism • Deficiency of vitamin D Causes of Hypercalcemia • Hyperparathyroidism • Hyperthyroidism Hyperthyroidism is reported to be associated with mild to moderate hypercalcemia in approximately 20% of total patients
13. Which among the following intervention is most appropriate in a client who is experiencing hemorrhage following thyroidectomy?
a. Intubate the client
b. Prepare for the tracheostomy
c. Lateral position
d. Start IV fluids
Answer: b. Prepare for the tracheostomy
Description:Hemorrhage after thyroidectomy is a serious complication that can lead to airway obstruction. If the bleeding is not controlled, the client may need a tracheostomy to maintain their airway. The other options are not as appropriate. Intubation is a temporary measure that can help to maintain the airway, but it is not a permanent solution. Lateral positioning can help to reduce bleeding, but it is not as effective as a tracheostomy. Starting IV fluids is important, but it is not the most important intervention in this situation. Therefore, the most appropriate intervention in a client who is experiencing hemorrhage following thyroidectomy is to prepare for the tracheostomy. This will ensure that the client's airway is protected in case the bleeding cannot be controlled. Here are some other interventions that may be necessary: Administer blood transfusions as needed. Monitor the client's vital signs closely. Reposition the client as needed to help reduce bleeding. Administer oxygen therapy as needed. Prepare the client for surgery to control the bleeding. Hemorrhage after thyroidectomy is a serious complication, but it is usually treatable. With prompt diagnosis and treatment, most clients make a full recovery.
14. A 45-year-old female patient underwent subtotal thyroidectomy in the morning. On the same day evening, she complains of nausea. Assessment found that her temperature is 104℉ , tachycardia and restlessness. This nurse understands that the most likely cause of these signs and symptoms.
a. Hypoglycemia
b. Thyroid crisis
c. DKA
d. Hypocalcemia
Answer: b. Thyroid crisis
Description:Thyroid crisis, also known as thyroid storm, is a life-threatening condition that occurs when there is a sudden and excessive release of thyroid hormones. This can happen after surgery, infection, or other stressors. The symptoms of thyroid crisis include: Fever Tachycardia Heart failure Tremors Nausea and vomiting Diarrhea Dehydration Restlessness Extreme agitation Delirium or coma If thyroid crisis is not treated, it can be fatal. The treatment for thyroid crisis includes: Medications to control the release of thyroid hormones Treatment for any underlying infections Supportive care, such as fluids and electrolytes The other options are incorrect. Hypoglycemia is a low blood sugar level, DKA is diabetic ketoacidosis, and hypocalcemia is a low blood calcium level. These conditions do not typically cause the symptoms that are described in the question. Therefore, the most likely cause of the symptoms in the question is thyroid crisis. This is a serious condition that requires immediate medical attention.
15. Which of the following is the best method to assess for hemorrhage in a client who underwent thyroidectomy?
a. Check blood pressure hourly
b. Asses the client for frequently swallowing
c. Roll the client to side and check for bleeding
d. Place a hand under the client’s neck and shoulders to feel bed linens
Answer: d. Place a hand under the client’s neck and shoulders to feel bed linens
Description:Client will be is semi-sitting position so drainage would go the back of the neck. So, the right method to asses bleeding is to place a hand under the client’s neck and shoulders to feel bed linens. Blood trickling down the throat is seen in patients with tonsillectomy.
16. A patient who has just had a thyroidectomy returns to the unit in a stable condition. Which of the following equipment is important for the nurse to have readily available?
a. Dressing set
b. Thoracotomy tray
c. Tracheostomy set
d. Ice collar
Answer: c. Tracheostomy set
Description:Thyroidectomy is subject to complications is the first 48 hours after surgery. Inflammation of operative site Amy cause airway obstruction. The nurse should have a tracheostomy set and oxygen at the bedside for 48 hours after thyroidectomy.
17. During early post-operative period after thyroidectomy, which of the following findings is a cause of concern?
a. A sore throat
b. Complaints of pain in the area of the surgical incision
c. Carpal spasm when the blood pressure is taken
d. Temperature of 101℉
Answer: c. Carpal spasm when the blood pressure is taken
Description:Carpal spasm in a sign of tetany and is known as trousseau sign. Trousseau sign of latent tetany is a medical sign observed in patients with low calcium. Inadvertent removal of parathyroid glands causes hypocalcemia which leads to tetany.
18. After thyroid surgery (thyroidectomy) patient shows cropped spasm. This sign indicates:
a. Severe post-operative bleeding
b. Very low thyroid hormone levels
c. Decreased metabolism and hypothermia
d. Hypocalcemia tetany
Answer: d. Hypocalcemia tetany
Description:Cropped spasm, also known as Chvostek's sign, is an indication of hypocalcemia tetany. Hypocalcemia refers to low levels of calcium in the blood, and tetany refers to muscle spasms and contractions due to calcium deficiency. During thyroid surgery, particularly a thyroidectomy, there is a risk of damage to the parathyroid glands, which regulate calcium levels in the body. If the parathyroid glands are compromised or removed during surgery, it can result in hypocalcemia. Cropped spasm is a clinical manifestation of hypocalcemia, characterized by facial muscle spasms in response to tapping the facial nerve. Therefore, the correct answer is option d: hypocalcemia tetany. Severe post-operative bleeding, very low thyroid hormone levels, and decreased metabolism with hypothermia are not directly associated with cropped spasm.
19. Which of the following is associated with hypercalcemia?
a. Tetany
b. Urinary calculi
c. Petechiae
d. T wave inversion in ECG
Answer: b. Urinary calculi
Description:Hypercalcemia is a condition in which the blood calcium level is too high. This can be caused by a number of things, including cancer, certain medications, and overactive parathyroid glands. Some of the symptoms of hypercalcemia include: Fatigue Muscle weakness Constipation Nausea and vomiting Polyuria (frequent urination) Polydipsia (increased thirst) Confusion Seizures Urinary calculi, also known as kidney stones, are a common complication of hypercalcemia. This is because the high calcium levels in the blood can lead to the formation of crystals in the kidneys. These crystals can then form stones, which can block the flow of urine and cause pain. The other options are not as associated with hypercalcemia. Tetany is a condition that is caused by low blood calcium levels, petechiae are small, pinpoint-sized red spots that can be caused by a number of things, and T wave inversion in ECG is a change in the T wave of the electrocardiogram that can be caused by a number of things, including heart disease. Therefore, the most likely symptom of hypercalcemia is urinary calculi. This is a serious condition that can cause pain and other complications. If you are experiencing any of the symptoms of hypercalcemia, it is important to see a doctor to get a diagnosis and treatment.
20. Hormones involved in calcium homeostasis is:
a. Calcitonin
b. Parathormone
c. Adrenaline
d. Both a and b
Answer: d. Both a and b
Description:Calcium homeostasis is the process of maintaining the correct level of calcium in the blood. This is important for a number of functions, including muscle contraction, nerve function, and blood clotting. Two hormones that are involved in calcium homeostasis are parathyroid hormone (PTH) and calcitonin. PTH is produced by the parathyroid glands, while calcitonin is produced by the thyroid gland. PTH increases the level of calcium in the blood by stimulating the bones to release calcium, increasing the absorption of calcium from the intestines, and reducing the excretion of calcium in the urine. Calcitonin decreases the level of calcium in the blood by stimulating the bones to store calcium and reducing the absorption of calcium from the intestines. Adrenaline is not involved in calcium homeostasis. Adrenaline is a hormone that is produced by the adrenal glands. It is involved in the fight-or-flight response. Therefore, the hormones that are involved in calcium homeostasis are PTH and calcitonin. These hormones work together to maintain the correct level of calcium in the blood.
21. Which among the following is an expected lab finding in client with primary hyperparathyroidism?
a. Elevated serum calcium
b. Low level of serum calcium
c. Increase bone density
d. Low urine calcium
Answer: a. Elevated serum calcium
Description:The expected lab finding in a client with primary hyperparathyroidism is elevated serum calcium levels. Primary hyperparathyroidism is a condition characterized by the overproduction of parathyroid hormone (PTH) by the parathyroid glands. PTH plays a crucial role in maintaining calcium balance in the body. In primary hyperparathyroidism, there is excessive production of PTH, leading to increased release of calcium from the bones and increased absorption of calcium from the intestines. As a result, serum calcium levels are elevated. Therefore, the correct answer is option a: elevated serum calcium. Low levels of serum calcium, increased bone density, and low urine calcium are not typical findings in primary hyperparathyroidism.
22. All are features of hyper-parathyroidism; EXCEPT:
a. Increase serum calcium
b. Decrease serum phosphate
c. Diarrhea
d. Nephrocalcinosis
Answer: c. Diarrhea
Description:The other options are all features of hyperparathyroidism. Increase serum calcium: This is caused by the overproduction of parathyroid hormone (PTH), which increases the absorption of calcium from the intestines and the release of calcium from the bones. Decrease serum phosphate: This is caused by the increased excretion of phosphate in the urine. Nephrocalcinosis: This is the formation of calcium deposits in the kidneys. Diarrhea is not a feature of hyperparathyroidism. In fact, it is more likely to be seen in people with hypoparathyroidism, which is a condition where the parathyroid glands do not produce enough PTH. Here are some other features of hyperparathyroidism: Bone pain Kidney stones Fatigue Muscle weakness Confusion Seizures
23. Clinical manifestation of hypoparathyroidism includes:
a. Muscle weakness
b. Positive Chvostek’s sign
c. Positive trousseau’s sign
d. All of these
Answer: d. All of these
Description:Clinical manifestations of hypoparathyroidism, which refers to decreased or absent production of parathyroid hormone (PTH), include muscle weakness, positive Chvostek's sign, and positive Trousseau's sign. Muscle weakness is a common symptom in hypoparathyroidism due to the decreased levels of calcium in the blood. Calcium is essential for proper muscle function, and its deficiency can lead to muscle weakness and cramping. Chvostek's sign is a clinical finding where tapping on the facial nerve near the ear causes twitching of the facial muscles. It is indicative of neuromuscular irritability and can be seen in hypoparathyroidism due to low levels of calcium affecting the excitability of the facial nerves. Trousseau's sign is another indication of neuromuscular irritability and is observed when applying a blood pressure cuff to the upper arm and inflating it to a level above systolic pressure. If the hand and fingers of the individual with hypoparathyroidism spasm or contract during this maneuver, it is considered a positive Trousseau's sign.
24. Which of the following is caused by hypoparathyroidism?
a. High serum calcium
b. Low serum calcium
c. High serum potassium
d. Low serum potassium
Answer: b. Low serum calcium
Description:Hypoparathyroidism is a condition in which the parathyroid glands do not produce enough parathyroid hormone (PTH). PTH is responsible for regulating the levels of calcium in the blood. When there is not enough PTH, the levels of calcium in the blood can drop too low. This can lead to a number of symptoms, including: Muscle cramps Tingling in the fingers and toes Numbness around the mouth Seizures Coma If you are experiencing any of these symptoms, it is important to see a doctor to get a diagnosis and treatment. The other options are incorrect. High serum calcium is caused by hyperparathyroidism, not hypoparathyroidism. High serum potassium is not caused by hypoparathyroidism. Low serum potassium can be caused by a number of things, including kidney disease, diarrhea, and vomiting. Therefore, the most likely symptom of hypoparathyroidism is low serum calcium. This is a serious condition that can cause a number of symptoms. If you are experiencing any of the symptoms, it is important to see a doctor to get a diagnosis and treatment.
25. Electrolyte imbalance seen in hyperparathyroidism is:
a. Hypocalcemia
b. Hypercalcemia
c. Hypernatremia
d. Hyperkalemia
Answer: b. Hypercalcemia
Description:The electrolyte imbalance seen in hyperparathyroidism is hypercalcemia, which refers to high levels of calcium in the blood. Hyperparathyroidism is a condition characterized by excessive production of parathyroid hormone (PTH) by the parathyroid glands. PTH plays a crucial role in regulating calcium balance in the body. In hyperparathyroidism, there is overproduction of PTH, leading to increased release of calcium from the bones and increased absorption of calcium from the intestines. As a result, serum calcium levels are elevated, causing hypercalcemia. Therefore, the correct answer is option b: hypercalcemia. Hypocalcemia (low calcium levels), hypernatremia (high sodium levels), and hyperkalemia (high potassium levels) are not typically associated with hyperparathyroidism.
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