What is a potential adverse effect of palpation of an enlarged thyroid gland?

Correct Answer: C

Rationale: The correct answer is C) Release of excessive thyroid hormone into circulation. Rationale: - Palpation of an enlarged thyroid gland can lead to the release of excess thyroid hormone into the circulation due to physical manipulation of the gland. This can result in a condition known as thyroid storm or thyrotoxicosis, characterized by symptoms such as rapid heart rate, sweating, tremors, and potentially life-threatening complications. - Option A) Carotid artery obstruction is incorrect as palpation of the thyroid gland would not directly cause obstruction of the carotid artery. - Option B) Damage to the cricoid cartilage is unlikely during palpation of the thyroid gland as the structures are anatomically separate. - Option D) Hoarseness from pressure on the recurrent laryngeal nerve is a possible complication of thyroid gland manipulation but is not directly related to the release of excessive thyroid hormone. Educational Context: Understanding the potential adverse effects of palpating an enlarged thyroid gland is crucial for healthcare providers, especially for those involved in conducting physical examinations. This knowledge helps in the proper handling of patients with thyroid disorders, preventing unnecessary complications, and ensuring patient safety. It emphasizes the importance of gentle and informed examination techniques to avoid triggering harmful physiological responses.

Correct Answer: B

Rationale: The correct answer is B) FPG for all individuals at age 45 and then every 3 years. This recommendation aligns with the guidelines from major health organizations like the American Diabetes Association, which suggests screening for diabetes in asymptomatic adults starting at age 45, and then every 3 years thereafter. This approach is evidence-based and cost-effective in identifying individuals at risk for diabetes. Option A) OGTT for all minority populations every year is not recommended as a routine screening test for diabetes in asymptomatic individuals. OGTT is more invasive, time-consuming, and costly compared to FPG, making it less feasible for widespread screening programs. Option C) Testing people under the age of 21 for islet cell antibodies is not a standard screening method for diabetes in the general population. Islet cell antibodies are more relevant in the context of autoimmune type 1 diabetes and are not routinely used for mass screening purposes. Option D) Testing for type 2 diabetes in all overweight or obese individuals is not as specific or efficient as the age-based screening recommended in option B. While obesity is a risk factor for type 2 diabetes, screening solely based on weight status may miss individuals who develop diabetes at a younger age or those with normal weight but other risk factors. In an educational context, understanding the rationale behind age-appropriate screening recommendations for diabetes is crucial for healthcare professionals to provide evidence-based care. By following established guidelines, nurses can effectively identify individuals at risk for diabetes, initiate early interventions, and promote better health outcomes. It is essential for healthcare providers to stay updated on screening recommendations to deliver high-quality patient care.

Correct Answer: B

Rationale: In the scenario of a patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH), the nurse should expect to find decreased urinary output as the correct manifestation. SIADH is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention by the kidneys and decreased urine output. Option A, decreased body weight, is incorrect because SIADH causes water retention, not weight loss. Option C, increased plasma osmolality, is incorrect because SIADH leads to dilution of the blood, causing decreased plasma osmolality. Option D, increased serum sodium levels, is incorrect because in SIADH, the excessive water retention dilutes the blood, resulting in decreased serum sodium levels, a condition known as hyponatremia. Educationally, understanding the manifestations of SIADH is crucial for nurses to provide appropriate care to patients with this condition. By grasping the pathophysiology of SIADH and its effects on body fluid regulation, nurses can implement interventions to manage water balance and prevent complications related to fluid and electrolyte imbalances. This knowledge is essential in ensuring patient safety and promoting optimal outcomes in clinical practice.

Correct Answer: A

Rationale: The correct answer is A) Never miss a daily dose of thyroid replacement therapy. After a subtotal thyroidectomy for hyperthyroidism, the patient's thyroid hormone production will be reduced, necessitating lifelong thyroid hormone replacement therapy to maintain normal bodily functions. Missing doses can lead to hypothyroidism symptoms, which can negatively impact the patient's health and quality of life. Option B) Avoid regular exercise until thyroid function is normalized is incorrect. While the patient may need to temporarily limit strenuous activities post-surgery, regular exercise is important for overall health. It should be gradually reintroduced based on the healthcare provider's recommendations. Option C) Using warm saltwater gargles several times a day to relieve throat pain is unrelated to post-thyroidectomy care. Throat pain may occur due to the surgical incision, but specific post-operative instructions regarding wound care and pain management should be provided instead. Option D) Substantially reduce caloric intake compared to what was eaten before surgery is incorrect. While some dietary modifications may be necessary post-thyroidectomy, such as avoiding certain foods that interfere with thyroid function, drastically reducing caloric intake without proper guidance can lead to nutritional deficiencies and other health issues. Educationally, it is important for nursing students to understand the critical role of thyroid replacement therapy in managing patients post-thyroidectomy. Emphasizing the lifelong nature of this therapy and the consequences of non-adherence can help students grasp the significance of patient education in promoting optimal health outcomes. Additionally, highlighting the need for individualized post-operative care tailored to each patient's specific needs reinforces the importance of personalized nursing interventions.

Correct Answer: C

Rationale: The correct answer is C) It minimizes hypothalamic-pituitary-adrenal suppression. In this scenario, the patient with mild iatrogenic Cushing syndrome is on an alternate-day regimen of corticosteroid therapy. This regimen is designed to reduce the risk of suppressing the hypothalamic-pituitary-adrenal (HPA) axis. By providing corticosteroids on alternate days, the body has the opportunity to recover and produce its own cortisol on non-treatment days, thus minimizing the suppression of the HPA axis. Option A) It maintains normal adrenal hormone balance: This is incorrect because the alternate-day regimen does not necessarily maintain normal adrenal hormone balance as the patient is still receiving exogenous corticosteroids. Option B) It prevents ACTH release from the pituitary gland: This is incorrect because the alternate-day regimen does not prevent ACTH release; rather, it aims to minimize the suppression of the HPA axis. Option D) It provides a more effective therapeutic effect of the drug: This is incorrect because the alternate-day regimen is not about enhancing the therapeutic effect but rather about managing the side effects and risks associated with long-term corticosteroid therapy. Educational context: Understanding the rationale behind alternate-day corticosteroid therapy is crucial for nurses caring for patients with conditions requiring such treatment. By grasping the concept of minimizing HPA suppression, nurses can effectively educate patients on the importance of adherence to the prescribed regimen and help monitor for any signs of adrenal insufficiency or exacerbation of the underlying condition.