Hyperthyroidism and Hypothyroidism (10 Questions)

1. Mme Ginette Tremblay, 55 years old, is newly diagnosed with Hypothyroidism (Hashimoto’s thyroiditis). The physician prescribes Levothyroxine (Synthroid) 50 mcg PO daily. Mme Tremblay asks the nurse, "I take a lot of vitamins and calcium for my bones in the morning. Can I take this pill with them?"

Question:
What is the nurse’s priority instruction regarding the administration of this medication? *

"Yes, taking it with calcium helps the absorption of the thyroid hormone."

"Take the medication in the evening with a glass of milk to prevent stomach upset."

"You must take this medication on an empty stomach, at least 30 to 60 minutes before breakfast or other medications."

"If you miss a dose, you should double the dose the next day to catch up."

2. M. Jacques Bernier, 35 years old, has a history of Graves’ Disease (Hyperthyroidism). He is admitted to the medical unit with pneumonia. During the initial assessment, the nurse notes he is extremely agitated, trembling, and diaphoretic.

His vital signs are:
*BP: 160/95 mmHg
*HR: 145 bpm (irregular)
*Temp: 39.5°C
*RR: 28 breaths/min

Question:
What medical emergency does the nurse suspect M. Bernier is experiencing? *

Myxedema Coma.

Septic Shock related to pneumonia.

Thyroid Storm.

Hypocalcemic Tetany.

3. Mme Sophie Gagnon, 42 years old, underwent a Total Thyroidectomy 12 hours ago. She reports a tingling sensation around her mouth (circumoral paresthesia) and in her fingertips. The nurse taps the patient's cheek just in front of the ear and observes a twitch of the facial muscle (Chvostek’s sign).

Question:
What is the nurse’s immediate action? *

Administer the prescribed PRN analgesic for nerve pain.

Document the finding as a normal return of sensation post-anesthesia.

Check the patency of the patient's airway and listen for stridor.

Notify the physician and prepare to administer IV Calcium Gluconate.

4. M. Pierre Dubois, 78 years old, is brought to the ER by his daughter. He has a history of untreated Hypothyroidism. The daughter states he has been confused and sleeping constantly for two days.

Assessment reveals:
*Skin: Pale, cool, and waxy swelling of the face.
*Temp: 35.0°C (Hypothermia).
*HR: 48 bpm.
*RR: 8 breaths/min.

Question:
Based on these findings, what is the nurse’s priority intervention? *

Apply warm blankets to correct the hypothermia rapidly.

Prepare for endotracheal intubation and mechanical ventilation.

Administer a high dose of sedative to manage the confusion.

Start IV fluids to treat dehydration.

5. Mme Claudette Roy, 30 years old, has hyperthyroidism and presents with Exophthalmos (bulging eyes). She complains that her eyes feel gritty, dry, and she cannot close her eyelids completely at night.

Question:
Which nursing recommendation is most appropriate to prevent corneal injury? *

"Apply warm moist compresses to the eyes every hour."

"Tape your eyelids shut with medical tape before going to sleep."

"Use artificial tears regularly and sleep with the head of the bed elevated."

"Massage the eyelids gently to reduce the swelling."

6. M. Luc Morin, 50 years old, visits the clinic complaining of unexplained weight gain despite a poor appetite, constipation, and feeling "cold to the bone" even in summer. The physician suspects thyroid dysfunction.

Question:
Which laboratory result would confirm a diagnosis of primary Hypothyroidism? *

Low TSH and High T4.

High TSH and Low T4.

High TSH and High T4.

Low TSH and Low T4.

7. Mme Valérie Fortin, 28 years old, is taking Methimazole (Tapazole) for Hyperthyroidism. She calls the clinic reporting that she has developed a sore throat and a fever of 38.5°C.

Question:
What is the nurse’s best response? *

"This is likely a viral cold; rest and drink plenty of fluids."

"Take Tylenol for the fever and continue your medication as prescribed."

"Stop the medication immediately and go to the ER for a blood test."

"Double your dose for 2 days to boost your immune system."

8. Mme Isabelle Bouchard, 45 years old, is 4 hours post-thyroidectomy. The nurse notes that her neck dressing is tight, and there is increased swelling in the anterior neck. Mme Bouchard makes a high-pitched sound when inhaling (stridor).

Question:
What is the nurse’s priority action? *

Loosen the dressing clips and call the Rapid Response Team immediately.

Elevate the head of the bed to 90 degrees.

Ask the patient to speak to check for laryngeal nerve damage.

Administer supplemental oxygen via nasal cannula.

9. M. Robert Lefebvre, 62 years old, has severe, untreated Hypothyroidism and is admitted for a hernia repair. The anesthesiologist and nurse are reviewing his medication plan.

Question:
What special consideration must be taken regarding the administration of sedatives and opioids for this patient? *

He will require higher doses because his metabolism is accelerated.

He will require lower doses because his metabolic rate is significantly slowed.

Opioids are contraindicated; only Tylenol should be used.

He should receive benzodiazepines to prevent thyroid storm.

10. M. Guillaume Pelletier, 22 years old, has uncontrolled Hyperthyroidism. He has lost 10 kg in the last month despite having a voracious appetite. The nurse is planning his nutritional care.

Question:
Which dietary plan is most appropriate for M. Pelletier? *

Low-calorie, high-fiber diet to prevent diarrhea.

High-calorie, high-protein diet with frequent meals.

Low-carbohydrate diet to regulate blood sugar spikes.

High-iodine diet including seaweed and fish.