Endocrine Systems > Medical Surgical
Exam Review
Goitre
Total Questions : 40
Showing 40 questions, Sign in for moreThe nurse is providing education to a group of clients about goiter. Which statement best describes a goiter?
Explanation
A goiter is a noncancerous enlargement of the thyroid gland in the neck. It can result from various causes, including iodine deficiency, thyroid dysfunction, and autoimmune conditions.
Incorrect choices:
a. A goiter is not a hormonal disorder that affects blood sugar levels; it specifically involves the thyroid gland.
c. A goiter is not a bacterial infection affecting the throat and tonsils but related to the thyroid gland.
d. A goiter does not cause inflammation of the adrenal glands; it is specific to the thyroid gland.
The nurse is conducting a health assessment for a client with a suspected goiter. Which area should the nurse palpate to assess for a goiter?
Explanation
The thyroid gland is located in the front of the neck, just below the Adam's apple. Palpation of this area can help assess for the presence of a goiter.
Incorrect choices:
a. Palpation over the sternum is not relevant to assessing a goiter.
b. Palpation behind the ears is not relevant to assessing a goiter.
c. Palpation over the parotid glands is not relevant to assessing a goiter.
The nurse is reviewing the medical history of a client with a goiter. Which condition is commonly associated with goiter development?
Explanation
Hypothyroidism, or an underactive thyroid, is commonly associated with goiter development. When the thyroid gland is unable to produce enough thyroid hormones, it can lead to an enlargement of the gland.
Incorrect choices:
a. Type 2 diabetes is not directly associated with goiter development.
b. Osteoporosis is not directly associated with goiter development.
d. Chronic obstructive pulmonary disease (COPD) is not directly associated with goiter development.
The nurse is assessing a client with a goiter. Which symptom is commonly associated with a goiter that is causing compression of nearby structures?
Explanation
A goiter that causes compression of nearby structures, such as the esophagus, can lead to difficulty swallowing (dysphagia).
Incorrect choices:
a. Weight gain is a symptom of hypothyroidism but not specifically related to goiter compression.
b. Constipation is a symptom of hypothyroidism but not specifically related to goiter compression.
d. Heat intolerance is a symptom of hyperthyroidism but not specifically related to goiter compression.
The nurse is providing education to a client with a goiter. Which dietary element is important for preventing goiter development?
Explanation
Iodine is an essential element for thyroid hormone production. Adequate dietary iodine intake is important for preventing goiter development.
Incorrect choices:
a. Sodium is not directly related to goiter prevention.
b. Calcium is important for bone health but not specifically related to goiter prevention.
d. Iron is important for red blood cell production but not specifically related to goiter prevention.
The nurse is educating a client about the different types of goiters. Which type of goiter is caused by an overproduction of thyroid hormones?
Explanation
A toxic goiter, also known as a toxic nodular goiter or toxic adenoma, is caused by the overproduction of thyroid hormones, leading to hyperthyroidism.
Incorrect choices:
a. A simple goiter is an enlargement of the thyroid gland without any specific hormonal dysfunction.
c. A colloid goiter is characterized by the accumulation of colloid within thyroid follicles and is not specifically related to thyroid hormone overproduction.
d. An endemic goiter is caused by iodine deficiency and is not specifically related to thyroid hormone overproduction.
The nurse is reviewing the medical records of several clients with goiters. Which type of goiter is characterized by multiple nodules within the thyroid gland?
Explanation
A multinodular goiter is characterized by the presence of multiple nodules within the thyroid gland. These nodules can be benign or malignant.
Incorrect choices:
a. A simple goiter is an enlargement of the thyroid gland without specific nodules.
b. A toxic goiter is characterized by the overproduction of thyroid hormones and may or may not be associated with nodules.
c. A colloid goiter is characterized by the accumulation of colloid within thyroid follicles and does not specifically refer to the presence of multiple nodules.
The nurse is providing education to a group of clients about the different types of goiters. Which type of goiter is associated with iodine deficiency?
Explanation
A simple goiter, also known as a nontoxic goiter, is often caused by iodine deficiency. It is characterized by the enlargement of the thyroid gland without specific nodules or hormonal dysfunction.
Incorrect choices:
b. A toxic goiter is characterized by the overproduction of thyroid hormones and may or may not be associated with iodine deficiency.
c. A colloid goiter is characterized by the accumulation of colloid within thyroid follicles and is not specifically related to iodine deficiency.
d. A multinodular goiter may or may not be associated with iodine deficiency and is characterized by the presence of multiple nodules within the thyroid gland.
The nurse is assessing a client with a large, diffuse, painless swelling in the neck. Which type of goiter is characterized by these findings?
Explanation
A simple goiter is characterized by a diffuse enlargement of the thyroid gland that is typically painless and not associated with specific nodules or hormonal dysfunction.
Incorrect choices:
b. A toxic goiter is characterized by the overproduction of thyroid hormones and may or may not present with a large, diffuse swelling.
c. A colloid goiter is characterized by the accumulation of colloid within thyroid follicles and does not specifically refer to the size or painlessness of the swelling.
d. An endemic goiter is caused by iodine deficiency and is not specifically characterized by a large, diffuse, painless swelling.
The nurse is caring for a client with a goiter and is reviewing the client's medical history. Which type of goiter is associated with Hashimoto's thyroiditis?
Explanation
Hashimoto's thyroiditis, an autoimmune condition, is commonly associated with the development of a simple goiter. The immune system attacks the thyroid gland, leading to its enlargement.
Incorrect choices:
b. A toxic goiter is characterized by the overproduction of thyroid hormones and is not specifically associated with Hashimoto's thyroiditis.
c. A colloid goiter is characterized by the accumulation of colloid within thyroid follicles and is not specifically associated with Hashimoto's thyroiditis.
d. An endemic goiter is caused by iodine deficiency and is not specifically associated with Hashimoto's thyroiditis.
The nurse is educating a group of clients about the different causes of goiter. Which cause of goiter is related to a deficiency of dietary iodine?
Explanation
Iodine deficiency is a common cause of goiter, especially in regions where there is insufficient dietary intake of iodine, leading to inadequate production of thyroid hormones.
Incorrect choices:
a. Autoimmune thyroid disease, such as Hashimoto's thyroiditis, is not specifically related to iodine deficiency and is characterized by immune system attack on the thyroid gland.
b. Excessive thyroid hormone production is associated with conditions such as toxic goiter or Graves' disease and is not directly related to iodine deficiency.
c. Radiation exposure can damage the thyroid gland and lead to goiter, but it is not directly related to iodine deficiency.
The nurse is assessing a client with a history of taking certain medications. Which class of medications is known to interfere with thyroid hormone synthesis and may contribute to the development of goiter?
Explanation
Antithyroid medications, such as propylthiouracil (PTU) and methimazole, can interfere with thyroid hormone synthesis and contribute to the development of goiter.
Incorrect choices:
a. Antihypertensives are not known to directly interfere with thyroid hormone synthesis or contribute to goiter development.
b. Antibiotics are not known to directly interfere with thyroid hormone synthesis or contribute to goiter development.
c. Anticoagulants are not known to directly interfere with thyroid hormone synthesis or contribute to goiter development.
The nurse is providing education to a client about the potential causes of goiter. Which condition is characterized by the immune system attacking the thyroid gland, leading to goiter development?
Explanation
Hashimoto's thyroiditis is an autoimmune condition in which the immune system attacks the thyroid gland, leading to inflammation and goiter development.
Incorrect choices:
a. Hypothyroidism can result from various causes, including Hashimoto's thyroiditis, but it is not the primary cause of goiter.
b. Hyperparathyroidism affects the parathyroid glands and is not the primary cause of goiter.
d. Cushing's syndrome is caused by excessive cortisol production and is not the primary cause of goiter.
The nurse is reviewing the medical history of a client with a goiter. Which condition is commonly associated with the development of a goiter?
Explanation
Hyperthyroidism, or excessive thyroid hormone production, is commonly associated with the development of a goiter.
Incorrect choices:
a. Osteoporosis is not directly related to the development of a goiter.
b. Diabetes mellitus is not directly related to the development of a goiter.
d. Chronic obstructive pulmonary disease (COPD) is not directly related to the development of a goiter.
The nurse is providing education to a client about the potential causes of goiter. Which factor may contribute to the development of a goiter in individuals with a genetic predisposition?
Explanation
A family history of thyroid disorders, especially goiter or autoimmune thyroid conditions, can contribute to the development of goiter in individuals with a genetic predisposition.
Incorrect choices:
a. Consumption of high-iodine foods can contribute to iodine-induced goiter but is not specifically related to genetic predisposition.
b. Regular physical exercise is not directly related to the development of goiter.
c. Exposure to cold temperatures is not directly related to the development of goiter.
The nurse is assessing a client with a goiter. Which clinical manifestation is commonly associated with a goiter?
Explanation
Enlargement of the thyroid gland in a goiter can lead to pressure on the esophagus and trachea, causing difficulty swallowing and sometimes difficulty breathing.
Incorrect choices:
a. Increased body temperature is not a typical clinical manifestation of a goiter.
b. Weight gain is not a typical clinical manifestation of a goiter.
d. Excessive thirst is not a typical clinical manifestation of a goiter.
The nurse is performing an assessment on a client with a goiter. Which symptom is commonly associated with a large goiter pressing on the trachea?
Explanation
A large goiter pressing on the trachea can cause wheezing or difficulty breathing due to the obstruction of airflow.
Incorrect choices:
a. Increased urination is not typically associated with a large goiter pressing on the trachea.
c. Increased appetite is not typically associated with a large goiter pressing on the trachea.
d. Swollen ankles are not typically associated with a large goiter pressing on the trachea.
The nurse is assessing a client with a goiter. Which clinical manifestation is commonly associated with an overactive thyroid gland (hyperthyroidism) that may accompany a goiter?
Explanation
Hyperthyroidism, which can be associated with a goiter, often leads to a rapid heartbeat (tachycardia) as a result of increased thyroid hormone levels.
Incorrect choices:
a. Weight gain is not typically associated with hyperthyroidism and goiter.
b. Cold intolerance is not typically associated with hyperthyroidism and goiter.
c. Fatigue may be present in hyperthyroidism, but it is not as specific as a rapid heartbeat.
The nurse is assessing a client with a goiter. Which clinical manifestation is commonly associated with an underactive thyroid gland (hypothyroidism) that may accompany a goiter?
Explanation
Hypothyroidism, which can be associated with a goiter, often leads to fatigue and lethargy due to decreased thyroid hormone levels.
Incorrect choices:
a. Heat intolerance is not typically associated with hypothyroidism and goiter.
b. Restlessness is not typically associated with hypothyroidism and goiter.
c. Weight loss is not typically associated with hypothyroidism and goiter.
The nurse is assessing a client with a goiter. Which clinical manifestation is commonly associated with a goiter that is caused by iodine deficiency?
Explanation
Iodine deficiency can lead to hypothyroidism, which may manifest as dry skin due to decreased thyroid hormone levels.
Incorrect choices:
a. Excessive sweating is not typically associated with iodine deficiency and goiter.
b. Weight gain is a common clinical manifestation of hypothyroidism but is not specific to iodine deficiency.
d. Exophthalmos (bulging eyes) is associated with hyperthyroidism (Graves' disease) and is not typically seen in iodine deficiency-related goiter.
The nurse is reviewing the diagnostic evaluation for a client suspected of having a goiter. Which laboratory test is commonly used to assess thyroid function and determine if the goiter is associated with hyperthyroidism or hypothyroidism?
Explanation
Thyroid-stimulating hormone (TSH) is a hormone produced by the pituitary gland that stimulates the thyroid gland to produce thyroid hormones. An elevated TSH level indicates hypothyroidism, while a low TSH level indicates hyperthyroidism, both of which can be associated with a goiter.
Incorrect choices:
a. Complete blood count (CBC) assesses various components of blood but is not directly related to thyroid function or goiter diagnosis.
b. Blood glucose level is used to diagnose diabetes mellitus and is not directly related to goiter diagnosis.
d. Serum creatinine level is used to assess kidney function and is not directly related to thyroid function or goiter diagnosis.
The nurse is assisting with a radioactive iodine uptake (RAIU) test for a client with a suspected goiter. What is the primary purpose of the RAIU test in the diagnosis of a goiter?
Explanation
The RAIU test involves administering a small amount of radioactive iodine and measuring its uptake by the thyroid gland. This helps assess the production and distribution of thyroid hormones and can aid in diagnosing various thyroid disorders, including goiter.
Incorrect choices:
a. Measuring blood glucose levels is not the primary purpose of the RAIU test and is not directly related to goiter diagnosis.
b. Assessing kidney function is not the primary purpose of the RAIU test and is not directly related to goiter diagnosis.
d. Detecting inflammation in the thyroid gland is not the primary purpose of the RAIU test and is not directly related to goiter diagnosis.
The nurse is reviewing the diagnostic process for a client with a suspected goiter. Which imaging technique is commonly used to visualize the size, shape, and characteristics of the thyroid gland?
Explanation
Thyroid ultrasound is a noninvasive imaging technique that uses sound waves to visualize the thyroid gland, assess its size, shape, and characteristics, and identify any abnormalities or nodules.
Incorrect choices:
a. Electrocardiogram (ECG) is used to assess the electrical activity of the heart and is not related to thyroid imaging.
b. Magnetic resonance imaging (MRI) and c. Computed tomography (CT) scan are imaging techniques that may be used for other purposes but are not typically used for routine thyroid imaging.
The nurse is assisting with a fine-needle aspiration (FNA) biopsy for a client with a thyroid nodule and suspected goiter. What is the primary purpose of an FNA biopsy in the diagnosis of a goiter?
Explanation
Fine-needle aspiration (FNA) biopsy involves using a thin needle to aspirate a tissue sample from the thyroid nodule. The tissue sample is then analyzed to determine if the nodule is benign or malignant, helping in the diagnosis of a goiter.
Incorrect choices:
a. Assessing blood clotting function is not the primary purpose of an FNA biopsy and is not directly related to goiter diagnosis.
b. Evaluating kidney function is not the primary purpose of an FNA biopsy and is not directly related to goiter diagnosis.
c. Determining blood glucose levels is not the primary purpose of an FNA biopsy and is not directly related to goiter diagnosis.
The nurse is educating a client about the diagnostic evaluation for goiter. Which diagnostic test measures the levels of thyroid hormones (T3 and T4) in the blood and can help determine if the goiter is associated with hyperthyroidism or hypothyroidism?
Explanation
A thyroid function panel measures the levels of thyroid hormones (T3 and T4) in the blood, as well as thyroid-stimulating hormone (TSH) levels. This test can help determine if the goiter is associated with hyperthyroidism or hypothyroidism.
Incorrect choices:
a. Serum albumin level is not directly related to thyroid function or goiter diagnosis.
b. Hemoglobin A1c level is used to assess long-term blood glucose control in diabetes and is not directly related to goiter diagnosis.
d. C-reactive protein (CRP) level is a marker of inflammation and is not directly related to thyroid function or goiter diagnosis.
The nurse is caring for a client with a goiter. Which dietary recommendation should the nurse provide to the client to support thyroid health and manage the goiter?
Explanation
Iodine is essential for thyroid hormone production. Increasing the consumption of iodized salt can help support thyroid health and manage goiter caused by iodine deficiency.
Incorrect choices:
b. Limiting intake of fruits and vegetables is not necessary and is not directly related to managing a goiter.
c. Consuming foods high in calcium is important for bone health but is not directly related to managing a goiter.
d. Avoiding foods rich in omega-3 fatty acids is not necessary and is not directly related to managing a goiter.
The nurse is caring for a client with a goiter. Which medication is commonly prescribed to manage hyperthyroidism and reduce the size of a goiter?
Explanation
Methimazole is an antithyroid medication commonly prescribed to manage hyperthyroidism and reduce the size of a goiter by decreasing thyroid hormone production.
Incorrect choices:
a. Levothyroxine (Synthroid) is a thyroid hormone replacement medication and is not used to manage hyperthyroidism or goiter.
c. Insulin glargine (Lantus) is used to manage diabetes and is not related to managing hyperthyroidism or goiter.
d. Metformin (Glucophage) is used to manage diabetes and is not related to managing hyperthyroidism or goiter.
The nurse is providing education to a client with a goiter. Which self-care measure should the nurse recommend to the client to alleviate discomfort and promote thyroid health?
Explanation
Applying warm compresses to the neck can help alleviate discomfort, improve circulation, and promote thyroid health.
Incorrect choices:
a. Applying ice packs to the neck is not recommended as it may worsen discomfort and is not related to promoting thyroid health.
b. Massaging the thyroid gland is not recommended as it can potentially irritate the thyroid and is not related to promoting thyroid health.
c. Performing neck stretches is not recommended as it may worsen discomfort and is not related to promoting thyroid health.
The nurse is caring for a client with a goiter. Which surgical procedure involves the removal of the entire thyroid gland and is considered a definitive treatment for goiter?
Explanation
Thyroidectomy is a surgical procedure that involves the removal of the entire thyroid gland. It is considered a definitive treatment for goiter when other management options are not effective.
Incorrect choices:
b. Parathyroidectomy involves the removal of the parathyroid glands and is not directly related to goiter treatment.
c. Adrenalectomy involves the removal of the adrenal glands and is not directly related to goiter treatment.
d. Nephrectomy involves the removal of a kidney and is not directly related to goiter treatment.
The nurse is caring for a client with a goiter. Which nursing intervention is important to include in the plan of care to prevent potential complications after thyroidectomy?
Explanation
Encouraging deep breathing and coughing exercises helps prevent respiratory complications such as pneumonia after thyroidectomy.
Incorrect choices:
b. Limiting fluid intake is not necessary and does not prevent complications after thyroidectomy.
c. Administering high doses of aspirin is not appropriate for pain management after thyroidectomy and can lead to bleeding complications.
d. Encouraging the client to flex the neck frequently is not recommended after thyroidectomy as it may strain the surgical site and potentially lead to complications.
The nurse is caring for a client with a large goiter. Which complication should the nurse monitor for that can occur due to compression of the trachea and airway obstruction?
Explanation
Compression of the trachea by a large goiter can lead to difficulty breathing (dyspnea) due to airway obstruction. This is an important complication to monitor for in clients with goiter.
Incorrect choices:
a. Hypothyroidism is not a direct complication of tracheal compression and airway obstruction caused by a goiter.
b. Hyperthyroidism is not a direct complication of tracheal compression and airway obstruction caused by a goiter.
c. Dysphagia, or difficulty swallowing, can be a complication of goiter but is not directly related to tracheal compression and airway obstruction.
The nurse is caring for a client with a goiter. Which potential complication should the nurse monitor for that can result from an untreated or inadequately managed goiter?
Explanation
An untreated or inadequately managed goiter can lead to hormonal imbalances and excessive thyroid hormone production, which can result in cardiac arrhythmias.
Incorrect choices:
a. Bradycardia is not a typical complication of an untreated or inadequately managed goiter.
b. Hypertension is not a typical complication of an untreated or inadequately managed goiter.
d. Gastrointestinal bleeding is not a direct complication of an untreated or inadequately managed goiter.
The nurse is providing education to a client with a goiter. Which potential complication should the nurse emphasize as a result of an enlarged thyroid gland pressing on the esophagus?
Explanation
An enlarged thyroid gland pressing on the esophagus can lead to difficulty swallowing (dysphagia) as a potential complication.
Incorrect choices:
a. Gastric ulcers are not directly related to an enlarged thyroid gland pressing on the esophagus.
b. Liver dysfunction is not directly related to an enlarged thyroid gland pressing on the esophagus.
c. Malabsorption is not directly related to an enlarged thyroid gland pressing on the esophagus.
The nurse is caring for a client with a goiter. Which complication should the nurse monitor for that can occur as a result of pressure on the recurrent laryngeal nerve by the enlarged thyroid gland?
Explanation
Pressure on the recurrent laryngeal nerve by an enlarged thyroid gland can lead to hoarseness or voice changes.
Incorrect choices:
a. Osteoporosis is not directly related to pressure on the recurrent laryngeal nerve by an enlarged thyroid gland.
b. Hypertension is not directly related to pressure on the recurrent laryngeal nerve by an enlarged thyroid gland.
d. Peripheral neuropathy is not directly related to pressure on the recurrent laryngeal nerve by an enlarged thyroid gland.
The nurse is assessing a client with a goiter. Which potential complication should the nurse monitor for that can occur due to the release of excess thyroid hormones into the bloodstream?
Explanation
The release of excess thyroid hormones into the bloodstream can lead to a life-threatening condition called thyroid storm, characterized by severe hyperthyroidism.
Incorrect choices:
a. Anemia is not directly related to the release of excess thyroid hormones into the bloodstream.
b. Hyperglycemia is not directly related to the release of excess thyroid hormones into the bloodstream.
c. Hypothyroidism is not directly related to the release of excess thyroid hormones into the bloodstream.
The nurse is assessing a client with a suspected goiter. Which finding would the nurse expect to observe upon physical examination?
Explanation
A goiter is characterized by an enlarged thyroid gland, which can be observed and palpated during a physical examination.
Incorrect choices:
a. Increased body temperature is not a specific finding associated with a goiter.
b. Bradycardia is not a specific finding associated with a goiter.
d. Cyanotic nail beds are not a specific finding associated with a goiter.
The nurse is educating a client about the risk factors for developing a goiter. Which statement by the client indicates a correct understanding of the risk factors?
Explanation
Exposure to excessive radiation is a known risk factor for the development of goiter.
Incorrect choices:
a. Having a family history of goiter can increase the risk of developing it.
b. Consuming a diet rich in iodine is important to prevent iodine deficiency-related goiter, but excessive iodine intake can also contribute to goiter.
d. Being physically inactive is not directly linked to the development of goiter.
The nurse is reviewing the medical history of a client with a goiter. Which condition should the nurse recognize as a potential cause of secondary goiter?
Explanation
Hypothyroidism can lead to an increase in thyroid-stimulating hormone (TSH), which can cause secondary goiter.
Incorrect choices:
b. Hyperthyroidism is more commonly associated with primary goiter.
c. Diabetes mellitus is not a direct cause of goiter.
d. Hypertension is not a direct cause of goiter.
The nurse is caring for a client with a goiter. Which assessment finding should the nurse prioritize in order to determine the client's thyroid function?
Explanation
Thyroid function blood tests, such as measuring levels of thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3), are the most accurate indicators of thyroid function.
Incorrect choices:
a. Blood pressure measurement is not directly related to determining thyroid function.
b. Visual acuity test is not directly related to determining thyroid function.
c. Deep tendon reflexes are not directly related to determining thyroid function.
The nurse is providing education to a client with a goiter. Which statement by the client indicates a need for further clarification regarding the management of goiter?
Explanation
While iodine deficiency can contribute to goiter, it's important for clients to have an adequate intake of iodine. Avoiding iodine-rich foods is not recommended.
Incorrect choices:
a. Taking prescribed thyroid hormone replacement medication as directed is an important part of managing goiter.
c. Regular follow-up appointments with a healthcare provider are important for monitoring the progress of the goiter and thyroid function.
d. Using over-the-counter pain relievers to manage discomfort associated with goiter is a reasonable approach.
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