NR 511 wk 6 quiz
Question 1
1 / 1 pts
A client with hyperthyroidism presents with a complaint of a “gritty” feeling in her eyes. Over
the past
... [Show More] week, her visual acuity has diminished, and her ability to see colors has changed. She
also has a feeling of pressure behind her eyes. The next step for the nurse practitioner is to:
Order a total thyroxine (T4).
Correct!
Refer the client for immediate evaluation by an ophthalmologist.
Order a thyroid ultrasound.
Prescribe a beta-adrenergic blocker.
The practitioner should refer the client for an immediate evaluation by an ophthalmologist.
Clinically recognized Graves ophthalmopathy occurs in about 50% of cases of Graves disease. A
client with Graves orbitopathy with these complaints is at risk of blindness if there is
compression of the optic nerve. Additional symptoms include photophobia and diplopia.
Autoantibodies present in Graves disease can cause increased muscle thickness in the eye,
leading to edema and compression of the optic nerve. Fundal exam may reveal disk swelling.
This is an emergency situation that may require hospitalization and treatment with prednisone to
diminish the inflammation. Artificial tears are also helpful. In 75% of clients, the onset of Graves
orbitopathy occurs within a year before or after the diagnosis of thyrotoxicosis but can
sometimes precede or follow thyrotoxicosis by several years.
Question 2
1 / 1 pts
A 23-year-old female complains of palpitations that started a few weeks ago; they occur 2 to 4
times a day and last 5 to 10 minutes. She feels nervous and is having trouble sleeping. Her stools
have been frequent (1-3 per day) and loose. She is taking levothyroxine 150 µg daily. Her labs
indicate free thyroxine (FT4) 2.28 and thyroid-stimulating hormone (TSH) 0.022. She has a
history of Graves disease and had radioactive iodine (RAI) treatment a few months ago. She has
been on thyroid replacement for 2 months. Based on these findings, what should the clinician do
next? [Show Less]