Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
28. A client with a history of Graves' disease is admitted for uncontrolled hyperglycemia and a foot ulcer. This client requires close monitoring because of the increased risk of: Select all that apply.
Test-Taking Tip
Focus on the options that would result from a metabolic "storm"—a thyroid storm. Recall that thyroid storm is rare but a life-threatening medical emergency.
Content Area: Adult Health, Endocrine; Integrated Process: Nursing Process, Analysis; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Medical Emergencies
Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
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Answer 1 is correct because the client is at risk for thyroid storm because of a second illness, which can lead to hypotension and if untreated, heart failure. Answer 2 is correct because an elevated temperature is a sign of thyroid storm, which is a life-threatening form of hyperthyroidism. When a client with hyperthyroidism suffers a second illness, thyroid storm is a risk. Answer 3 is incorrect because Graves' disease is a hyperthyroid state. Answer 4 is incorrect because the added illnesses of hyperglycemia and a foot ulcer may potentiate a thyroid storm. Hypoglycemia may be a concern later with treatment. Answer 5 is correct because thyroid storm is an acute episode of thyroid overactivity. The metabolism is markedly increased, and extreme tachycardia occurs.
