During the physical examination of a 36-year-old female, the ...

[jessicacav]

During the physical examination of a 36-year-old female, the nurse finds that the patient's thyroid gland cannot be palpated. The most appropriate action by the nurse is to
 
  a. palpate the patient's neck more deeply.
  b. document that the thyroid was nonpalpable.
  c. notify the health care provider immediately.
  d. teach the patient about thyroid hormone testing.

Question 2

A 30-year-old patient seen in the emergency department for severe headache and acute confusion is found to have a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test?
 
  a. Urinary 17-ketosteroids
  b. Antidiuretic hormone level
  c. Growth hormone stimulation test
  d. Adrenocorticotropic hormone level

[smrtceo]

Answer to Question 1

ANS: B
The thyroid is frequently nonpalpable. The nurse should simply document the finding. There is no need to notify the health care provider immediately about a normal finding. There is no indication for thyroid-stimulating hormone (TSH) testing unless there is evidence of thyroid dysfunction. Deep palpation of the neck is not appropriate.

Answer to Question 2

ANS: B
Elevated levels of antidiuretic hormone will cause water retention and decrease serum sodium levels. The other tests would not be helpful in determining possible causes of the patient's hyponatremia.