During a head and neck assessment, the nurse notes that the client's neck is enlarged, which is later confirmed to be due to a goiter. The client's serum thyroid levels are within normal limits. Which type of goiter does the nurse suspect?
A) Toxic multinodular goiter
B) Endemic goiter
C) Nontoxic diffuse goiter
D) Chronic autoimmune thyroiditis
C) Nontoxic diffuse goiter
Explanation: A) Specific types of goiters include nontoxic diffuse goiters, nontoxic multinodular goiters, endemic goiter, chronic autoimmune (Hashimoto) thyroiditis, and toxic multinodular goiter (Graves disease). Toxic multinodular goiter (Graves disease) is the most common cause of hyperthyroidism. A client with this condition would have serum thyroid levels reflecting hyperthyroidism.
B) Specific types of goiters include nontoxic diffuse goiters, nontoxic multinodular goiters, endemic goiter, chronic autoimmune (Hashimoto) thyroiditis, and toxic multinodular goiter (Graves disease). Endemic goiter is caused by iodine deficiency, leading to increased TSH secretion. The client's TSH would be elevated, not within normal limits.
C) Specific types of goiters include nontoxic diffuse goiters, nontoxic multinodular goiters, endemic goiter, chronic autoimmune (Hashimoto) thyroiditis, and toxic multinodular goiter (Graves disease). Nontoxic diffuse goiter causes a diffuse enlargement of the neck with normal TSH levels. This best describes the client's clinical presentation.
D) Specific types of goiters include nontoxic diffuse goiters, nontoxic multinodular goiters, endemic goiter, chronic autoimmune (Hashimoto) thyroiditis, and toxic multinodular goiter (Graves disease). Hashimoto thyroiditis is the most common cause of hypothyroidism. The client's TSH would be increased in this condition, not within normal limits.
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