CEA Nursing Practice Exam

In a patient presenting with severe exophthalmos, what diagnosis should be prioritized?

1. Bilateral conjunctivitis.

2. Hyperthyroidism.

3. Hypothyroidism.

4. Myxedema.

The correct answer is: Hyperthyroidism.

Severe exophthalmos, which is the protrusion of one or both eyes, is primarily associated with hyperthyroidism, particularly in the context of Graves' disease. In this autoimmune condition, the thyroid gland becomes overactive, leading to an increase in thyroid hormones. The elevated hormone levels can result in the accumulation of glycosaminoglycans within the retro-orbital space, causing inflammation and swelling that pushes the eye outward. While conditions such as bilateral conjunctivitis or hypothyroidism may present with eye symptoms, they do not typically cause the pronounced exophthalmos seen in hyperthyroidism. Myxedema, a severe form of hypothyroidism, is more likely to present with other symptoms like edema, weight gain, and general lethargy rather than exophthalmos. Therefore, hyperthyroidism is the most relevant diagnosis to prioritize in the presence of severe exophthalmos.