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Concept 10: Thermoregulation
Giddens: Concepts for Nursing Practice, 2nd Edition

MULTIPLE CHOICE

1. The nursery nurse should identify which newborn at significant risk for hypothermic
alteration in thermoregulation?
a. Large for gestational age
b. Low birth weight
c. Born at term
d. Well nourished
ANS: B
Low birth weight and poorly nourished infants (particularly premature infants) and children
are at greatest risk for hypothermia. A large for gestational age infant would not be
malnourished. An infant born at term is not considered at significant risk. A well nourished
infant is not at significant risk.

REF: Page 88
OBJ: NCLEX® Client Needs Category: Physiological Integrity: Physiological Adaptation

2. A volunteer at the senior center asks the visiting nurse why the senior citizens always seem to
be complaining about the temperature. What is the nurse’s best response?
a. Older people have a diminished ability to regulate body temperature because of
active sweat glands.
b. Older people have a diminished ability to regulate body temperature because of
increased circulation.
c. Older people have a diminished ability to regulate body temperature because of
peripheral vasoconstriction.
d. Older people have a diminished ability to regulate body temperature because of
slower metabolic rates.
ANS: D
Slower metabolic rates are one factor that reduces the ability of older adults to regulate
temperature and be comfortable when there are any temperature changes. As the body ages,
the sweat glands decrease in number and efficiency. Older adults have reduced circulation.
The body conserves heat through peripheral vasoconstriction, and older adults have a
decreased vasoconstrictive response, which impacts ability to respond to temperature changes.

REF: Page 88
OBJ: NCLEX® Client Needs Category: Physiological Integrity: Physiological Adaptation

3. The nurse admitting a patient to the emergency department on a very hot summer day would
suspect hyperthermia when the patient demonstrates which assessment finding?
a. Decreased respirations
b. Low pulse rate
c. Red, sweaty skin
d. Slow capillary refill
ANS: C
 With hyperthermia, vasodilatation occurs causing the skin to appear flushed and warm or hot
to touch. There is an increased respiration rate with hyperthermia. The heart rate increases
with hyperthermia. With hypothermia there is slow capillary refill.

REF: Page 89
OBJ: NCLEX® Client Needs Category: Physiological Integrity: Physiological Adaptation

4. What is the priority nursing action for a patient suspected to be hypothermic?

a. Assess vital signs.
b. Hydrate with intravenous (IV) fluids.
c. Provide a warm blanket.
d. Remove wet clothes.
ANS: D
The first thing to do with a patient suspected to be hypothermic is to remove wet clothes,
because heat loss is five times greater when clothing is wet. Assessing vital signs is important,
but the wet clothes should be removed first. Hydration is very important with hyperthermia
and the associated danger of dehydration, but there is not a similar risk with hypothermia. A
warm blanket over wet clothes would not be an effective warming strategy.

REF: Page 90
OBJ: NCLEX® Client Needs Category: Physiological Integrity: Physiological Adaptation

5. Which strategies should the nurse include in a community program for senior citizens related
to dealing with cold winter temperatures?
a. Avoiding hot beverages
b. Shopping at an indoor mall
c. Using a fan at low speed
d. Walking slowly in the park
ANS: B
Shopping indoors where there is protection from the elements and temperature control is one
strategy to avoid cold temperatures. Hot beverages can help an individual deal with cold
weather. Avoiding breezes and air currents is recommended to conserve body temperature.
Physical activity can increase body temperature, and if the senior is going to walk in the park,
weather-appropriate (warm) clothing and a usual or brisk pace, not a slow pace, would be
recommended.

REF: Page 90
OBJ: NCLEX® Client Needs Category: Physiological Integrity: Physiological Adaptation

6. During orientation to an emergency department, the nurse educator would be concerned if the
new nurse listed which of the following as a risk factor for impaired thermoregulation?
a. Impaired cognition
b. Occupational exposure
c. Physical agility
d. Temperature extremes
ANS: C
 Physical agility is not a risk factor for impaired thermoregulation. The nurse educator would
use this information to plan additional teaching to include medical conditions and gait
disturbance as risk factors for hypothermia, because their bodies have a reduced ability to
generate heat. Impaired cognition is a risk factor. Recreational or occupational exposure is a
risk factor. Temperature extremes are risk factors for impaired thermoregulation.

REF: Page 88 |Page 89

OBJ: NCLEX® Client Needs Category: Physiological Integrity: Physiological Adaptation

7. What is the most appropriate measure for a nurse to use in assessing core body temperature
when there are suspected problems with thermoregulation?
a. Oral thermometer
b. Rectal thermometer
c. Temporal thermometer scan
d. Tympanic membrane sensor
ANS: B
The most reliable means available for assessing core temperature is a rectal temperature,
which is considered the standard of practice. An oral temperature is a common measure but
not the most reliable. A temporal thermometer scan has some limitations and is not the
standard. The tympanic membrane sensor could be used as a second source for temperature
assessment.

REF: Page 89
OBJ: NCLEX® Client Needs Category: Physiological Integrity: Physiological Adaptation

8. The nurse planning care for a patient with hypothermia should consider what similar
exemplar?
a. Heat exhaustion
b. Heat stroke
c. Infection
d. Prematurity
ANS: D
Prematurity, frost bite, environmental exposure, and brain injury are considered exemplars of
hypothermia. Heat exhaustion is an exemplar of hyperthermia. Heat stroke is an exemplar of
hyperthermia. Infection is an exemplar of hyperthermia.

REF: Page 89
OBJ: NCLEX® Client Needs Category: Physiological Integrity: Physiological Adaptation
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95 July
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400 Ward W A 99 April
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July
2827 Wallace J Cav 2M
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15 Oct
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14 Aug
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27
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- 9
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24
146 June
2310 Welsh L
B 22
120 Sept
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9428 Weaver J Cav 1E Sept
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184 Aug
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22 Oct
11061 Wellder C M Cav
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155 Oct
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12 Aug
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151 July
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20 Mar
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125 April
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22 Aug
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12049 Whitmans P
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4155 Whitlock Wm Art
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132 May
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3757 Wilson John
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11983 Wilson W
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63 Sept
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3947 Williams O, S’t Bat
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24 Aug
7112 Williams I B Cav
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85 Aug
6219 Williams C R
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3069 Wiron P Cav
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63 July
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1938 Wilcox Geo Cav
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14 June
2044 Wilcox R
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55 Oct
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11428 Wilcox C, S’t Cav 5G
24
59 Feb
12607 Wiley I 65
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121 Oct
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6
164 Sept
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115 Sept
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21
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10977
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5663 Wicks Frank Art 1K
14
100 Oct
11474 Winney G A
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10 Oct
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117 Aug
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19
115 Sept
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10063 Wood H
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9715 Wood J Cav
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D 10
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24 Aug
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52 April
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C 16
118 Aug
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E 6
43 Oct
10941 Wright D
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148 Aug
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I 9
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147 Aug
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12 Aug
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21
41 Aug
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5598 Young Chas
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22 Sept
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Aug
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148 Aug
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10481 Yonker W Art
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Sept
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40 Dec
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145 Feb
12617 Zegler S 65
G 9
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2571.
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June
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275 Callowhill B 2F Mar 31
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11844 Moss Wm 1F Nov 5
1
8690 Norfield Warren Sept 14
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370 Stone Jno A 2F Apr 5
2636 Smith Jas 2F June 29
2
4899 Smith George Aug 5
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333 Turner F 2 I Apr 2
798 Turner H, Colored 2 I Apr 29
204 Weeks Nathan 2F Mar 28
2
712 Williams Thos Apr 24
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Total 17.

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Mar
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30
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789
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100 May
1118 Ames George
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45 June
1550 Allen W
B 1
51 June
1569 Alinger D
C 2
111 June
1724 Anderson D
B 8
89 June
1779 Augustus T
K 9
94 June
1805 Akers A A
F 10
33 June
2040 Aldridge C W
- 15
103 July
2935 Adam Miller
I 5
93 July
3046 Anderson R
C 8
60 July
3197 Aldbrook C W
- 12
89 July
3485 Arthur J C, S’t
A 17
21 July
3852 Armebrish A
A 24
72 July
3932 Almond A
A 25
Aug
4529 Arnold Chas Cav 9G
2
20 Aug
4990 Ailes T G
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5048 Andrews Sam’l - - Aug
G 8
Aug
6422 Adams E Cav 2C
22
121 Aug
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C 31
135 Sept
7482 Alward A
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69 Sept
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64 Sept
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D 4
34 Sept
9818 Alown A
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63 Oct
10393 Andrews I R
K 6
122 Oct
10425 Adams I
I 6
91 Oct
10874 Allen James C
F 13
24 Oct
11198 Andermill John
K 20
Jan
12495 Allen J W, Cor 1G 65
20
45 Mar
188 Baiel W T, S’t 64
F 27
Bodin Thomas 44 Mar
207
S, S’t - 28
Beaver George 111 Apr
691
E B 23
Beeman 125 May
829
Richard E 1
Biddinger M, 94 May
861
Mus K 3
952 Branigan 82 May
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70 May
1094 Blangy S
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45 May
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99 May
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May
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25
45 May
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May
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89 May
1385 Bowers James
A 26
May
1468 Boyd H I 7H
30
June
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4
16 June
1609 Bryan R
C 4
19 June
1781 Balcomb D
F 9
June
1919 Brownles John 7 I
14
135 June
1937 Brooks J
I 14
45 June
1970 Bothin W J
F 15
Bartholomew E 205 June
1993
W C 15
105 June
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45 June
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49 June
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90 June
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2292 Burnham W Art 1K
21
45 June
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21 June
2492 Bratt G, S’t
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39 June
2599 Broughfman I
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15 June
2696 Brandon John
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92 July
3053 Barnes V H
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23 July
3245 Brown Charles
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111 July
3299 Burns M G
B 13
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3608 Brackneck H Cav 7A
19
July
3656 Bogart John 9G
20
July
3706 Bontrell C 6G
21
45 July
3756 Butch O
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51 July
3831 Bowman S
K 23
4073 Brockway M Art 2D July
 27
11 July
4279 Boyle W H
H 30
125 Aug
4684 Britton B H
H 4
45 Aug
4968 Berdy M J
D 7
126 Aug
5138 Buckle J J
E 9
Aug
5219 Brabham Geo Cav 9B
10
Aug
5498 Baldwin Geo “ 9G
13
Bonestine W H, 107 Aug
5653
Cor I 14
121 Aug
5656 Burna J M
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19 Aug
5758 Balmet J
I 15
10 Aug
5771 Brutch E Cav
I 15
123 Aug
5819 Bond S T
B 16
130 Aug
5825 Boyle H
B 16
61 Aug
5937 Bower F
I 17
31 Aug
5985 Birch L T
H 17
104 Aug
6008 Bowman A
E 17
July
6020 Bright N 6E
17
111 Aug
6152 Brown G S
F 18
6839 Baren T J, Cor 89 Aug
A 25
26 Aug
7280 Barrett S C
F 30
70 Aug
7283 Bell A
B 30
121 Sept
7484 Baxter P D
D 1
14 Sept
7490 Brenning C
G 1
26 Sept
7529 Brown W
G 1
33 Sept
7806 Bear E
A 4
54 Sept
7983 Bender C
C 6
110 Sept
7993 Brown M, Cor
F 6
31 Sept
7994 Barnes T S
B 6
135 Sept
8365 Benear W A
F 10
135 Sept
8376 Barston G H
F 10
60 Sept
8476 Brenner N
F 11
36 Sept
8496 Barnes A
G 11
Sept
8508 Blythe C 1 I
12
65 Sept
8509 Brinhomer J
C 12
41 Sept
8676 Brown H H
A 13
8693 Bell James 135 Sept
 B 14
126 Sept
8872 Buckley J G
A 15
Sept
8939 Blessing C 9F
16
94 Sept
9287 Baker W C
- 19
135 Sept
9446 Brookover Geo
B 21
122 Sept
9473 Briace J R
C 21
101 Sept
9625 Bradley A
A 24
72 Sept
9679 Blackman S
G 24
14 Sept
9897 Birchfield Eli
- 27
34 Sept
9949 Beant H T
D 28
43 Oct
10120 Brewer D C
K 1
21 Oct
10199 Brown E N
E 2
20 Oct
10281 Brum W H, S’t
B 4
17 Oct
10591 Briggs F
G 10
153 Oct
11072 Baymher L G
A 17
112 Oct
11307 Boles G
H 22
11 Oct
11308 Bunker J 64
K 22
12 Oct
11313 Burns M
K 22