2026/2027
Herzing University NSG 223
Medical-Surgical Nursing II Exam 1
2026/2027 Quiz Bank and Detailed
Revision Study Notes for Success
Question 1
A 42-year-old female with suspected Graves’ disease is assessed by the nurse. Which
clinical finding is most expected?
A. Anorexia
B. Tachycardia
C. Weight gain
D. Cold skin
Correct Answer: B. Tachycardia
Rationale: Graves’ disease is a hyperthyroid condition characterized by increased
metabolic activity and sympathetic stimulation. This leads to tachycardia, heat
intolerance, weight loss, and nervousness. Anorexia, weight gain, and cold skin are
typically associated with hypothyroidism, not hyperthyroidism.
Question 2
A client with thyrotoxicosis is asked about menstrual changes. Which finding is most
likely?
A. Dysmenorrhea
B. Metrorrhagia
C. Oligomenorrhea
D. Menorrhagia
Correct Answer: C. Oligomenorrhea
Rationale: Thyrotoxicosis commonly causes hormonal imbalance leading to reduced
menstrual flow or even amenorrhea (oligomenorrhea). Dysmenorrhea is painful
menstruation, while menorrhagia and metrorrhagia are more associated with
hypothyroidism.
Question 3
,2026/2027
Which findings are expected in hypothyroidism? (Select all that apply)
A. Rapid pulse
B. Fatigue
C. Weight gain
D. Hair loss
E. Constipation
F. Menorrhagia
Correct Answer: B, C, D, E, F
Rationale: Hypothyroidism slows metabolism, leading to fatigue, weight gain, coarse
hair, constipation, and heavy menstrual bleeding (menorrhagia). Rapid pulse is
incorrect because hypothyroidism causes bradycardia.
Question 4
A client taking Propylthiouracil (PTU) should immediately report which symptom?
A. Constipation
B. Sore throat
C. Increased urination
D. Menstrual pain
Correct Answer: B. Sore throat
Rationale: PTU can cause agranulocytosis, a dangerous drop in white blood cells.
Early signs include sore throat and fever, which must be reported immediately. Other
options are not related to PTU toxicity.
Question 5
A client with thyrotoxicosis is irritable and emotionally unstable. What is the best
explanation?
A. Psychological stress
B. Temporary confusion
C. Excess thyroid hormone levels
D. Work-related anxiety
Correct Answer: C. Excess thyroid hormone levels
Rationale: High thyroid hormone levels overstimulate the nervous system, leading to
irritability, anxiety, and emotional instability. This is physiological, not psychological
or situational.
,2026/2027
Question 6
A client taking PTU reports improved sleep. This indicates:
A. Overdose of medication
B. Therapeutic effect
C. Disease progression
D. Side effect of medication
Correct Answer: B. Therapeutic effect
Rationale: Improved sleep indicates reduced hyperthyroid activity. PTU decreases
thyroid hormone production, reducing hypermetabolic symptoms such as insomnia.
Question 7
A client with exophthalmos should be instructed to:
A. Massage eyes daily
B. Apply moist gauze
C. Wear dark sunglasses
D. Use eye anesthetics regularly
Correct Answer: C. Wear dark sunglasses
Rationale: Sunglasses protect exposed corneas from irritation due to eyelid retraction
in Graves’ disease. Other interventions do not prevent corneal injury effectively.
Question 8
Radioactive iodine (RAI) therapy works by:
A. Blocking iodine absorption
B. Increasing hormone storage
C. Destroying thyroid tissue
D. Stimulating hormone release
Correct Answer: C. Destroying thyroid tissue
Rationale: RAI destroys thyroid follicular cells, permanently reducing hormone
production. It is used as a non-surgical thyroid ablation method.
Question 9
A key teaching after RAI therapy is:
, 2026/2027
A. Monitor for hyperthyroidism
B. Avoid all physical activity
C. Lifelong thyroid hormone replacement
D. Stop medications after 1 week
Correct Answer: C. Lifelong thyroid hormone replacement
Rationale: RAI often results in permanent hypothyroidism, requiring lifelong
levothyroxine replacement therapy.
Question 10
SSKI is given preoperatively to:
A. Reduce hormone production
B. Reduce thyroid vascularity
C. Treat infection
D. Stimulate metabolism
Correct Answer: B. Reduce thyroid vascularity
Rationale: SSKI decreases blood flow to the thyroid, reducing surgical bleeding risk
during thyroidectomy.
Question 11
How should SSKI be administered?
A. Undiluted
B. With ice chips
C. Diluted through straw
D. Mixed with food
Correct Answer: C. Diluted through straw
Rationale: SSKI must be diluted to reduce irritation and prevent tooth staining.
Drinking through a straw protects teeth.
Question 12
After thyroidectomy, asking the client to speak assesses:
A. Bleeding
B. Airway obstruction
Herzing University NSG 223
Medical-Surgical Nursing II Exam 1
2026/2027 Quiz Bank and Detailed
Revision Study Notes for Success
Question 1
A 42-year-old female with suspected Graves’ disease is assessed by the nurse. Which
clinical finding is most expected?
A. Anorexia
B. Tachycardia
C. Weight gain
D. Cold skin
Correct Answer: B. Tachycardia
Rationale: Graves’ disease is a hyperthyroid condition characterized by increased
metabolic activity and sympathetic stimulation. This leads to tachycardia, heat
intolerance, weight loss, and nervousness. Anorexia, weight gain, and cold skin are
typically associated with hypothyroidism, not hyperthyroidism.
Question 2
A client with thyrotoxicosis is asked about menstrual changes. Which finding is most
likely?
A. Dysmenorrhea
B. Metrorrhagia
C. Oligomenorrhea
D. Menorrhagia
Correct Answer: C. Oligomenorrhea
Rationale: Thyrotoxicosis commonly causes hormonal imbalance leading to reduced
menstrual flow or even amenorrhea (oligomenorrhea). Dysmenorrhea is painful
menstruation, while menorrhagia and metrorrhagia are more associated with
hypothyroidism.
Question 3
,2026/2027
Which findings are expected in hypothyroidism? (Select all that apply)
A. Rapid pulse
B. Fatigue
C. Weight gain
D. Hair loss
E. Constipation
F. Menorrhagia
Correct Answer: B, C, D, E, F
Rationale: Hypothyroidism slows metabolism, leading to fatigue, weight gain, coarse
hair, constipation, and heavy menstrual bleeding (menorrhagia). Rapid pulse is
incorrect because hypothyroidism causes bradycardia.
Question 4
A client taking Propylthiouracil (PTU) should immediately report which symptom?
A. Constipation
B. Sore throat
C. Increased urination
D. Menstrual pain
Correct Answer: B. Sore throat
Rationale: PTU can cause agranulocytosis, a dangerous drop in white blood cells.
Early signs include sore throat and fever, which must be reported immediately. Other
options are not related to PTU toxicity.
Question 5
A client with thyrotoxicosis is irritable and emotionally unstable. What is the best
explanation?
A. Psychological stress
B. Temporary confusion
C. Excess thyroid hormone levels
D. Work-related anxiety
Correct Answer: C. Excess thyroid hormone levels
Rationale: High thyroid hormone levels overstimulate the nervous system, leading to
irritability, anxiety, and emotional instability. This is physiological, not psychological
or situational.
,2026/2027
Question 6
A client taking PTU reports improved sleep. This indicates:
A. Overdose of medication
B. Therapeutic effect
C. Disease progression
D. Side effect of medication
Correct Answer: B. Therapeutic effect
Rationale: Improved sleep indicates reduced hyperthyroid activity. PTU decreases
thyroid hormone production, reducing hypermetabolic symptoms such as insomnia.
Question 7
A client with exophthalmos should be instructed to:
A. Massage eyes daily
B. Apply moist gauze
C. Wear dark sunglasses
D. Use eye anesthetics regularly
Correct Answer: C. Wear dark sunglasses
Rationale: Sunglasses protect exposed corneas from irritation due to eyelid retraction
in Graves’ disease. Other interventions do not prevent corneal injury effectively.
Question 8
Radioactive iodine (RAI) therapy works by:
A. Blocking iodine absorption
B. Increasing hormone storage
C. Destroying thyroid tissue
D. Stimulating hormone release
Correct Answer: C. Destroying thyroid tissue
Rationale: RAI destroys thyroid follicular cells, permanently reducing hormone
production. It is used as a non-surgical thyroid ablation method.
Question 9
A key teaching after RAI therapy is:
, 2026/2027
A. Monitor for hyperthyroidism
B. Avoid all physical activity
C. Lifelong thyroid hormone replacement
D. Stop medications after 1 week
Correct Answer: C. Lifelong thyroid hormone replacement
Rationale: RAI often results in permanent hypothyroidism, requiring lifelong
levothyroxine replacement therapy.
Question 10
SSKI is given preoperatively to:
A. Reduce hormone production
B. Reduce thyroid vascularity
C. Treat infection
D. Stimulate metabolism
Correct Answer: B. Reduce thyroid vascularity
Rationale: SSKI decreases blood flow to the thyroid, reducing surgical bleeding risk
during thyroidectomy.
Question 11
How should SSKI be administered?
A. Undiluted
B. With ice chips
C. Diluted through straw
D. Mixed with food
Correct Answer: C. Diluted through straw
Rationale: SSKI must be diluted to reduce irritation and prevent tooth staining.
Drinking through a straw protects teeth.
Question 12
After thyroidectomy, asking the client to speak assesses:
A. Bleeding
B. Airway obstruction
