MED SURG II HESI ELSEVIER EXAM 2026 AND
2027 ULTIMATE SUCCESS PACK COMPLETE
QUESTIONS WITH 100% CORRECT ANSWERS.
◎ When conducting a health history with a female client with thyrotoxicosis, the nurse
should ask about which of the following changes in the menstrual cycle?
1. dysmenorrhea
2. metrorrhagia
3. oligomenorrhea
4. menorrhagia ANSWER:- 3. oligomenorrhea
A change in the menstrual interval, diminished menstrual flow (oligomenorrhea), or even
the absence of menstruation (amenorrhea) may result from the hormonal imbalances of
thyrotoxicosis. Oligomenorrhea in women and decreased libido and impotence in men
are common features of thyrotoxicosis. Dysmenorrhea is painful menstruation.
Metrorrhagia, blood loss between menstrual periods, is a symptom of hypothyroidism.
Menorrhagia, excessive bleeding during menstrual periods, is a symptom of
hypothyroidism.
CN: Physiological adaptation; CL: Analyze
◎ A 34-year-old female is diagnosed with hypothyroidism. The nurse should assess the
client for which of the following? (Select all that apply.)
1. rapid pulse
2. decreased energy and fatigue
3. weight gain of 10 lbs (4.5 kg)
4. fine, thin hair with hair loss
5. constipation
6. menorrhagia. ANSWER:- 2. decreased energy and fatigue, 3. weight gain of 10 lbs
(4.5 kg), 5. constipation, 6. menorrhagia
Clients with hypothyroidism exhibit symptoms indicating a lack of thyroid hormone.
Bradycardia, decreased energy and lethargy, memory problems, weight gain, coarse
hair, constipation, and menorrhagia are common signs and
symptoms of hypothyroidism.
CN: Physiological adaptation; CL: Analyze
◎ Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse
should teach the client to immediately report which of the following?
,1. sore throat
2. painful, excessive menstruation
3. constipation
4. increased urine output ANSWER:- 1. sore throat
The most serious adverse effects of PTU are leukopenia and agranulocytosis, which
usually occur within the first 3 months of treatment. The client should be taught to
promptly report to the health care provider signs and symptoms of infection, such as a
sore throat and fever. Clients having a sore throat and fever should have an immediate
white blood cell count and differential performed, and the drug must be withheld until
the results are obtained. Painful menstruation, constipation, and increased urine output
are not associated with PTU therapy.
CN: Pharmacological and parenteral therapies; CL: Synthesize
◎ A client with thyrotoxicosis says to the nurse, "I am so irritable. I am having
problems at work because I lose my temper very easily." Which of the following
responses by the nurse would give the client the most accurate explanation of her
behavior?
1. "Your behavior is caused by temporary confusion brought on by your illness."
2. "Your behavior is caused by the excess thyroid hormone in your system."
3. "Your behavior is caused by your worrying about the seriousness of your illness."
4. "Your behavior is caused by the stress of trying to manage a career and cope with
illness." ANSWER:- 2. "Your behavior is caused by the excess thyroid hormone in your
system."
A typical sign of thyrotoxicosis is irritability caused by the high levels of circulating
thyroid hormones in the body. This symptom decreases as the client responds to
therapy. Thyrotoxicosis does not cause confusion. The client may be worried about her
illness, and stress may influence her mood; however, irritability is a common symptom
of thyrotoxicosis and the client should be informed of that fact rather than blamed.
CN: Psychosocial integrity; CL: Synthesize
◎ The nurse is evaluating a client with hyperthyroidism who is taking
Propylthiouracil (PTU) 100 mg/day in three divided doses for maintenance therapy.
Which of the following statements from the client indicates the desired outcome of the
drug?
1. "I have excess energy throughout the day."
2. "I am able to sleep and rest at night."
3. "I have lost weight since taking this medication."
4. "I do perspire throughout the entire day." ANSWER:- 2. "I am able to sleep and rest at
night."
, PTU is a prototype of thioamide antithyroid drugs. It inhibits production of thyroid
hormones and peripheral conversion of T4 to the more active T3. A client taking this
antithyroid drug should be able to sleep and rest well at night since the level of thyroid
hormones is reduced in the blood. Excess energy throughout the day, loss of weight
and perspiring through the day are symptoms of hyperthyroidism indicating the drug has
not produced its outcome.
CN: Pharmacological and parenteral therapies; CL: Evaluate.
◎ The nurse should teach the client with Graves' disease to prevent corneal
irritation from mild exophthalmos by:
1. Massaging the eyes at regular intervals.
2. Instilling an ophthalmic anesthetic as prescribed.
3. Wearing dark-colored glasses.
4. Covering both eyes with moistened gauze pads. ANSWER:- 3. Wearing dark-colored
glasses.
Treatment of mild ophthalmopathy that may accompany thyrotoxicosis includes
measures such as wearing sunglasses to protect the eyes from corneal irritation.
Treatment of ophthalmopathy should be performed in consultation with an
ophthalmologist. Massaging the eyes will not help to protect the cornea. An ophthalmic
anesthetic is used to examine and possibly treat a painful eye, not protect the cornea.
Covering the eyes with moist gauze pads is not a satisfactory nursing measure to
protect
the eyes of a client with exophthalmos because treatment is not focused on moisture to
the eye but rather on protecting the cornea and optic nerve. In exophthalmos, the
retrobulbar connective tissues and extraocular muscle volume are expanded because of
fluid retention. The pressure is also increased.
CN: Reduction of risk potential; CL: Synthesize
◎ A client with Graves' disease is treated with radioactive iodine (RAI) in the
form of sodium iodide 131I. Which of the following statements by the nurse will explain
to the client how the drug works?
1. "The RAI stabilizes the thyroid hormone levels before a thyroidectomy."
2. "The RAI reduces uptake of thyroxine and thereby improves your condition."
3. "The RAI lowers the levels of thyroid hormones by slowing your body's
production of them."
4. "The RAI destroys thyroid tissue so that thyroid hormones are no longer produced."
ANSWER:- 4. "The RAI destroys thyroid tissue so that thyroid hormones are no longer
produced."
Sodium iodide 131I destroys the thyroid follicular cells, and thyroid hormones are no
longer produced. RAI is commonly recommended for clients with Graves'
2027 ULTIMATE SUCCESS PACK COMPLETE
QUESTIONS WITH 100% CORRECT ANSWERS.
◎ When conducting a health history with a female client with thyrotoxicosis, the nurse
should ask about which of the following changes in the menstrual cycle?
1. dysmenorrhea
2. metrorrhagia
3. oligomenorrhea
4. menorrhagia ANSWER:- 3. oligomenorrhea
A change in the menstrual interval, diminished menstrual flow (oligomenorrhea), or even
the absence of menstruation (amenorrhea) may result from the hormonal imbalances of
thyrotoxicosis. Oligomenorrhea in women and decreased libido and impotence in men
are common features of thyrotoxicosis. Dysmenorrhea is painful menstruation.
Metrorrhagia, blood loss between menstrual periods, is a symptom of hypothyroidism.
Menorrhagia, excessive bleeding during menstrual periods, is a symptom of
hypothyroidism.
CN: Physiological adaptation; CL: Analyze
◎ A 34-year-old female is diagnosed with hypothyroidism. The nurse should assess the
client for which of the following? (Select all that apply.)
1. rapid pulse
2. decreased energy and fatigue
3. weight gain of 10 lbs (4.5 kg)
4. fine, thin hair with hair loss
5. constipation
6. menorrhagia. ANSWER:- 2. decreased energy and fatigue, 3. weight gain of 10 lbs
(4.5 kg), 5. constipation, 6. menorrhagia
Clients with hypothyroidism exhibit symptoms indicating a lack of thyroid hormone.
Bradycardia, decreased energy and lethargy, memory problems, weight gain, coarse
hair, constipation, and menorrhagia are common signs and
symptoms of hypothyroidism.
CN: Physiological adaptation; CL: Analyze
◎ Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse
should teach the client to immediately report which of the following?
,1. sore throat
2. painful, excessive menstruation
3. constipation
4. increased urine output ANSWER:- 1. sore throat
The most serious adverse effects of PTU are leukopenia and agranulocytosis, which
usually occur within the first 3 months of treatment. The client should be taught to
promptly report to the health care provider signs and symptoms of infection, such as a
sore throat and fever. Clients having a sore throat and fever should have an immediate
white blood cell count and differential performed, and the drug must be withheld until
the results are obtained. Painful menstruation, constipation, and increased urine output
are not associated with PTU therapy.
CN: Pharmacological and parenteral therapies; CL: Synthesize
◎ A client with thyrotoxicosis says to the nurse, "I am so irritable. I am having
problems at work because I lose my temper very easily." Which of the following
responses by the nurse would give the client the most accurate explanation of her
behavior?
1. "Your behavior is caused by temporary confusion brought on by your illness."
2. "Your behavior is caused by the excess thyroid hormone in your system."
3. "Your behavior is caused by your worrying about the seriousness of your illness."
4. "Your behavior is caused by the stress of trying to manage a career and cope with
illness." ANSWER:- 2. "Your behavior is caused by the excess thyroid hormone in your
system."
A typical sign of thyrotoxicosis is irritability caused by the high levels of circulating
thyroid hormones in the body. This symptom decreases as the client responds to
therapy. Thyrotoxicosis does not cause confusion. The client may be worried about her
illness, and stress may influence her mood; however, irritability is a common symptom
of thyrotoxicosis and the client should be informed of that fact rather than blamed.
CN: Psychosocial integrity; CL: Synthesize
◎ The nurse is evaluating a client with hyperthyroidism who is taking
Propylthiouracil (PTU) 100 mg/day in three divided doses for maintenance therapy.
Which of the following statements from the client indicates the desired outcome of the
drug?
1. "I have excess energy throughout the day."
2. "I am able to sleep and rest at night."
3. "I have lost weight since taking this medication."
4. "I do perspire throughout the entire day." ANSWER:- 2. "I am able to sleep and rest at
night."
, PTU is a prototype of thioamide antithyroid drugs. It inhibits production of thyroid
hormones and peripheral conversion of T4 to the more active T3. A client taking this
antithyroid drug should be able to sleep and rest well at night since the level of thyroid
hormones is reduced in the blood. Excess energy throughout the day, loss of weight
and perspiring through the day are symptoms of hyperthyroidism indicating the drug has
not produced its outcome.
CN: Pharmacological and parenteral therapies; CL: Evaluate.
◎ The nurse should teach the client with Graves' disease to prevent corneal
irritation from mild exophthalmos by:
1. Massaging the eyes at regular intervals.
2. Instilling an ophthalmic anesthetic as prescribed.
3. Wearing dark-colored glasses.
4. Covering both eyes with moistened gauze pads. ANSWER:- 3. Wearing dark-colored
glasses.
Treatment of mild ophthalmopathy that may accompany thyrotoxicosis includes
measures such as wearing sunglasses to protect the eyes from corneal irritation.
Treatment of ophthalmopathy should be performed in consultation with an
ophthalmologist. Massaging the eyes will not help to protect the cornea. An ophthalmic
anesthetic is used to examine and possibly treat a painful eye, not protect the cornea.
Covering the eyes with moist gauze pads is not a satisfactory nursing measure to
protect
the eyes of a client with exophthalmos because treatment is not focused on moisture to
the eye but rather on protecting the cornea and optic nerve. In exophthalmos, the
retrobulbar connective tissues and extraocular muscle volume are expanded because of
fluid retention. The pressure is also increased.
CN: Reduction of risk potential; CL: Synthesize
◎ A client with Graves' disease is treated with radioactive iodine (RAI) in the
form of sodium iodide 131I. Which of the following statements by the nurse will explain
to the client how the drug works?
1. "The RAI stabilizes the thyroid hormone levels before a thyroidectomy."
2. "The RAI reduces uptake of thyroxine and thereby improves your condition."
3. "The RAI lowers the levels of thyroid hormones by slowing your body's
production of them."
4. "The RAI destroys thyroid tissue so that thyroid hormones are no longer produced."
ANSWER:- 4. "The RAI destroys thyroid tissue so that thyroid hormones are no longer
produced."
Sodium iodide 131I destroys the thyroid follicular cells, and thyroid hormones are no
longer produced. RAI is commonly recommended for clients with Graves'
