Med-Surg II HESI Exam - set one Study
Guide Questions With Well Elaborated
Solutions
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'
disease, especially the elderly. The treatment results in a "medical thyroidectomy."
RAI is given in lieu of surgery, not before surgery. RAI does not reduce uptake of
thyroxine.
The outcome of giving RAI is the destruction of the thyroid follicular cells. It is
possible to slow the production of thyroid hormones with RAI.
CN: Pharmacological and parenteral therapies; CL: Synthesize
After treatment with radioactive iodine (RAI) in the form of sodium iodide 131I,
the nurse teaches the client to:
1. Monitor for signs and symptoms of hyperthyroidism.
2. Rest for 1 week to prevent complications of the medication.
, 3. Take thyroxine replacement for the remainder of the client's life.
4. Assess for hypertension and tachycardia resulting from altered thyroid activity. -
ANSWER -3. Take thyroxine replacement for the remainder of the client's life.
The client needs to be educated about the need for lifelong thyroid hormone
replacement. Permanent hypothyroidism is the major complication of RAI 131I
treatment. Lifelong medical follow-up and thyroid replacement are warranted. The
client needs to
monitor for signs and symptoms of hypothyroidism, not hyperthyroidism. Resting
for 1 week is not necessary. Hypertension and tachycardia are signs of
hyperthyroidism, not hypothyroidism.
CN: Pharmacological and parenteral therapies; CL: Synthesize
A client with a large goiter is scheduled for a subtotal thyroidectomy to treat
thyrotoxicosis. Saturated solution of potassium iodide (SSKI) is prescribed
preoperatively for the client. The expected outcome of using this drug is that it
helps:
1. Slow progression of exophthalmos.
2. Reduce the vascularity of the thyroid gland.
3. Decrease the body's ability to store thyroxine.
4. Increase the body's ability to excrete thyroxine. - ANSWER -2. Reduce the
vascularity of the thyroid gland.
SSKI is frequently administered before a thyroidectomy because it helps decrease
the vascularity of the thyroid gland. A highly vascular thyroid gland is very friable,
a condition that presents a hazard during surgery. Preparation of the client for
surgery includes depleting the gland of thyroid hormone and decreasing
vascularity.
SSKI does not decrease the progression of exophthalmos, and it does not decrease
the body's ability to store thyroxine or increase the body's ability to excrete
thyroxine.
CN: Pharmacological and parenteral therapies; CL: Apply
The nurse is administering a saturated solution of potassium iodide (SSKI). The
nurse should:
1. Pour the solution over ice chips.
Guide Questions With Well Elaborated
Solutions
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'
disease, especially the elderly. The treatment results in a "medical thyroidectomy."
RAI is given in lieu of surgery, not before surgery. RAI does not reduce uptake of
thyroxine.
The outcome of giving RAI is the destruction of the thyroid follicular cells. It is
possible to slow the production of thyroid hormones with RAI.
CN: Pharmacological and parenteral therapies; CL: Synthesize
After treatment with radioactive iodine (RAI) in the form of sodium iodide 131I,
the nurse teaches the client to:
1. Monitor for signs and symptoms of hyperthyroidism.
2. Rest for 1 week to prevent complications of the medication.
, 3. Take thyroxine replacement for the remainder of the client's life.
4. Assess for hypertension and tachycardia resulting from altered thyroid activity. -
ANSWER -3. Take thyroxine replacement for the remainder of the client's life.
The client needs to be educated about the need for lifelong thyroid hormone
replacement. Permanent hypothyroidism is the major complication of RAI 131I
treatment. Lifelong medical follow-up and thyroid replacement are warranted. The
client needs to
monitor for signs and symptoms of hypothyroidism, not hyperthyroidism. Resting
for 1 week is not necessary. Hypertension and tachycardia are signs of
hyperthyroidism, not hypothyroidism.
CN: Pharmacological and parenteral therapies; CL: Synthesize
A client with a large goiter is scheduled for a subtotal thyroidectomy to treat
thyrotoxicosis. Saturated solution of potassium iodide (SSKI) is prescribed
preoperatively for the client. The expected outcome of using this drug is that it
helps:
1. Slow progression of exophthalmos.
2. Reduce the vascularity of the thyroid gland.
3. Decrease the body's ability to store thyroxine.
4. Increase the body's ability to excrete thyroxine. - ANSWER -2. Reduce the
vascularity of the thyroid gland.
SSKI is frequently administered before a thyroidectomy because it helps decrease
the vascularity of the thyroid gland. A highly vascular thyroid gland is very friable,
a condition that presents a hazard during surgery. Preparation of the client for
surgery includes depleting the gland of thyroid hormone and decreasing
vascularity.
SSKI does not decrease the progression of exophthalmos, and it does not decrease
the body's ability to store thyroxine or increase the body's ability to excrete
thyroxine.
CN: Pharmacological and parenteral therapies; CL: Apply
The nurse is administering a saturated solution of potassium iodide (SSKI). The
nurse should:
1. Pour the solution over ice chips.
