• Mental Health Care 09/15/2026
Test Bank for Medical-Surgical Nursing: Concepts for
Clinical Judgment and Collaborative Care, 11th Edition by
Donna D. Ignatavicius | Complete Chapters 1-65 | Questions
& Answers with NCLEX®-Style | Next Generation NCLEX®
(NGN) Prep
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."
P 1
, • Mental Health Care 09/15/2026
- Correct 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." –
Correct 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.
P 2
, • Mental Health Care 09/15/2026
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. –
Correct 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."
P 3
, • Mental Health Care 09/15/2026
- Correct 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. –
Correct 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:
P 4
Test Bank for Medical-Surgical Nursing: Concepts for
Clinical Judgment and Collaborative Care, 11th Edition by
Donna D. Ignatavicius | Complete Chapters 1-65 | Questions
& Answers with NCLEX®-Style | Next Generation NCLEX®
(NGN) Prep
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."
P 1
, • Mental Health Care 09/15/2026
- Correct 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." –
Correct 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.
P 2
, • Mental Health Care 09/15/2026
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. –
Correct 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."
P 3
, • Mental Health Care 09/15/2026
- Correct 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. –
Correct 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:
P 4
