FINAL EXAM NURS 315: 2025/2026,
WITH CORRECT/ACCURATE ANSWERS
What are the factors delaying wound healing? - CORRECT
ANSWERS- Malnutrition, blood supply, corticosteroid &
chemotherapy drugs, infection, smoking, mechanical friction on
wound, age, obesity, diabetes, poor health, anemia
Hyperthyroidism - CORRECT ANSWERS- Excessive T4, T3 or both,
most common cause is graves disease. can also be caused by
toxic nodular goiter and pituitary tumor
What are the clinical manifestations of hyperthyroidism? -
CORRECT ANSWERS- Goiter, vascularity in the gland,
exophthalmos (protruding eyeballs), weight loss, nervousness,
atrial fibrillation, hypertension, insomnia, intolerance to heat
(feels very hot), hyperreflexia of tendon reflexes
What are the clinical manifestations of thyrotoxic crisis? -
CORRECT ANSWERS- Thyroid storm: fever, tachycardia, HTN,
agitation - life threatening
What are the major types of drug therapy for hyperthyroidism? -
CORRECT ANSWERS- - Antithyroid drugs, e.g., Propylthiouracil
(PTU), Methimazole (Tapazole): slow improvement - educate to
continue to take, don't abruptly stop medication
,- Iodine: effect decreases with the time
- β-adrenergic blockers: decrease heart rate - PRIORITY
MEDICATION
- Radioactive Iodine Therapy: damages thyroid tissue
What are acute nursing interventions for thyrotoxic crisis? -
CORRECT ANSWERS- - Monitor cardiac dysrhythmias, O2, iv fluid
and electrolytes
- Provide calm, quiet, cool room, assist with exercise to relieve
tension and restlessness.
- Eye care for exophthalmos: artificial tears, salt (sodium)
restriction and elevating head of bed to promote drainage from
the periorbital area.
What are goals for drug therapy before the thyroidectomy? -
CORRECT ANSWERS- - Antithyroid drugs, iodine, β-adrenergic
blockers are taken before surgery
o Important to keep taking these medications until the day of the
surgery because all of these medications help stabilize the thyroid
Post-operative care for thyroidectomy - CORRECT ANSWERS- -
Monitor for hemorrhage and respiratory distress (caused by
edema or laryngeal nerve damage).
- Monitor for hypocalcemia (hypoparathyroidism because they are
also removed during the surgery): tetany, Trousseau's (when a BP
cuff is placed on arm they have hand twitches) and Chvostek's
signs (muscle twitching on face), laryngeal stridor (high pitch
sound), hoarseness.
,- Sit in a semi-Fowler's position, support head with pillow to avoid
tension on the suture lines
- Monitor for hypo/hyper-thyroidism
Hypothyroidism - CORRECT ANSWERS- - Insufficient circulating
thyroid hormone,
o Primary-destruction of thyroid tissue or defective hormone
synthesis - high TSH & low T4
o Secondary-pituitary disease with decreased TSH secretion - low
TSH & low T4
What are the clinical manifestations of hypothyroidism? -
CORRECT ANSWERS- Fatigue, constipation, anemia, myxedema,
cold intolerance
What is myxedema coma? - CORRECT ANSWERS- (emergency)
hypotension, Brady, hypothermia, respiratory failure, coma
What precautions need to take when administrating Synthroid
(levothyroxine) to the patient? - CORRECT ANSWERS- - It
increases sympathetic nervous system activity so:
- Monitor for cardiovascular disease, HR>100, chest pain, weight
loss, tremors, insomnia
What are the clinical manifestations of Cushing's syndrome? -
CORRECT ANSWERS- o Metabolic disorder: Hyperglycemia,
, weight gain, (truncal obesity), muscle atrophy/ weakness (thin
extremities), moon face
o Hypocalcemia, osteoporosis
o Hypertension
o Hypernatremia
o Hypokalemia
o Purple streaks (mostly on abdomen)
o Hirsutism
What is the characteristic of clinical manifestations of Addison's
disease? - CORRECT ANSWERS- No symptoms until 90% of
adrenal cortex destroyed, Orthostatic hypotension, hyponatremia,
hyperkalemia, hypercalcemia, nausea, vomiting, diarrhea, skin
hyperpigmentation
Corticosteroid Therapy Side Effects - CORRECT ANSWERS- -
Cushing's syndrome:
o Hypertension, hyperglycemia, gastric ulcers and bleeding
(SECOND TOP CONCERN), Increased risk of infection (TOP
CONCERN), delayed healing, hypocalcemia, fracture/osteoporosis
o Weight gain, skeletal muscle atrophy and weakness
o Hypokalemia
DO NOT STOP ABRUPTLY
WITH CORRECT/ACCURATE ANSWERS
What are the factors delaying wound healing? - CORRECT
ANSWERS- Malnutrition, blood supply, corticosteroid &
chemotherapy drugs, infection, smoking, mechanical friction on
wound, age, obesity, diabetes, poor health, anemia
Hyperthyroidism - CORRECT ANSWERS- Excessive T4, T3 or both,
most common cause is graves disease. can also be caused by
toxic nodular goiter and pituitary tumor
What are the clinical manifestations of hyperthyroidism? -
CORRECT ANSWERS- Goiter, vascularity in the gland,
exophthalmos (protruding eyeballs), weight loss, nervousness,
atrial fibrillation, hypertension, insomnia, intolerance to heat
(feels very hot), hyperreflexia of tendon reflexes
What are the clinical manifestations of thyrotoxic crisis? -
CORRECT ANSWERS- Thyroid storm: fever, tachycardia, HTN,
agitation - life threatening
What are the major types of drug therapy for hyperthyroidism? -
CORRECT ANSWERS- - Antithyroid drugs, e.g., Propylthiouracil
(PTU), Methimazole (Tapazole): slow improvement - educate to
continue to take, don't abruptly stop medication
,- Iodine: effect decreases with the time
- β-adrenergic blockers: decrease heart rate - PRIORITY
MEDICATION
- Radioactive Iodine Therapy: damages thyroid tissue
What are acute nursing interventions for thyrotoxic crisis? -
CORRECT ANSWERS- - Monitor cardiac dysrhythmias, O2, iv fluid
and electrolytes
- Provide calm, quiet, cool room, assist with exercise to relieve
tension and restlessness.
- Eye care for exophthalmos: artificial tears, salt (sodium)
restriction and elevating head of bed to promote drainage from
the periorbital area.
What are goals for drug therapy before the thyroidectomy? -
CORRECT ANSWERS- - Antithyroid drugs, iodine, β-adrenergic
blockers are taken before surgery
o Important to keep taking these medications until the day of the
surgery because all of these medications help stabilize the thyroid
Post-operative care for thyroidectomy - CORRECT ANSWERS- -
Monitor for hemorrhage and respiratory distress (caused by
edema or laryngeal nerve damage).
- Monitor for hypocalcemia (hypoparathyroidism because they are
also removed during the surgery): tetany, Trousseau's (when a BP
cuff is placed on arm they have hand twitches) and Chvostek's
signs (muscle twitching on face), laryngeal stridor (high pitch
sound), hoarseness.
,- Sit in a semi-Fowler's position, support head with pillow to avoid
tension on the suture lines
- Monitor for hypo/hyper-thyroidism
Hypothyroidism - CORRECT ANSWERS- - Insufficient circulating
thyroid hormone,
o Primary-destruction of thyroid tissue or defective hormone
synthesis - high TSH & low T4
o Secondary-pituitary disease with decreased TSH secretion - low
TSH & low T4
What are the clinical manifestations of hypothyroidism? -
CORRECT ANSWERS- Fatigue, constipation, anemia, myxedema,
cold intolerance
What is myxedema coma? - CORRECT ANSWERS- (emergency)
hypotension, Brady, hypothermia, respiratory failure, coma
What precautions need to take when administrating Synthroid
(levothyroxine) to the patient? - CORRECT ANSWERS- - It
increases sympathetic nervous system activity so:
- Monitor for cardiovascular disease, HR>100, chest pain, weight
loss, tremors, insomnia
What are the clinical manifestations of Cushing's syndrome? -
CORRECT ANSWERS- o Metabolic disorder: Hyperglycemia,
, weight gain, (truncal obesity), muscle atrophy/ weakness (thin
extremities), moon face
o Hypocalcemia, osteoporosis
o Hypertension
o Hypernatremia
o Hypokalemia
o Purple streaks (mostly on abdomen)
o Hirsutism
What is the characteristic of clinical manifestations of Addison's
disease? - CORRECT ANSWERS- No symptoms until 90% of
adrenal cortex destroyed, Orthostatic hypotension, hyponatremia,
hyperkalemia, hypercalcemia, nausea, vomiting, diarrhea, skin
hyperpigmentation
Corticosteroid Therapy Side Effects - CORRECT ANSWERS- -
Cushing's syndrome:
o Hypertension, hyperglycemia, gastric ulcers and bleeding
(SECOND TOP CONCERN), Increased risk of infection (TOP
CONCERN), delayed healing, hypocalcemia, fracture/osteoporosis
o Weight gain, skeletal muscle atrophy and weakness
o Hypokalemia
DO NOT STOP ABRUPTLY
