Med-Surg II HESI Exam - set one
Study online at https://quizlet.com/_94qydw
1. The nurse is completing a health assessment of a 42-year-old female with
suspected Graves' Disease. The nurse should assess this client for:
1. anorexia
2. tachycardia
3. weight gain
4. cold skin: 2. tachycardia
Graves' disease, the most common type of thyrotoxicosis, is a state of hypermetabolism. The increased metabolic rate
generates heat and produces tachycardia and fine muscle tremors. Anorexia is associated with hypothyroidism. Loss
of weight, despite a good appetite and adequate caloric intake, is a common feature of hyperthyroidism. Cold skin is
associated with hypothyroidism.
CN: Physiological adaptation; CL: Analyze
2. 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: 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. Metr-
orrhagia, 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
3. 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
, Med-Surg II HESI Exam - set one
Study online at https://quizlet.com/_94qydw
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.: 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
4. 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: 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
5. 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?
, Med-Surg II HESI Exam - set one
Study online at https://quizlet.com/_94qydw
1. "Your behavior is caused by temporary confusion brought on by your ill-
ness."
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.": 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
6. 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.": 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.
7. The nurse should teach the client with Graves' disease to prevent corneal
irritation from mild exophthalmos by:
, Med-Surg II HESI Exam - set one
Study online at https://quizlet.com/_94qydw
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.: 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
8. 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.": 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
Study online at https://quizlet.com/_94qydw
1. The nurse is completing a health assessment of a 42-year-old female with
suspected Graves' Disease. The nurse should assess this client for:
1. anorexia
2. tachycardia
3. weight gain
4. cold skin: 2. tachycardia
Graves' disease, the most common type of thyrotoxicosis, is a state of hypermetabolism. The increased metabolic rate
generates heat and produces tachycardia and fine muscle tremors. Anorexia is associated with hypothyroidism. Loss
of weight, despite a good appetite and adequate caloric intake, is a common feature of hyperthyroidism. Cold skin is
associated with hypothyroidism.
CN: Physiological adaptation; CL: Analyze
2. 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: 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. Metr-
orrhagia, 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
3. 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
, Med-Surg II HESI Exam - set one
Study online at https://quizlet.com/_94qydw
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.: 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
4. 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: 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
5. 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?
, Med-Surg II HESI Exam - set one
Study online at https://quizlet.com/_94qydw
1. "Your behavior is caused by temporary confusion brought on by your ill-
ness."
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.": 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
6. 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.": 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.
7. The nurse should teach the client with Graves' disease to prevent corneal
irritation from mild exophthalmos by:
, Med-Surg II HESI Exam - set one
Study online at https://quizlet.com/_94qydw
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.: 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
8. 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.": 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
