MED-SURG II HESI EXAM - SET ONE
QUESTIONS AND CORRECT ANSWERS
The nurse is completing a health assessment of a 42-year-
gv gv gv gv gv gv gv gv gv
old female with suspected Graves' Disease. The nurse should assess this client for
gv gv gv gv gv gv gv gv gv gv gv gv
:
1. anorexia
gv
2. tachycardia
gv
3. weight gain
gv gv
4. cold skin - ANSWERS-2. tachycardia
gv gv gv gv gv
Graves' disease, the most common type of thyrotoxicosis, is a state of hypermetab
gv gv gv gv gv gv gv gv gv gv gv gv
olism. The increased metabolic rate generates heat and produces tachycardia and
gv gv gv gv gv gv gv gv gv gv gv
fine muscle tremors. Anorexia is associated with hypothyroidism. Loss of weight, d
gv gv gv gv gv gv gv gv gv gv gv
espite a good appetite and adequate caloric intake, is a common feature of hypert
gv gv gv gv gv gv gv gv gv gv gv gv gv
hyroidism. Cold skin is associated with hypothyroidism.
gv gv gv gv gv gv
CN: Physiological adaptation; CL: Analyze
gv gv gv gv
When conducting a health history with a female client with thyrotoxicosis, the nurse
gv gv gv gv gv gv gv gv gv gv gv gv
should ask about which of the following changes in the menstrual cycle?
gv gv gv gv gv gv gv gv gv gv gv gv
1. dysmenorrhea
gv
2. metrorrhagia
gv
3. oligomenorrhea
gv
4. menorrhagia - ANSWERS-3. oligomenorrhea
gv gv gv gv
A change in the menstrual interval, diminished menstrual flow (oligomenorrhea), or
gv gv gv gv gv gv gv gv gv gv g
even the absence of menstruation (amenorrhea) may result from the hormonal imb
v gv gv gv gv gv gv gv gv gv gv gv
alances of thyrotoxicosis. Oligomenorrhea in women and decreased libido and imp
gv gv gv gv gv gv gv gv gv gv
otence in men are common features of thyrotoxicosis. Dysmenorrhea is painful me
gv gv gv gv gv gv gv gv gv gv gv
nstruation. Metrorrhagia, blood loss between menstrual periods, is a symptom of h
gv gv gv gv gv gv gv gv gv gv gv
ypothyroidism. Menorrhagia, excessive bleeding during menstrual periods, is a sym
gv gv gv gv gv gv gv gv gv
ptom of hypothyroidism. gv gv
CN: Physiological adaptation; CL: Analyze
gv gv gv gv
A 34-year-
gv
old female is diagnosed with hypothyroidism. The nurse should assess the client fo
gv gv gv gv gv gv gv gv gv gv gv gv
r which of the following? (Select all that apply.)
gv gv gv gv gv gv gv gv
1. rapid pulse
gv gv
2. decreased energy and fatigue
gv gv gv gv
3. weight gain of 10 lbs (4.5 kg)
gv gv gv gv gv gv gv
4. fine, thin hair with hair loss
gv gv gv gv gv gv
5. constipation
gv
,6. menorrhagia. - ANSWERS-
gv gv gv
2. decreased energy and fatigue, 3. weight gain of 10 lbs (4.5 kg), 5. constipation,
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
6. menorrhagia
gv
Clients with hypothyroidism exhibit symptoms indicating a lack of thyroid hormone.
gv gv gv gv gv gv gv gv gv gv gv
Bradycardia, decreased energy and lethargy, memory problems, weight gain, coars
gv gv gv gv gv gv gv gv gv
e hair, constipation, and menorrhagia are common signs and
gv gv gv gv gv gv gv gv
symptoms of hypothyroidism. gv gv
CN: Physiological adaptation; CL: Analyze
gv gv gv gv
Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse sh
gv gv gv gv gv gv gv gv gv gv gv gv
ould teach the client to immediately report which of the following?
gv gv gv gv gv gv gv gv gv gv
1. gv sore throat gv
2. gv painful, excessive menstruation gv gv
3. gv constipation
4. gv increased urine output - ANSWERS-1. sore throat gv gv gv gv gv gv
The most serious adverse effects of PTU are leukopenia and agranulocytosis, whic
gv gv gv gv gv gv gv gv gv gv gv
h usually occur within the first 3 months of treatment. The client should be taught t
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
o promptly report to the health care provider signs and symptoms of infection, such
gv gv gv gv gv gv gv gv gv gv gv gv gv
as a sore throat and fever. Clients having a sore throat and fever should have an
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
immediate white blood cell count and differential performed, and the drug must be
gv gv gv gv gv gv gv gv gv gv gv gv gv
withheld until gv
the results are obtained. Painful menstruation, constipation, and increased urine ou
gv gv gv gv gv gv gv gv gv gv
tput are not associated with PTU therapy.
gv gv gv gv gv gv
CN: Pharmacological and parenteral therapies; CL: Synthesize
gv gv gv gv gv gv
A client with thyrotoxicosis says to the nurse, "I am so irritable. I am having
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
problems at work because I lose my temper very easily." Which of the following re
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
sponses by the nurse would give the client the most accurate explanation of her b
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
ehavior?
1. "Your behavior is caused
gv gv gv gv gv by temporary confusion brought on by your illness."
gv gv gv gv gv gv gv
2. "Your behavior is caused
gv gv gv gv gv by the excess thyroid hormone in your system."
gv gv gv gv gv gv gv
3. "Your behavior is caused
gv gv gv gv gv by your worrying about the seriousness of your illness.
gv gv gv gv gv gv gv gv
"
4. "Your behavior is caused
gv gv gv gv gv by the stress of trying to manage a career and cope w
gv gv gv gv gv gv gv gv gv gv gv
ith illness." - ANSWERS-
gv gv gv
2. "Your behavior is caused
gv gv gv gv gv by the excess thyroid hormone in your system."
gv gv gv gv gv gv gv
A typical sign of thyrotoxicosis is irritability caused by the high levels of circulating t
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
hyroid hormones in the body. This symptom decreases as the client responds to th
gv gv gv gv gv gv gv gv gv gv gv gv gv
erapy. Thyrotoxicosis does not cause confusion. The client may be worried about h
gv gv gv gv gv gv gv gv gv gv gv gv
er illness, and stress may influence her mood; however, irritability is a common sy
gv gv gv gv gv gv gv gv gv gv gv gv gv
mptom of thyrotoxicosis and the client should be informed of that fact rather than b
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
lamed.
, CN: Psychosocial integrity; CL: Synthesize
gv gv gv gv
The nurse is evaluating a client with hyperthyroidism who is taking
gv gv gv gv gv gv gv gv gv gv
Propylthiouracil (PTU) 100 mg/day in three divided doses for maintenance therapy.
gv gv gv gv gv gv gv gv gv gv g
vWhich of the following statements from the client indicates the desired outcome of
gv gv gv gv gv gv gv gv gv gv gv gv gv
the
drug?
1. gv "I gv have excess energy throughout the day."
gv gv gv gv gv
2. gv "I gv am able to sleep and rest at night."
gv gv gv gv gv gv gv
3. gv "I gv have lost weight since taking this medication."
gv gv gv gv gv gv
4. gv "I gv do perspire throughout the entire day." - ANSWERS-
gv gv gv gv gv gv gv
2. gv "I gv am able to sleep and rest at night."
gv gv gv gv gv gv gv
PTU is a prototype of thioamide antithyroid drugs. It inhibits production of thyroid h
gv gv gv gv gv gv gv gv gv gv gv gv gv
ormones and peripheral conversion of T4 to the more active T3. A client taking this
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
antithyroid drug should be able to sleep and rest well at night since the level of th
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
yroid hormones is reduced in the blood. Excess energy throughout the day, loss of
gv gv gv gv gv gv gv gv gv gv gv gv gv g
vweight and perspiring through the day are symptoms of hyperthyroidism indicating
gv gv gv gv gv gv gv gv gv gv gv
the drug has not produced its outcome.
gv gv gv gv gv gv
CN: Pharmacological and parenteral therapies; CL: Evaluate.
gv gv gv gv gv gv
The nurse should teach the client with Graves' disease to prevent corneal
gv gv gv gv gv gv gv gv gv gv gv
irritation from mild exophthalmos by:
gv gv gv gv
1. Massaging the eyes at regular intervals.
gv gv gv gv gv gv
2. Instilling an ophthalmic anesthetic as prescribed.
gv gv gv gv gv gv
3. Wearing dark-colored glasses.
gv gv gv
4. Covering both eyes with moistened gauze pads. - ANSWERS-3. Wearing dark-
gv gv gv gv gv gv gv gv gv gv gv
colored glasses. gv gv
Treatment of mild ophthalmopathy that may accompany thyrotoxicosis includes me
gv gv gv gv gv gv gv gv gv
asures such as wearing sunglasses to protect the eyes from corneal irritation.
gv gv gv gv gv gv gv gv gv gv gv
Treatment of ophthalmopathy should be performed in consultation with an ophthal
gv gv gv gv gv gv gv gv gv gv
mologist. Massaging the eyes will not help to protect the cornea. An ophthalmic
gv gv gv gv gv gv gv gv gv gv gv gv
anesthetic is used to examine and possibly treat a painful eye, not protect the corn
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
ea. Covering the eyes with moist gauze pads is not a satisfactory nursing measure
gv gv gv gv gv gv gv gv gv gv gv gv gv
to protect
gv gv
the eyes of a client with exophthalmos because treatment is not focused on moistu
gv gv gv gv gv gv gv gv gv gv gv gv gv
re to the eye but rather on protecting the cornea and optic nerve. In exophthalmos,
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
the retrobulbar connective tissues and extraocular muscle volume are expanded b
gv gv gv gv gv gv gv gv gv gv gv
ecause of fluid retention. The pressure is also increased.
gv gv gv gv gv gv gv gv
CN: Reduction of risk potential; CL: Synthesize
gv gv gv gv gv gv
A client with Graves' disease is treated with radioactive iodine (RAI) in the
gv gv gv gv gv gv gv gv gv gv gv gv
form of sodium iodide 131I. Which of the following statements by the nurse will ex
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
plain to the client how the drug works?
gv gv gv gv gv gv gv
QUESTIONS AND CORRECT ANSWERS
The nurse is completing a health assessment of a 42-year-
gv gv gv gv gv gv gv gv gv
old female with suspected Graves' Disease. The nurse should assess this client for
gv gv gv gv gv gv gv gv gv gv gv gv
:
1. anorexia
gv
2. tachycardia
gv
3. weight gain
gv gv
4. cold skin - ANSWERS-2. tachycardia
gv gv gv gv gv
Graves' disease, the most common type of thyrotoxicosis, is a state of hypermetab
gv gv gv gv gv gv gv gv gv gv gv gv
olism. The increased metabolic rate generates heat and produces tachycardia and
gv gv gv gv gv gv gv gv gv gv gv
fine muscle tremors. Anorexia is associated with hypothyroidism. Loss of weight, d
gv gv gv gv gv gv gv gv gv gv gv
espite a good appetite and adequate caloric intake, is a common feature of hypert
gv gv gv gv gv gv gv gv gv gv gv gv gv
hyroidism. Cold skin is associated with hypothyroidism.
gv gv gv gv gv gv
CN: Physiological adaptation; CL: Analyze
gv gv gv gv
When conducting a health history with a female client with thyrotoxicosis, the nurse
gv gv gv gv gv gv gv gv gv gv gv gv
should ask about which of the following changes in the menstrual cycle?
gv gv gv gv gv gv gv gv gv gv gv gv
1. dysmenorrhea
gv
2. metrorrhagia
gv
3. oligomenorrhea
gv
4. menorrhagia - ANSWERS-3. oligomenorrhea
gv gv gv gv
A change in the menstrual interval, diminished menstrual flow (oligomenorrhea), or
gv gv gv gv gv gv gv gv gv gv g
even the absence of menstruation (amenorrhea) may result from the hormonal imb
v gv gv gv gv gv gv gv gv gv gv gv
alances of thyrotoxicosis. Oligomenorrhea in women and decreased libido and imp
gv gv gv gv gv gv gv gv gv gv
otence in men are common features of thyrotoxicosis. Dysmenorrhea is painful me
gv gv gv gv gv gv gv gv gv gv gv
nstruation. Metrorrhagia, blood loss between menstrual periods, is a symptom of h
gv gv gv gv gv gv gv gv gv gv gv
ypothyroidism. Menorrhagia, excessive bleeding during menstrual periods, is a sym
gv gv gv gv gv gv gv gv gv
ptom of hypothyroidism. gv gv
CN: Physiological adaptation; CL: Analyze
gv gv gv gv
A 34-year-
gv
old female is diagnosed with hypothyroidism. The nurse should assess the client fo
gv gv gv gv gv gv gv gv gv gv gv gv
r which of the following? (Select all that apply.)
gv gv gv gv gv gv gv gv
1. rapid pulse
gv gv
2. decreased energy and fatigue
gv gv gv gv
3. weight gain of 10 lbs (4.5 kg)
gv gv gv gv gv gv gv
4. fine, thin hair with hair loss
gv gv gv gv gv gv
5. constipation
gv
,6. menorrhagia. - ANSWERS-
gv gv gv
2. decreased energy and fatigue, 3. weight gain of 10 lbs (4.5 kg), 5. constipation,
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
6. menorrhagia
gv
Clients with hypothyroidism exhibit symptoms indicating a lack of thyroid hormone.
gv gv gv gv gv gv gv gv gv gv gv
Bradycardia, decreased energy and lethargy, memory problems, weight gain, coars
gv gv gv gv gv gv gv gv gv
e hair, constipation, and menorrhagia are common signs and
gv gv gv gv gv gv gv gv
symptoms of hypothyroidism. gv gv
CN: Physiological adaptation; CL: Analyze
gv gv gv gv
Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse sh
gv gv gv gv gv gv gv gv gv gv gv gv
ould teach the client to immediately report which of the following?
gv gv gv gv gv gv gv gv gv gv
1. gv sore throat gv
2. gv painful, excessive menstruation gv gv
3. gv constipation
4. gv increased urine output - ANSWERS-1. sore throat gv gv gv gv gv gv
The most serious adverse effects of PTU are leukopenia and agranulocytosis, whic
gv gv gv gv gv gv gv gv gv gv gv
h usually occur within the first 3 months of treatment. The client should be taught t
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
o promptly report to the health care provider signs and symptoms of infection, such
gv gv gv gv gv gv gv gv gv gv gv gv gv
as a sore throat and fever. Clients having a sore throat and fever should have an
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
immediate white blood cell count and differential performed, and the drug must be
gv gv gv gv gv gv gv gv gv gv gv gv gv
withheld until gv
the results are obtained. Painful menstruation, constipation, and increased urine ou
gv gv gv gv gv gv gv gv gv gv
tput are not associated with PTU therapy.
gv gv gv gv gv gv
CN: Pharmacological and parenteral therapies; CL: Synthesize
gv gv gv gv gv gv
A client with thyrotoxicosis says to the nurse, "I am so irritable. I am having
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
problems at work because I lose my temper very easily." Which of the following re
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
sponses by the nurse would give the client the most accurate explanation of her b
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
ehavior?
1. "Your behavior is caused
gv gv gv gv gv by temporary confusion brought on by your illness."
gv gv gv gv gv gv gv
2. "Your behavior is caused
gv gv gv gv gv by the excess thyroid hormone in your system."
gv gv gv gv gv gv gv
3. "Your behavior is caused
gv gv gv gv gv by your worrying about the seriousness of your illness.
gv gv gv gv gv gv gv gv
"
4. "Your behavior is caused
gv gv gv gv gv by the stress of trying to manage a career and cope w
gv gv gv gv gv gv gv gv gv gv gv
ith illness." - ANSWERS-
gv gv gv
2. "Your behavior is caused
gv gv gv gv gv by the excess thyroid hormone in your system."
gv gv gv gv gv gv gv
A typical sign of thyrotoxicosis is irritability caused by the high levels of circulating t
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
hyroid hormones in the body. This symptom decreases as the client responds to th
gv gv gv gv gv gv gv gv gv gv gv gv gv
erapy. Thyrotoxicosis does not cause confusion. The client may be worried about h
gv gv gv gv gv gv gv gv gv gv gv gv
er illness, and stress may influence her mood; however, irritability is a common sy
gv gv gv gv gv gv gv gv gv gv gv gv gv
mptom of thyrotoxicosis and the client should be informed of that fact rather than b
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
lamed.
, CN: Psychosocial integrity; CL: Synthesize
gv gv gv gv
The nurse is evaluating a client with hyperthyroidism who is taking
gv gv gv gv gv gv gv gv gv gv
Propylthiouracil (PTU) 100 mg/day in three divided doses for maintenance therapy.
gv gv gv gv gv gv gv gv gv gv g
vWhich of the following statements from the client indicates the desired outcome of
gv gv gv gv gv gv gv gv gv gv gv gv gv
the
drug?
1. gv "I gv have excess energy throughout the day."
gv gv gv gv gv
2. gv "I gv am able to sleep and rest at night."
gv gv gv gv gv gv gv
3. gv "I gv have lost weight since taking this medication."
gv gv gv gv gv gv
4. gv "I gv do perspire throughout the entire day." - ANSWERS-
gv gv gv gv gv gv gv
2. gv "I gv am able to sleep and rest at night."
gv gv gv gv gv gv gv
PTU is a prototype of thioamide antithyroid drugs. It inhibits production of thyroid h
gv gv gv gv gv gv gv gv gv gv gv gv gv
ormones and peripheral conversion of T4 to the more active T3. A client taking this
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
antithyroid drug should be able to sleep and rest well at night since the level of th
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
yroid hormones is reduced in the blood. Excess energy throughout the day, loss of
gv gv gv gv gv gv gv gv gv gv gv gv gv g
vweight and perspiring through the day are symptoms of hyperthyroidism indicating
gv gv gv gv gv gv gv gv gv gv gv
the drug has not produced its outcome.
gv gv gv gv gv gv
CN: Pharmacological and parenteral therapies; CL: Evaluate.
gv gv gv gv gv gv
The nurse should teach the client with Graves' disease to prevent corneal
gv gv gv gv gv gv gv gv gv gv gv
irritation from mild exophthalmos by:
gv gv gv gv
1. Massaging the eyes at regular intervals.
gv gv gv gv gv gv
2. Instilling an ophthalmic anesthetic as prescribed.
gv gv gv gv gv gv
3. Wearing dark-colored glasses.
gv gv gv
4. Covering both eyes with moistened gauze pads. - ANSWERS-3. Wearing dark-
gv gv gv gv gv gv gv gv gv gv gv
colored glasses. gv gv
Treatment of mild ophthalmopathy that may accompany thyrotoxicosis includes me
gv gv gv gv gv gv gv gv gv
asures such as wearing sunglasses to protect the eyes from corneal irritation.
gv gv gv gv gv gv gv gv gv gv gv
Treatment of ophthalmopathy should be performed in consultation with an ophthal
gv gv gv gv gv gv gv gv gv gv
mologist. Massaging the eyes will not help to protect the cornea. An ophthalmic
gv gv gv gv gv gv gv gv gv gv gv gv
anesthetic is used to examine and possibly treat a painful eye, not protect the corn
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
ea. Covering the eyes with moist gauze pads is not a satisfactory nursing measure
gv gv gv gv gv gv gv gv gv gv gv gv gv
to protect
gv gv
the eyes of a client with exophthalmos because treatment is not focused on moistu
gv gv gv gv gv gv gv gv gv gv gv gv gv
re to the eye but rather on protecting the cornea and optic nerve. In exophthalmos,
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
the retrobulbar connective tissues and extraocular muscle volume are expanded b
gv gv gv gv gv gv gv gv gv gv gv
ecause of fluid retention. The pressure is also increased.
gv gv gv gv gv gv gv gv
CN: Reduction of risk potential; CL: Synthesize
gv gv gv gv gv gv
A client with Graves' disease is treated with radioactive iodine (RAI) in the
gv gv gv gv gv gv gv gv gv gv gv gv
form of sodium iodide 131I. Which of the following statements by the nurse will ex
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
plain to the client how the drug works?
gv gv gv gv gv gv gv
