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