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NUR 265 Exams 1–3 & Final Medical-Surgical Nursing Study
Guide | Comprehensive Exam Review | Practice Questions with
Detailed Answers, Rationales & Clinical Concepts | Digital PDF
Download
NUR 265 Exam Summary
This comprehensive examination covers medical-surgical nursing concepts including thyroid
disorders (Graves' disease, hypothyroidism), peptic ulcer disease, gastric surgery,
thrombocytopenia, platelet disorders, deep vein thrombosis, pulmonary embolism, hypertension
management, anticoagulant therapy, and basic nursing assistant skills. The exam emphasizes
clinical assessment, pharmacological interventions, patient teaching, and prioritization of care
across the medical-surgical nursing spectrum, with questions ranging from pathophysiology and
medication effects to nursing interventions and complication management.
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:
a. Anorexia
b. Tachycardia
c. Weight gain
d. Cold skin
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Correct Answer: b. Tachycardia
Graves' disease creates a hypermetabolic state where increased metabolic rate generates
excessive body heat and produces tachycardia along with fine muscle tremors; the opposite
findings of anorexia, weight gain, and cold skin are characteristic of hypothyroidism rather than
hyperthyroidism.
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?
a. Dysmenorrhea
b. Metrorrhagia
c. Oligomenorrhea
d. Menorrhagia
Correct Answer: c. Oligomenorrhea
Thyrotoxicosis creates hormonal imbalances that commonly result in diminished menstrual flow
or oligomenorrhea and possibly amenorrhea, while dysmenorrhea, metrorrhagia, and
menorrhagia are typically associated with hypothyroidism rather than hyperthyroid states.
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.)
a. Rapid pulse
b. Decreased energy and fatigue
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c. Weight gain of 10 lbs (4.5 kg)
d. Fine, thin hair with hair loss
e. Constipation
f. Menorrhagia
Correct Answers: b, c, e, f
Hypothyroidism presents with bradycardia, lethargy, memory problems, weight gain, coarse hair,
constipation, and menorrhagia due to insufficient thyroid hormone affecting multiple body
systems and metabolic processes throughout the body.
4. Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse should
teach the client to immediately report which of the following?
a. Sore throat
b. Painful, excessive menstruation
c. Constipation
d. Increased urine output
Correct Answer: a. Sore throat
The most serious adverse effects of PTU are leukopenia and agranulocytosis occurring within
the first 3 months of treatment, requiring immediate reporting of sore throat and fever for prompt
white blood cell count evaluation and drug withholding until results are obtained.
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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?
a. "Your behavior is caused by temporary confusion brought on by your illness."
b. "Your behavior is caused by the excess thyroid hormone in your system."
c. "Your behavior is caused by your worrying about the seriousness of your illness."
d. "Your behavior is caused by the stress of trying to manage a career and cope with illness."
Correct Answer: b. "Your behavior is caused by the excess thyroid hormone in your system."
Irritability is a classic sign of thyrotoxicosis directly caused by high circulating thyroid hormone
levels, and this symptom typically decreases as the client responds to therapy, so the nurse
should provide this physiological explanation rather than attributing it to psychological factors.
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?
a. "I have excess energy throughout the day."
b. "I am able to sleep and rest at night."
c. "I have lost weight since taking this medication."
d. "I do perspire throughout the entire day."
Correct Answer: b. "I am able to sleep and rest at night."
NUR 265 Exams 1–3 & Final Medical-Surgical Nursing Study
Guide | Comprehensive Exam Review | Practice Questions with
Detailed Answers, Rationales & Clinical Concepts | Digital PDF
Download
NUR 265 Exam Summary
This comprehensive examination covers medical-surgical nursing concepts including thyroid
disorders (Graves' disease, hypothyroidism), peptic ulcer disease, gastric surgery,
thrombocytopenia, platelet disorders, deep vein thrombosis, pulmonary embolism, hypertension
management, anticoagulant therapy, and basic nursing assistant skills. The exam emphasizes
clinical assessment, pharmacological interventions, patient teaching, and prioritization of care
across the medical-surgical nursing spectrum, with questions ranging from pathophysiology and
medication effects to nursing interventions and complication management.
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:
a. Anorexia
b. Tachycardia
c. Weight gain
d. Cold skin
,2|Page
Correct Answer: b. Tachycardia
Graves' disease creates a hypermetabolic state where increased metabolic rate generates
excessive body heat and produces tachycardia along with fine muscle tremors; the opposite
findings of anorexia, weight gain, and cold skin are characteristic of hypothyroidism rather than
hyperthyroidism.
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?
a. Dysmenorrhea
b. Metrorrhagia
c. Oligomenorrhea
d. Menorrhagia
Correct Answer: c. Oligomenorrhea
Thyrotoxicosis creates hormonal imbalances that commonly result in diminished menstrual flow
or oligomenorrhea and possibly amenorrhea, while dysmenorrhea, metrorrhagia, and
menorrhagia are typically associated with hypothyroidism rather than hyperthyroid states.
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.)
a. Rapid pulse
b. Decreased energy and fatigue
,3|Page
c. Weight gain of 10 lbs (4.5 kg)
d. Fine, thin hair with hair loss
e. Constipation
f. Menorrhagia
Correct Answers: b, c, e, f
Hypothyroidism presents with bradycardia, lethargy, memory problems, weight gain, coarse hair,
constipation, and menorrhagia due to insufficient thyroid hormone affecting multiple body
systems and metabolic processes throughout the body.
4. Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse should
teach the client to immediately report which of the following?
a. Sore throat
b. Painful, excessive menstruation
c. Constipation
d. Increased urine output
Correct Answer: a. Sore throat
The most serious adverse effects of PTU are leukopenia and agranulocytosis occurring within
the first 3 months of treatment, requiring immediate reporting of sore throat and fever for prompt
white blood cell count evaluation and drug withholding until results are obtained.
, 4|Page
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?
a. "Your behavior is caused by temporary confusion brought on by your illness."
b. "Your behavior is caused by the excess thyroid hormone in your system."
c. "Your behavior is caused by your worrying about the seriousness of your illness."
d. "Your behavior is caused by the stress of trying to manage a career and cope with illness."
Correct Answer: b. "Your behavior is caused by the excess thyroid hormone in your system."
Irritability is a classic sign of thyrotoxicosis directly caused by high circulating thyroid hormone
levels, and this symptom typically decreases as the client responds to therapy, so the nurse
should provide this physiological explanation rather than attributing it to psychological factors.
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?
a. "I have excess energy throughout the day."
b. "I am able to sleep and rest at night."
c. "I have lost weight since taking this medication."
d. "I do perspire throughout the entire day."
Correct Answer: b. "I am able to sleep and rest at night."
