NURS 1220 EXAMINATION SCRIPT 2025/2026 QUESTIONS
WITH ANSWERS GRADED A+
✔✔1. The nurse is planning health teaching for a client starting on levothyroxine. What
health teaching about this drug would the nurse include?
a. The need to take the drug when the client feels fatigued and weak.
b. The need to report chest pain and dyspnea when starting the drug.
c. The need to check blood pressure and pulse every day.
d. The need to rotate injection sites when giving self the drug. - ✔✔ANS: B
Levothyroxine is a replacement hormone for clients who have hypothyroidism and is
taken orally for life. Vital signs do not have to be checked every day, but the client
should report any chest pain and dyspnea when first starting the drug.
✔✔A nurse assesses a client who is recovering from a subtotal thyroidectomy and
observes the development of stridor. What is the priority action for the nurse to take?
a. Apply oxygen via nasal cannula at 2 L/min.
b. Document the finding and assess the client hourly.
c. Place the client in high-Fowler position in the bed.
d. Contact the Rapid Response Team and prepare for intubation. - ✔✔ANS: D
Stridor on exhalation is a hallmark of respiratory distress, usually caused by obstruction
resulting from edema. The nurse should prepare to assist with emergency intubation or
tracheostomy while notifying the Rapid Response Team. Stridor is an emergency
situation; therefore, reassuring the client, documenting, and reassessing in an hour do
not address the urgency of the situation. Oxygen should be applied, but this action will
not keep the airway open.
✔✔A nurse assesses a client who is recovering from a subtotal thyroidectomy. On the
first postoperative day before discharge, the client states, "I feel numbness and tingling
around my mouth." What action does the nurse take?
a. Offer mouth care.
b. Loosen the dressing.
c. Assess for muscle twitching.
d. Ask the client orientation questions - ✔✔ANS: C
PRIMEXAM.COM
Numbness and tingling around the mouth or in the fingers and toes are manifestations
of hypocalcemia, which could progress to cause tetany and seizure activity. The nurse
would assess for muscle twitching and, if present, notify the surgeon or Rapid
Response Team to give calcium gluconate or other IV calcium replacement. Mouth
care, loosening the dressing, and orientation questions do not provide important
information to prevent complications of low calcium levels.
✔✔4. A nurse assesses a client on the medical-surgical unit. Which statement made by
the client alerts the nurse to assess the patient for hypothyroidism?
a. "My sister has thyroid problems."
b. "I seem to feel the heat more than other people."
,c. "Food just doesn't taste good without a lot of salt."
d. "I am always tired, even with 12 hours of sleep." - ✔✔ANS: D
Clients with hypothyroidism usually feel tired or weak despite getting many hours of
sleep. Most thyroid problems are not inherited, although they may occur in families.
Heat intolerance is indicative of hyperthyroidism. Loss of taste is not a manifestation of
hypothyroidism. The nurse would assess the client further for hypothyroidism.
✔✔A nurse cares for a client who presents with bradycardia secondary to
hypothyroidism. Which medication does the nurse prepare to administer?
a. Atropine sulfate
b. Levothyroxine
c. Propranolol
d. Epinephrine - ✔✔ANS: B
The treatment for bradycardia from hypothyroidism is to treat the hypothyroidism using
levothyroxine. If the heart rate were so slow that it became an emergency, then atropine
or epinephrine might be an option for short-term management. Propranolol is a beta
blocker and would be contraindicated for a client with bradycardia.
✔✔A nurse plans care for a client with hypothyroidism. Which priority problem does the
nurse address first for this client?
a. Heat intolerance
b. Body image problems
c. Depression and withdrawal
d. Obesity and water retention - ✔✔ANS: C
Hypothyroidism causes many problems in psychosocial functioning. Depression is the
most common reason for seeking medical attention. Memory and attention span may be
impaired. The client's family may have great difficulty accepting and dealing with these
changes. The client is often unmotivated to participate in self-care. Lapses in memory
and attention require the nurse to ensure that the patient's environment is safe. Heat
intolerance is seen in hyperthyroidism. Body image problems and weight issues do not
take priority over mental
✔✔A nurse assesses a client who is prescribed levothyroxine for hypothyroidism. Which
assessment finding ALERTS the nurse that drug therapy is EFFECTIVE?
A. Thirst is recognized and fluid intake is appropriate.
B.Weight has been the same for 3 weeks.
C. Total white blood cell count is 6000 cells/mm3 (6 109/L).
D.Heart rate is 76 beats/min and regular. - ✔✔ANS: D
Hypothyroidism decreases body functioning and can result in effects such as
bradycardia, confusion, and constipation. If a client's heart rate is bradycardic while on
thyroid hormone replacement, this is an indicator that the replacement may not be
adequate. Conversely, a heart rate above 100 beats/min may indicate that the client is
receiving too much of the thyroid hormone. Thirst, fluid intake, weight, and white blood
cell count do not represent a therapeutic response to this medication.
, ✔✔A nurse cares for a client who has hypothyroidism as a result of
Hashimotothyroiditis. The client asks, "How long will I need to take this thyroid
medication?" How would the nurse respond?
a. "You will need to take the thyroid medication until the goiter is completely gone."
b. "Thyroiditis is cured with antibiotics. Then you won't need thyroid medication."
c. "You'll need thyroid pills for life because your thyroid won't start working again."
d. "When blood tests indicate normal thyroid function, you can stop the medication." -
✔✔ANS: C
Hashimoto thyroiditis results in a permanent loss of thyroid function. The client will need
lifelong thyroid replacement therapy and will not be able to stop taking the medication.
✔✔The nurse is caring for a client who is starting on propylthiouracil for
hyperthyroidism. What statement by the client indicates a need for FURTHER teaching?
a. "I will let my provider know if I have weight gain and cold intolerance."
b. "I will let my provider know if I have a metallic taste or stomach upset."
c. "I will avoid crowds and other people who have infection."
d. "I am aware that if the drug changes the color of my urine, I should stop it." - ✔✔ANS:
B
If the client's urine turns dark and/or the skin has a yellow appearance, the client may
have possible liver toxicity from the drug. This is a serious adverse effect and needs to
be reported to the primary health care provider after stopping the drug. If weight gain
and cold intolerance occurs, then the client may need a lower dose of the drug. The
drug should not cause GI distress or a metallic taste in his or her mouth.
✔✔A nurse plans care for a client with hypERparathyroidism. Which intervention does
the nurse include in this client's plan of care?
a. Use a lift sheet to assist the client with position changes in bed.
b. Ask the client to ambulate in the hallway twice a day.
c. Provide the client with a soft-bristled toothbrush for oral care.
d. Instruct the assistive personnel to strain the patient's urine for stones. - ✔✔ANS: A
HYPER=TAKES AWAY CALCIUM
Hyperparathyroidism causes increased resorption of calcium from the bones, increasing
the risk for pathologic fractures. Using a lift sheet when moving or positioning the client,
instead of pulling on the client, reduces the risk of bone injury. Hyperparathyroidism can
cause kidney stones, but not every client will need to have urine strained. The priority is
preventing injury. Ambulating in the hall and using a soft toothbrush are not specific
interventions for this patient.
✔✔While assessing a client with Graves disease, the nurse notes that the client's
temperature has risen 1° F (1° C). What does the nurse do FIRST?
a. Turn the lights down and shut the patient's door.
b. Call for an immediate electrocardiogram (ECG).
c. Calculate the client's apical-radial pulse deficit.
d. Administer a dose of acetaminophen. - ✔✔ANS: A
WITH ANSWERS GRADED A+
✔✔1. The nurse is planning health teaching for a client starting on levothyroxine. What
health teaching about this drug would the nurse include?
a. The need to take the drug when the client feels fatigued and weak.
b. The need to report chest pain and dyspnea when starting the drug.
c. The need to check blood pressure and pulse every day.
d. The need to rotate injection sites when giving self the drug. - ✔✔ANS: B
Levothyroxine is a replacement hormone for clients who have hypothyroidism and is
taken orally for life. Vital signs do not have to be checked every day, but the client
should report any chest pain and dyspnea when first starting the drug.
✔✔A nurse assesses a client who is recovering from a subtotal thyroidectomy and
observes the development of stridor. What is the priority action for the nurse to take?
a. Apply oxygen via nasal cannula at 2 L/min.
b. Document the finding and assess the client hourly.
c. Place the client in high-Fowler position in the bed.
d. Contact the Rapid Response Team and prepare for intubation. - ✔✔ANS: D
Stridor on exhalation is a hallmark of respiratory distress, usually caused by obstruction
resulting from edema. The nurse should prepare to assist with emergency intubation or
tracheostomy while notifying the Rapid Response Team. Stridor is an emergency
situation; therefore, reassuring the client, documenting, and reassessing in an hour do
not address the urgency of the situation. Oxygen should be applied, but this action will
not keep the airway open.
✔✔A nurse assesses a client who is recovering from a subtotal thyroidectomy. On the
first postoperative day before discharge, the client states, "I feel numbness and tingling
around my mouth." What action does the nurse take?
a. Offer mouth care.
b. Loosen the dressing.
c. Assess for muscle twitching.
d. Ask the client orientation questions - ✔✔ANS: C
PRIMEXAM.COM
Numbness and tingling around the mouth or in the fingers and toes are manifestations
of hypocalcemia, which could progress to cause tetany and seizure activity. The nurse
would assess for muscle twitching and, if present, notify the surgeon or Rapid
Response Team to give calcium gluconate or other IV calcium replacement. Mouth
care, loosening the dressing, and orientation questions do not provide important
information to prevent complications of low calcium levels.
✔✔4. A nurse assesses a client on the medical-surgical unit. Which statement made by
the client alerts the nurse to assess the patient for hypothyroidism?
a. "My sister has thyroid problems."
b. "I seem to feel the heat more than other people."
,c. "Food just doesn't taste good without a lot of salt."
d. "I am always tired, even with 12 hours of sleep." - ✔✔ANS: D
Clients with hypothyroidism usually feel tired or weak despite getting many hours of
sleep. Most thyroid problems are not inherited, although they may occur in families.
Heat intolerance is indicative of hyperthyroidism. Loss of taste is not a manifestation of
hypothyroidism. The nurse would assess the client further for hypothyroidism.
✔✔A nurse cares for a client who presents with bradycardia secondary to
hypothyroidism. Which medication does the nurse prepare to administer?
a. Atropine sulfate
b. Levothyroxine
c. Propranolol
d. Epinephrine - ✔✔ANS: B
The treatment for bradycardia from hypothyroidism is to treat the hypothyroidism using
levothyroxine. If the heart rate were so slow that it became an emergency, then atropine
or epinephrine might be an option for short-term management. Propranolol is a beta
blocker and would be contraindicated for a client with bradycardia.
✔✔A nurse plans care for a client with hypothyroidism. Which priority problem does the
nurse address first for this client?
a. Heat intolerance
b. Body image problems
c. Depression and withdrawal
d. Obesity and water retention - ✔✔ANS: C
Hypothyroidism causes many problems in psychosocial functioning. Depression is the
most common reason for seeking medical attention. Memory and attention span may be
impaired. The client's family may have great difficulty accepting and dealing with these
changes. The client is often unmotivated to participate in self-care. Lapses in memory
and attention require the nurse to ensure that the patient's environment is safe. Heat
intolerance is seen in hyperthyroidism. Body image problems and weight issues do not
take priority over mental
✔✔A nurse assesses a client who is prescribed levothyroxine for hypothyroidism. Which
assessment finding ALERTS the nurse that drug therapy is EFFECTIVE?
A. Thirst is recognized and fluid intake is appropriate.
B.Weight has been the same for 3 weeks.
C. Total white blood cell count is 6000 cells/mm3 (6 109/L).
D.Heart rate is 76 beats/min and regular. - ✔✔ANS: D
Hypothyroidism decreases body functioning and can result in effects such as
bradycardia, confusion, and constipation. If a client's heart rate is bradycardic while on
thyroid hormone replacement, this is an indicator that the replacement may not be
adequate. Conversely, a heart rate above 100 beats/min may indicate that the client is
receiving too much of the thyroid hormone. Thirst, fluid intake, weight, and white blood
cell count do not represent a therapeutic response to this medication.
, ✔✔A nurse cares for a client who has hypothyroidism as a result of
Hashimotothyroiditis. The client asks, "How long will I need to take this thyroid
medication?" How would the nurse respond?
a. "You will need to take the thyroid medication until the goiter is completely gone."
b. "Thyroiditis is cured with antibiotics. Then you won't need thyroid medication."
c. "You'll need thyroid pills for life because your thyroid won't start working again."
d. "When blood tests indicate normal thyroid function, you can stop the medication." -
✔✔ANS: C
Hashimoto thyroiditis results in a permanent loss of thyroid function. The client will need
lifelong thyroid replacement therapy and will not be able to stop taking the medication.
✔✔The nurse is caring for a client who is starting on propylthiouracil for
hyperthyroidism. What statement by the client indicates a need for FURTHER teaching?
a. "I will let my provider know if I have weight gain and cold intolerance."
b. "I will let my provider know if I have a metallic taste or stomach upset."
c. "I will avoid crowds and other people who have infection."
d. "I am aware that if the drug changes the color of my urine, I should stop it." - ✔✔ANS:
B
If the client's urine turns dark and/or the skin has a yellow appearance, the client may
have possible liver toxicity from the drug. This is a serious adverse effect and needs to
be reported to the primary health care provider after stopping the drug. If weight gain
and cold intolerance occurs, then the client may need a lower dose of the drug. The
drug should not cause GI distress or a metallic taste in his or her mouth.
✔✔A nurse plans care for a client with hypERparathyroidism. Which intervention does
the nurse include in this client's plan of care?
a. Use a lift sheet to assist the client with position changes in bed.
b. Ask the client to ambulate in the hallway twice a day.
c. Provide the client with a soft-bristled toothbrush for oral care.
d. Instruct the assistive personnel to strain the patient's urine for stones. - ✔✔ANS: A
HYPER=TAKES AWAY CALCIUM
Hyperparathyroidism causes increased resorption of calcium from the bones, increasing
the risk for pathologic fractures. Using a lift sheet when moving or positioning the client,
instead of pulling on the client, reduces the risk of bone injury. Hyperparathyroidism can
cause kidney stones, but not every client will need to have urine strained. The priority is
preventing injury. Ambulating in the hall and using a soft toothbrush are not specific
interventions for this patient.
✔✔While assessing a client with Graves disease, the nurse notes that the client's
temperature has risen 1° F (1° C). What does the nurse do FIRST?
a. Turn the lights down and shut the patient's door.
b. Call for an immediate electrocardiogram (ECG).
c. Calculate the client's apical-radial pulse deficit.
d. Administer a dose of acetaminophen. - ✔✔ANS: A
