Med-Surg II HESI Exam - set one EXAM QUESTIONS ACCURATE AND VERIFIED ACTUAL EXAM QUESTIONS WITH DETAILED ANSWERS FOR GUARANTEED PASS | ALREADY GRADED A

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 best explains how the drug works? A. “The RAI stabilizes the thyroid hormone levels before a thyroidectomy.” B. “The RAI reduces uptake of thyroxine and thereby improves your condition.” C. “The RAI lowers the levels of thyroid hormones by slowing your body's production of them.” D. “The RAI destroys thyroid tissue so that thyroid hormones are no longer produced.” Correct Answer: D Rationale: Radioactive iodine destroys thyroid follicular cells, stopping hormone production. This results in a “medical thyroidectomy.” It is not given before surgery and does not simply reduce thyroxine uptake. After treatment with radioactive iodine (RAI), the nurse teaches the client to: A. Monitor for signs and symptoms of hyperthyroidism. B. Rest for 1 week to prevent complications. C. Take thyroxine replacement for life. D. Assess for hypertension and tachycardia. Correct Answer: C Rationale: RAI commonly leads to permanent hypothyroidism, requiring lifelong thyroid hormone replacement. Monitoring should focus on hypothyroidism, not hyperthyroidism. A client with a large goiter is scheduled for a subtotal thyroidectomy. Saturated solution of potassium iodide (SSKI) is prescribed preoperatively. What is the expected outcome? A. Slow progression of exophthalmos B. Reduce vascularity of the thyroid gland C. Decrease storage of thyroxine D. Increase excretion of thyroxine Correct Answer: B Rationale: SSKI decreases thyroid gland vascularity, reducing bleeding risk during surgery. It does not affect exophthalmos or thyroxine storage/excretion. The nurse is administering SSKI. What is the correct method? A. Pour over ice chips B. Mix with an antacid C. Dilute with water, milk, or juice and give with a straw D. Mix with pureed food Correct Answer: C Rationale: SSKI has a strong taste and can irritate mucosa. Dilution and use of a straw reduce irritation and prevent tooth staining. Following a subtotal thyroidectomy, the nurse asks the client to speak immediately after regaining consciousness to assess for: A. Internal hemorrhage B. Decreasing level of consciousness C. Laryngeal nerve damage D. Upper airway obstruction Correct Answer: C Rationale: The recurrent laryngeal nerve may be damaged during surgery. Hoarseness or weak voice indicates possible injury. After a subtotal thyroidectomy, which equipment should be kept at the bedside? A. Total parenteral nutrition setup B. Cutdown infusion supplies C. Tube feeding equipment D. Tracheotomy set Correct Answer: D Rationale: Airway obstruction is a major risk postoperatively. Emergency tracheotomy equipment must be readily available. One day after thyroidectomy, a client reports tingling in fingers and toes. What should the nurse do first? A. Encourage movement of extremities B. Notify the physician C. Assess for thrombophlebitis D. Ask the client to speak Correct Answer: B Rationale: Tingling suggests hypocalcemia from possible parathyroid damage. This can progress to tetany and requires immediate medical attention. Which medication should be available for emergency treatment of tetany? A. Sodium phosphate B. Calcium gluconate C. Echothiophate iodide D. Sodium bicarbonate Correct Answer: B Rationale: Calcium gluconate rapidly corrects hypocalcemia and treats tetany. A 60-year-old female with hypothyroidism should be assessed for: A. Tachycardia B. Weight gain C. Diarrhea D. Nausea Correct Answer: B Rationale: Hypothyroidism slows metabolism, leading to weight gain, not weight loss or tachycardia. The nurse should assess a client with hypothyroidism for: A. Corneal abrasion B. Weight loss C. Fluid loss from diarrhea D. Decreased activity due to fatigue Correct Answer: D Rationale: Fatigue and decreased activity are hallmark signs of hypothyroidism due to reduced metabolic rate. A client with hypothyroidism reports depression. What is the best response? A. It is caused by medication and will go away B. It will not diminish over time C. It is part of chronic illness D. It is due to low thyroid hormone and will improve with treatment Correct Answer: D Rationale: Low thyroid hormone levels can cause depression, which typically improves with proper hormone replacement therapy. A client takes levothyroxine (Synthroid), digoxin (Lanoxin), and simvastatin (Zocor). Which instruction is correct? A. Take Synthroid with breakfast B. Take Synthroid before breakfast and others 4 hours later C. Take all medications together after breakfast D. Take all medications at bedtime Correct Answer: B Rationale: Levothyroxine should be taken on an empty stomach for optimal absorption and separated from other medications. When using an empowerment approach with a diabetic client, which question should the nurse ask first? A. How much should your family be involved? B. What does your family need to manage your care? C. What activities are important for you to maintain control of your diabetes? D. What do you know about your medications? Correct Answer: C Rationale: Empowerment focuses on the client’s priorities, goals, and self-management, making this the most appropriate initial question.