Med-Surg II HESI Exam Questions with Answers
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:
1. anorexia
2. tachycardia
3. weight gain
4. cold skin: 2. tachycardia
Graves' disease, the most common type of thyrotoxicosis, is a state of hypermetabolism. The increased
metabolic rate generates heat and produces tachycardia and fine muscle tremors. Anorexia is
associated with hypothyroidism. Loss of weight, despite a good appetite and adequate caloric intake, is
a common feature of hyperthyroidism. Cold skin is associated with hypothyroidism.
CN: Physiological adaptation; CL: Analyze
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?
1. dysmenorrhea
2. metrorrhagia
3. oligomenorrhea
4. menorrhagia: 3. oligomenorrhea
A change in the menstrual interval, diminished menstrual flow (oligomenorrhea), or even the absence of
menstruation (amenorrhea) may result from the hormonal imbalances of thyrotoxicosis.
Oligomenorrhea in women and decreased libido and impotence in men are common features of
thyrotoxicosis. Dysmenorrhea is painful menstruation. Metr- orrhagia, blood loss between menstrual
periods, is a symptom of hypothyroidism. Menorrhagia, excessive bleeding during menstrual periods, is
a symptom of hypothyroidism.
CN: Physiological adaptation; CL: Analyze
,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.)
1. rapid pulse
2. decreased energy and fatigue
3. weight gain of 10 lbs (4.5 kg)
4. fine, thin hair with hair loss
5. constipation
6. menorrhagia.: 2. decreased energy and fatigue, 3. weight gain of 10 lbs (4.5 kg), 5.
constipation, 6. menorrhagia
Clients with hypothyroidism exhibit symptoms indicating a lack of thyroid hormone. Bradycardia,
decreased energy and lethargy, memory problems, weight gain, coarse hair, constipation, and
menorrhagia are common signs and symptoms of hypothyroidism.
CN: Physiological adaptation; CL: Analyze
4. Propylthiouracil (PTU) is prescribed for a client with Graves' disease.
The nurse should teach the client to immediately report which of
the following?
1. sore throat
2. painful, excessive menstruation
3. constipation
4. increased urine output: 1. sore throat
The most serious adverse ettects of PTU are leukopenia and agranulocytosis, which usually occur
within the first 3 months of treatment. The client should be taught to promptly report to the health care
provider signs and symptoms of infection, such as a sore throat and fever. Clients having a sore throat
and fever should have an immediate white blood cell count and ditterential performed, and the drug
must be withheld until
the results are obtained. Painful menstruation, constipation, and increased urine output are not associated
with PTU therapy.
,CN: Pharmacological and parenteral therapies; CL: Synthesize
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?
, 1. "Your behavior is caused by temporary confusion brought on by
your ill- ness."
2. "Your behavior is caused by the excess thyroid hormone in your
system."
3. "Your behavior is caused by your worrying about the
seriousness of your illness."
4. "Your behavior is caused by the stress of trying to manage a career
and cope with illness.": 2. "Your behavior is caused by the excess thyroid hormone in your
system."
A typical sign of thyrotoxicosis is irritability caused by the high levels of circulating thyroid hormones in the
body. This symptom decreases as the client responds to therapy. Thyrotoxicosis does not cause
confusion. The client may be worried about her illness, and stress may influence her mood; however,
irritability is a common symptom of thyrotoxicosis and the client should be informed of that fact
rather than blamed.
CN: Psychosocial integrity; CL: Synthesize
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?
1. "I have excess energy throughout the day."
2. "I am able to sleep and rest at night."
3. "I have lost weight since taking this medication."
4. "I do perspire throughout the entire day.": 2. "I am able to sleep and rest at
night."
PTU is a prototype of thioamide antithyroid drugs. It inhibits production of thyroid hormones and peripheral
conversion of T4 to the more active T3. A client taking this antithyroid drug should be able to sleep and
rest well at night since the level of thyroid hormones is reduced in the blood. Excess energy throughout
the day, loss of weight and perspiring through the day are symptoms of hyperthyroidism indicating the
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:
1. anorexia
2. tachycardia
3. weight gain
4. cold skin: 2. tachycardia
Graves' disease, the most common type of thyrotoxicosis, is a state of hypermetabolism. The increased
metabolic rate generates heat and produces tachycardia and fine muscle tremors. Anorexia is
associated with hypothyroidism. Loss of weight, despite a good appetite and adequate caloric intake, is
a common feature of hyperthyroidism. Cold skin is associated with hypothyroidism.
CN: Physiological adaptation; CL: Analyze
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?
1. dysmenorrhea
2. metrorrhagia
3. oligomenorrhea
4. menorrhagia: 3. oligomenorrhea
A change in the menstrual interval, diminished menstrual flow (oligomenorrhea), or even the absence of
menstruation (amenorrhea) may result from the hormonal imbalances of thyrotoxicosis.
Oligomenorrhea in women and decreased libido and impotence in men are common features of
thyrotoxicosis. Dysmenorrhea is painful menstruation. Metr- orrhagia, blood loss between menstrual
periods, is a symptom of hypothyroidism. Menorrhagia, excessive bleeding during menstrual periods, is
a symptom of hypothyroidism.
CN: Physiological adaptation; CL: Analyze
,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.)
1. rapid pulse
2. decreased energy and fatigue
3. weight gain of 10 lbs (4.5 kg)
4. fine, thin hair with hair loss
5. constipation
6. menorrhagia.: 2. decreased energy and fatigue, 3. weight gain of 10 lbs (4.5 kg), 5.
constipation, 6. menorrhagia
Clients with hypothyroidism exhibit symptoms indicating a lack of thyroid hormone. Bradycardia,
decreased energy and lethargy, memory problems, weight gain, coarse hair, constipation, and
menorrhagia are common signs and symptoms of hypothyroidism.
CN: Physiological adaptation; CL: Analyze
4. Propylthiouracil (PTU) is prescribed for a client with Graves' disease.
The nurse should teach the client to immediately report which of
the following?
1. sore throat
2. painful, excessive menstruation
3. constipation
4. increased urine output: 1. sore throat
The most serious adverse ettects of PTU are leukopenia and agranulocytosis, which usually occur
within the first 3 months of treatment. The client should be taught to promptly report to the health care
provider signs and symptoms of infection, such as a sore throat and fever. Clients having a sore throat
and fever should have an immediate white blood cell count and ditterential performed, and the drug
must be withheld until
the results are obtained. Painful menstruation, constipation, and increased urine output are not associated
with PTU therapy.
,CN: Pharmacological and parenteral therapies; CL: Synthesize
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?
, 1. "Your behavior is caused by temporary confusion brought on by
your ill- ness."
2. "Your behavior is caused by the excess thyroid hormone in your
system."
3. "Your behavior is caused by your worrying about the
seriousness of your illness."
4. "Your behavior is caused by the stress of trying to manage a career
and cope with illness.": 2. "Your behavior is caused by the excess thyroid hormone in your
system."
A typical sign of thyrotoxicosis is irritability caused by the high levels of circulating thyroid hormones in the
body. This symptom decreases as the client responds to therapy. Thyrotoxicosis does not cause
confusion. The client may be worried about her illness, and stress may influence her mood; however,
irritability is a common symptom of thyrotoxicosis and the client should be informed of that fact
rather than blamed.
CN: Psychosocial integrity; CL: Synthesize
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?
1. "I have excess energy throughout the day."
2. "I am able to sleep and rest at night."
3. "I have lost weight since taking this medication."
4. "I do perspire throughout the entire day.": 2. "I am able to sleep and rest at
night."
PTU is a prototype of thioamide antithyroid drugs. It inhibits production of thyroid hormones and peripheral
conversion of T4 to the more active T3. A client taking this antithyroid drug should be able to sleep and
rest well at night since the level of thyroid hormones is reduced in the blood. Excess energy throughout
the day, loss of weight and perspiring through the day are symptoms of hyperthyroidism indicating the
