BSN 246 questions and answers with
rationales 2026 update
1. The h,nurse h,is h,completing h,a h,health h,assessment h,of h,a h,42-year-old
h,female h, with
suspected h,Graves' h,disease. h,The h,nurse h,should h,assess h,this h,client h,for:
1. Anorexia.
2. Tachycardia.
3. Weight h,gain.
4. Cold h,skin.
ANS➤➤ h,2. h,Graves' h,disease, h,the h,most h,common h,type h,ofh,thyrotoxicosis, h,is h,a h,state h,ofh,hypermetabolism. h,The h,increased
metabolic h,rate h,generates h,heat h,and h,produces h,tachycardia h,and h,fine h,muscle h,tremors. h,Anorexia h,is h,associated
with h,hypothyroidism. h,Loss h,of h,weight, h,despite h,a h,good h,appetite h,and h,adequate h,caloric h,intake, h,is h,a
h,
h, common h,feature h,of h,hyperthyroidism. h,Cold h,skin h,is h,associated h,with h,hypothyroidism.
CN: h,Physiological h,adaptation; h,CL: h,Analyze
2. When h,conducting h,a h,health h,history h,with h,a h,female h,client h,with h,thyrotoxicosis, h,the h,nurse h,should h,ask h,about h,which
h, of h,the h,following h,changes h,in h,the h,menstrual h,cycle?
1. Dysmenorrhea.
2. Metrorrhagia.
3. Oligomenorrhea.
4. Menorrhagia.
,ANS➤➤3. h,A h,change h,in h,the h,menstrual h,interval, h,diminished h,menstrual h,flow
(oligomenorrhea), h,or h,even h,the h,absence h,of h,menstruation h,(amenorrhea) h,may h,result h,from h,the h,hormonal h,imbalances h,of
h, thyrotoxicosis. h,Oligomenorrhea h,in h,women h,and h,decreased h,libido h,and h,impotence h,in h,men h,are h,common h,features h,of
h, thyrotoxicosis. h,Dysmenorrhea h,is h,painful h,menstruation. h,Metrorrhagia, h,blood h,loss h,between h,menstrual h,periods, h,is h,a
symptom h,of h,hypothyroidism. h,Menorrhagia, h,excessive h,bleeding h,during h,menstrual h,periods, h,is h,a h,symptom h,of
h,
h, hypothyroidism.
CN: h,Physiological h,adaptation; h,CL: h,Analyze
3. A h,34-year-old h,female h,is h,diagnosed h,with h,hypothyroidism. h,The h,nurse h,should h,assess h,the h,client h,for h,which
of h,the h,following? h,Select h,all h,that h,apply.
h,
1. Rapid h,pulse.
2. Decreased h,energy h,and h,fatigue.
3. Weight h,gain h,of h,10 h,lb h,(4.5 h,kg).
4. Fine, h,thin h,hair h,with h,hair h,loss.
5. Constipation.
6. Menorrhagia.
ANS➤➤2, h,3, h,5, h,6. h,Clients h,with h,hypothyroidism h,exhibit h,symptoms h,indicating h,a h,lack h,ofh,thyroid h,hormone. h,Bradycardia,
decreased h,energy h,and h,lethargy, h,memory h,problems, h,weight h,gain, h,coarse h,hair, h,constipation, h,and h,menorrhagia h,are
common h,signs h,and h,symptoms h,of h,hypothyroidism.
h,
CN: h,Physiological h,adaptation; h,CL: h,Analyze
4. Propylthiouracil h,(PTU) h,is h,prescribed h,for h,a h,client h,with h,Graves' h,disease. h,The h,nurse h,should h,teach h,the h,client h,to
immediately h,report h,which h,of h,the h,following?
h,
1. Sore h,throat.
2. Painful, h,excessive h,menstruation.
,3. Constipation.
4. Increased h,urine h,output.
ANS➤➤1. h,The h,most h,serious h,adverse h,effects h,ofh,PTU h,are h,leukopenia h,and h,agranulocytosis, h,which h,usually h,occur h,within h,the
first h,3 h,months h,of h,treatment. h,The h,client h,should h,be h,taught h,to h,promptly h,report h,to h,the h,health h,care h,provider h,signs h,and
h, symptoms h,of h,infection, h,such h,as h,a h,sore h,throat h,and h,fever. h,Clients h,having h,a h,sore h,throat h,and h,fever h,should h,have h,an
h, immediate h,white h,blood h,cell h,count h,and h,differential h,performed, h,and h,the h,drug h,must h,be h,withheld h,until h,the h,results h,are
h, obtained. h,Painful h,menstruation, h,constipation, h,and h,increased h,urine h,output h,are h,not h,associated h,with h,PTU h,therapy.
CN: h,Pharmacological h,and h,parenteral h,therapies; h,CL: h,Synthesize
5. A h,client h,with h,thyrotoxicosis h,says h,to h,the h,nurse, h,"I h,am h,so h,irritable. h,I h,am h,having h,problems h,at h,work h,because h,I h,lose
h, my h,temper h,very h,easily." h,Which h,of h,the h,following h,responses h,by h,the h,nurse h,would h,give h,the h,client h,the h,most h,accurate
h, explanation h,of h,her h,behavior?
1. "Your h,behavior h,is h,caused h,by h,temporary h,confusion h,brought h,on h,by h,your h,illness."
2. "Your h,behavior h,is h,caused h,by h,the h,excess h,thyroid h,hormone h,in h,your h,system." h,3. h,"Your h,behavior h,is h,caused
by h,your h,worrying h,about h,the h,seriousness h,of h,your h,illness."
h,
4. h,"Your h,behavior h,is h,caused h,by h,the h,stress h,of h,trying h,to h,manage h,a h,career h,and h,cope h,with h,illness."
ANS➤➤2. h,A h,typical h,sign h,ofh,thyrotoxicosis h,is h,irritabilityh,caused h,by h,the h,high h,levels h,of h,circulating h,thyroid h,hormones h,in h,the
body. h,This h,symptom h,decreases h,as h,the h,client h,responds h,to h,therapy. h,Thyrotoxicosis h,does h,not h,cause h,confusion. h,The
client h,may h,be h,worried h,about h,her h,illness, h,and h,stress h,may h,influence h,her h,mood; h,however, h,irritability h,is h,a h,common
h,
h, symptom h,of h,thyrotoxicosis h,and h,the h,client h,should h,be h,informed h,of h,that h,fact h,rather h,than h,blamed.
CN: h,Psychosocial h,integrity; h,CL: h,Synthesize
6. The h,nurse h,is h,evaluating h,a h,client h,with h,hyperthyroidism h,who h,is h,taking
h, Propylthiouracil h,(PTU) h,100 h,mg/day h,in h,three h,divided h,doses h,for h,maintenance
therapy.
h,
, Which h,of h,the h,following h,statements h,from h,the h,client h,indicates h,the h,desired h,outcome h,of h,the h,drug?
1. "I h,have h,excess h,energy h,throughout h,the h,day."
2. "I h,am h,able h,to h,sleep h,and h,rest h,at h,night."
3. "I h,have h,lost h,weight h,since h,taking h,this h,medication."
4. "I h,do h,perspire h,throughout h,the h,entire h,day."
ANS➤➤2. h,PTU h,is h,a h,prototype h,ofh,thioamide h,antithyroid h,drugs. h,It h,inhibits h,production h,ofh,thyroid h,hormones h,and h,peripheral
conversion h,of h,T4 h,to h,the h,more h,active h,T3. h,A h,client h,taking h,this h,antithyroid h,drug h,should h,be h,able h,to h,sleep h,and h,rest h,well
h, at h,night h,since h,the h,level h,of h,thyroid h,hormones h,is h,reduced h,in h,the h,blood. h,Excess h,energy h,throughout h,the h,day, h,loss h,of
h, weight h,and h,perspiring h,through h,the h,day h,are h,symptoms h,of h,hyperthyroidism h,indicating h,the h,drug h,has h,not h,produced h,its
h, outcome.
CN: h,Pharmacological h,and h,parenteral h,therapies; h,CL: h,Evaluate.
7. The h,nurse h,should h,teach h,the h,client h,with h,Graves' h,disease h,to h,prevent h,corneal h,irritation h,from h,mild h,exophthalmos h,by:
1. Massaging h,the h,eyes h,at h,regular h,intervals.
2. Instilling h,an h,ophthalmic h,anesthetic h,as h,prescribed.
3. Wearing h,dark-colored h,glasses.
4. Covering h,both h,eyes h,with h,moistened h,gauze h,pads.
ANS➤➤3. h,Treatment h,ofh,mild h,ophthalmopathyh,that h,may h,accompany h,thyrotoxicosis h,includes h,measures h,such h,as h,wearing
sunglasses h,to h,protect h,the h,eyes h,from h,corneal h,irritation. h,Treatment h,of h,ophthalmopathy h,should h,be h,performed h,in
h, consultation h,with h,an h,ophthalmologist. h,Massaging h,the h,eyes h,will h,not h,help h,to h,protect h,the h,cornea. h,An h,ophthalmic
h, anesthetic h,is h,used h,to h,examine h,and h,possibly h,treat h,a h,painful h,eye, h,not h,protect h,the h,cornea. h,Covering h,the h,eyes h,with
h, moist h,gauze h,pads h,is h,not h,a
satisfactory h,nursing h,measure h,to h,protect h,the h,eyes h,of h,a h,client h,with h,exophthalmos h,because h,treatment h,is h,not h,focused
h, on h,moisture h,to h,the h,eye h,but h,rather h,on h,protecting h,the h,cornea h,and h,optic h,nerve. h,In h,exophthalmos, h,the h,retrobulbar
h, connective h,tissues h,and h,extraocular h,muscle h,volume h,are h,expanded h,because h,of h,fluid h,retention. h,The h,pressure h,is h,also
rationales 2026 update
1. The h,nurse h,is h,completing h,a h,health h,assessment h,of h,a h,42-year-old
h,female h, with
suspected h,Graves' h,disease. h,The h,nurse h,should h,assess h,this h,client h,for:
1. Anorexia.
2. Tachycardia.
3. Weight h,gain.
4. Cold h,skin.
ANS➤➤ h,2. h,Graves' h,disease, h,the h,most h,common h,type h,ofh,thyrotoxicosis, h,is h,a h,state h,ofh,hypermetabolism. h,The h,increased
metabolic h,rate h,generates h,heat h,and h,produces h,tachycardia h,and h,fine h,muscle h,tremors. h,Anorexia h,is h,associated
with h,hypothyroidism. h,Loss h,of h,weight, h,despite h,a h,good h,appetite h,and h,adequate h,caloric h,intake, h,is h,a
h,
h, common h,feature h,of h,hyperthyroidism. h,Cold h,skin h,is h,associated h,with h,hypothyroidism.
CN: h,Physiological h,adaptation; h,CL: h,Analyze
2. When h,conducting h,a h,health h,history h,with h,a h,female h,client h,with h,thyrotoxicosis, h,the h,nurse h,should h,ask h,about h,which
h, of h,the h,following h,changes h,in h,the h,menstrual h,cycle?
1. Dysmenorrhea.
2. Metrorrhagia.
3. Oligomenorrhea.
4. Menorrhagia.
,ANS➤➤3. h,A h,change h,in h,the h,menstrual h,interval, h,diminished h,menstrual h,flow
(oligomenorrhea), h,or h,even h,the h,absence h,of h,menstruation h,(amenorrhea) h,may h,result h,from h,the h,hormonal h,imbalances h,of
h, thyrotoxicosis. h,Oligomenorrhea h,in h,women h,and h,decreased h,libido h,and h,impotence h,in h,men h,are h,common h,features h,of
h, thyrotoxicosis. h,Dysmenorrhea h,is h,painful h,menstruation. h,Metrorrhagia, h,blood h,loss h,between h,menstrual h,periods, h,is h,a
symptom h,of h,hypothyroidism. h,Menorrhagia, h,excessive h,bleeding h,during h,menstrual h,periods, h,is h,a h,symptom h,of
h,
h, hypothyroidism.
CN: h,Physiological h,adaptation; h,CL: h,Analyze
3. A h,34-year-old h,female h,is h,diagnosed h,with h,hypothyroidism. h,The h,nurse h,should h,assess h,the h,client h,for h,which
of h,the h,following? h,Select h,all h,that h,apply.
h,
1. Rapid h,pulse.
2. Decreased h,energy h,and h,fatigue.
3. Weight h,gain h,of h,10 h,lb h,(4.5 h,kg).
4. Fine, h,thin h,hair h,with h,hair h,loss.
5. Constipation.
6. Menorrhagia.
ANS➤➤2, h,3, h,5, h,6. h,Clients h,with h,hypothyroidism h,exhibit h,symptoms h,indicating h,a h,lack h,ofh,thyroid h,hormone. h,Bradycardia,
decreased h,energy h,and h,lethargy, h,memory h,problems, h,weight h,gain, h,coarse h,hair, h,constipation, h,and h,menorrhagia h,are
common h,signs h,and h,symptoms h,of h,hypothyroidism.
h,
CN: h,Physiological h,adaptation; h,CL: h,Analyze
4. Propylthiouracil h,(PTU) h,is h,prescribed h,for h,a h,client h,with h,Graves' h,disease. h,The h,nurse h,should h,teach h,the h,client h,to
immediately h,report h,which h,of h,the h,following?
h,
1. Sore h,throat.
2. Painful, h,excessive h,menstruation.
,3. Constipation.
4. Increased h,urine h,output.
ANS➤➤1. h,The h,most h,serious h,adverse h,effects h,ofh,PTU h,are h,leukopenia h,and h,agranulocytosis, h,which h,usually h,occur h,within h,the
first h,3 h,months h,of h,treatment. h,The h,client h,should h,be h,taught h,to h,promptly h,report h,to h,the h,health h,care h,provider h,signs h,and
h, symptoms h,of h,infection, h,such h,as h,a h,sore h,throat h,and h,fever. h,Clients h,having h,a h,sore h,throat h,and h,fever h,should h,have h,an
h, immediate h,white h,blood h,cell h,count h,and h,differential h,performed, h,and h,the h,drug h,must h,be h,withheld h,until h,the h,results h,are
h, obtained. h,Painful h,menstruation, h,constipation, h,and h,increased h,urine h,output h,are h,not h,associated h,with h,PTU h,therapy.
CN: h,Pharmacological h,and h,parenteral h,therapies; h,CL: h,Synthesize
5. A h,client h,with h,thyrotoxicosis h,says h,to h,the h,nurse, h,"I h,am h,so h,irritable. h,I h,am h,having h,problems h,at h,work h,because h,I h,lose
h, my h,temper h,very h,easily." h,Which h,of h,the h,following h,responses h,by h,the h,nurse h,would h,give h,the h,client h,the h,most h,accurate
h, explanation h,of h,her h,behavior?
1. "Your h,behavior h,is h,caused h,by h,temporary h,confusion h,brought h,on h,by h,your h,illness."
2. "Your h,behavior h,is h,caused h,by h,the h,excess h,thyroid h,hormone h,in h,your h,system." h,3. h,"Your h,behavior h,is h,caused
by h,your h,worrying h,about h,the h,seriousness h,of h,your h,illness."
h,
4. h,"Your h,behavior h,is h,caused h,by h,the h,stress h,of h,trying h,to h,manage h,a h,career h,and h,cope h,with h,illness."
ANS➤➤2. h,A h,typical h,sign h,ofh,thyrotoxicosis h,is h,irritabilityh,caused h,by h,the h,high h,levels h,of h,circulating h,thyroid h,hormones h,in h,the
body. h,This h,symptom h,decreases h,as h,the h,client h,responds h,to h,therapy. h,Thyrotoxicosis h,does h,not h,cause h,confusion. h,The
client h,may h,be h,worried h,about h,her h,illness, h,and h,stress h,may h,influence h,her h,mood; h,however, h,irritability h,is h,a h,common
h,
h, symptom h,of h,thyrotoxicosis h,and h,the h,client h,should h,be h,informed h,of h,that h,fact h,rather h,than h,blamed.
CN: h,Psychosocial h,integrity; h,CL: h,Synthesize
6. The h,nurse h,is h,evaluating h,a h,client h,with h,hyperthyroidism h,who h,is h,taking
h, Propylthiouracil h,(PTU) h,100 h,mg/day h,in h,three h,divided h,doses h,for h,maintenance
therapy.
h,
, Which h,of h,the h,following h,statements h,from h,the h,client h,indicates h,the h,desired h,outcome h,of h,the h,drug?
1. "I h,have h,excess h,energy h,throughout h,the h,day."
2. "I h,am h,able h,to h,sleep h,and h,rest h,at h,night."
3. "I h,have h,lost h,weight h,since h,taking h,this h,medication."
4. "I h,do h,perspire h,throughout h,the h,entire h,day."
ANS➤➤2. h,PTU h,is h,a h,prototype h,ofh,thioamide h,antithyroid h,drugs. h,It h,inhibits h,production h,ofh,thyroid h,hormones h,and h,peripheral
conversion h,of h,T4 h,to h,the h,more h,active h,T3. h,A h,client h,taking h,this h,antithyroid h,drug h,should h,be h,able h,to h,sleep h,and h,rest h,well
h, at h,night h,since h,the h,level h,of h,thyroid h,hormones h,is h,reduced h,in h,the h,blood. h,Excess h,energy h,throughout h,the h,day, h,loss h,of
h, weight h,and h,perspiring h,through h,the h,day h,are h,symptoms h,of h,hyperthyroidism h,indicating h,the h,drug h,has h,not h,produced h,its
h, outcome.
CN: h,Pharmacological h,and h,parenteral h,therapies; h,CL: h,Evaluate.
7. The h,nurse h,should h,teach h,the h,client h,with h,Graves' h,disease h,to h,prevent h,corneal h,irritation h,from h,mild h,exophthalmos h,by:
1. Massaging h,the h,eyes h,at h,regular h,intervals.
2. Instilling h,an h,ophthalmic h,anesthetic h,as h,prescribed.
3. Wearing h,dark-colored h,glasses.
4. Covering h,both h,eyes h,with h,moistened h,gauze h,pads.
ANS➤➤3. h,Treatment h,ofh,mild h,ophthalmopathyh,that h,may h,accompany h,thyrotoxicosis h,includes h,measures h,such h,as h,wearing
sunglasses h,to h,protect h,the h,eyes h,from h,corneal h,irritation. h,Treatment h,of h,ophthalmopathy h,should h,be h,performed h,in
h, consultation h,with h,an h,ophthalmologist. h,Massaging h,the h,eyes h,will h,not h,help h,to h,protect h,the h,cornea. h,An h,ophthalmic
h, anesthetic h,is h,used h,to h,examine h,and h,possibly h,treat h,a h,painful h,eye, h,not h,protect h,the h,cornea. h,Covering h,the h,eyes h,with
h, moist h,gauze h,pads h,is h,not h,a
satisfactory h,nursing h,measure h,to h,protect h,the h,eyes h,of h,a h,client h,with h,exophthalmos h,because h,treatment h,is h,not h,focused
h, on h,moisture h,to h,the h,eye h,but h,rather h,on h,protecting h,the h,cornea h,and h,optic h,nerve. h,In h,exophthalmos, h,the h,retrobulbar
h, connective h,tissues h,and h,extraocular h,muscle h,volume h,are h,expanded h,because h,of h,fluid h,retention. h,The h,pressure h,is h,also
