BSN 246 HESI REVIEWED EXAM
REVISION QUESTIONS AND CORRECT
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. 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. 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. Metrorrhagia, 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 lb (4.5 kg).
4. Fine, thin hair with hair loss.
5. Constipation.
6. Menorrhagia.
2, 3, 5, 6. 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. The most serious adverse effects 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 differential 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 illness."
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. 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
REVISION QUESTIONS AND CORRECT
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. 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. 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. Metrorrhagia, 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 lb (4.5 kg).
4. Fine, thin hair with hair loss.
5. Constipation.
6. Menorrhagia.
2, 3, 5, 6. 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. The most serious adverse effects 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 differential 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 illness."
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. 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
