nightingale 265 Hesi med surg | Questions and
answers
Questions in this set (100)
1. The nurse is 2. Graves' disease, the most common type of thyrotoxicosis, is a
completing a health state of hypermetabolism. The increased metabolic rate generates
assessment of a 42-year-old heat and produces tachycardia
female with suspected Graves' and fine muscle tremors. Anorexia is associated with
disease. The nurse should hypothyroidism. Loss of weight, despite a good appetite and
assess this client for: adequate caloric intake, is a common feature of
1. Anorexia. hyperthyroidism. Cold skin is associated with hypothyroidism.
2. Tachycardia. CN: Physiological adaptation; CL: Analyze
3. Weight gain.
4. Cold skin.
3. A change in the menstrual interval, diminished menstrual
flow (oligomenorrhea), or even the absence of menstruation
2. When conducting a health
(amenorrhea) may result from the
history with a female client with
hormonal imbalances of thyrotoxicosis. Oligomenorrhea in women
thyrotoxicosis, the nurse should
and decreased libido
ask about which of the following
and impotence in men are common features of thyrotoxicosis.
changes in the menstrual cycle?
Dysmenorrhea is painful
1. Dysmenorrhea.
menstruation. Metrorrhagia, blood loss between menstrual periods,
2. Metrorrhagia.
3. Oligomenorrhea.
is a symptom of hypothyroidism. Menorrhagia, excessive bleeding
4. Menorrhagia.
during menstrual periods, is a symptom of hypothyroidism.
CN: Physiological adaptation; CL: Analyze
,3. A 34-year-old female is 2, 3, 5, 6. Clients with hypothyroidism exhibit symptoms indicating a lack of
diagnosed with hypothyroidism. thyroid hormone. Bradycardia, decreased energy and lethargy,
The nurse should assess the memory problems, weight gain, coarse hair, constipation, and
client for which of the following? menorrhagia are common signs and symptoms of
Select all that apply. hypothyroidism.
1. Rapid pulse. CN: Physiological adaptation; CL: Analyze
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.
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
4. Propylthiouracil (PTU) is
promptly report to the health care provider signs and symptoms of
prescribed for a client with
infection, such as a
Graves' disease. The nurse
sore throat and fever. Clients having a sore throat and fever should
should teach the client to
have an immediate
immediately report which of
white blood cell count and differential performed, and the drug
the following?
must be withheld until
1. Sore throat.
2. Painful, excessive the results are obtained. Painful menstruation, constipation, and
menstruation. increased urine output
3. Constipation. are not associated with PTU therapy.
4. Increased urine output. CN: Pharmacological and parenteral therapies; CL: Synthesize
5. A client with thyrotoxicosis 2. A typical sign of thyrotoxicosis is irritability caused by
says to the nurse, "I am so the high levels of circulating thyroid hormones in the body.
irritable. I am having problems at This symptom decreases as the client responds
work because I lose my temper to therapy. Thyrotoxicosis does not cause confusion. The client may
very easily." Which of the be worried about her illness, and stress may influence her mood;
following responses by the however, irritability is a common symptom of thyrotoxicosis and the
nurse would give the client the client should be informed of that fact rather than blamed.
most accurate explanation of her CN: Psychosocial integrity; CL: Synthesize
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."
,6. The nurse is evaluating a 2. PTU is a prototype of thioamide antithyroid drugs. It inhibits
client with hyperthyroidism who production of thyroid hormones and peripheral conversion of T4
is taking Propylthiouracil (PTU) to the more active T3. A client taking
100 mg/day in three divided this antithyroid drug should be able to sleep and rest well at night
doses for maintenance therapy. since the level of thyroid hormones is reduced in the blood. Excess
Which of the following statements energy throughout the day, loss of weight and perspiring through
from the client indicates the the day are symptoms of hyperthyroidism indicating the
desired outcome of the drug? drug has not produced its outcome.
1. "I have excess energy CN: Pharmacological and parenteral therapies; CL: Evaluate.
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."
, 3. Treatment of mild ophthalmopathy that may accompany
thyrotoxicosis includes measures such as wearing sunglasses to
protect the eyes from corneal irritation. Treatment of
7. The nurse should teach ophthalmopathy should be performed in consultation with an
the client with Graves' ophthalmologist. Massaging the eyes will not help to protect
disease to prevent corneal the cornea. An ophthalmic
irritation from mild anesthetic is used to examine and possibly treat a painful eye, not
exophthalmos by: protect the cornea. Covering the eyes with moist gauze pads is not
1. Massaging the eyes at a satisfactory nursing measure to protect
regular intervals.
the eyes of a client with exophthalmos because treatment is not
2. Instilling an ophthalmic
focused on moisture to
anesthetic as prescribed.
the eye but rather on protecting the cornea and optic nerve. In
3. Wearing dark-colored
glasses. exophthalmos, the retrobulbar connective tissues and
4. Covering both eyes with extraocular muscle volume are expanded because of
moistened gauze pads. fluid retention. The pressure is also
increased. CN: Reduction of risk
potential; CL: Synthesize
8. A client with Graves' disease is 4. Sodium iodide 131I destroys the thyroid follicular cells, and
treated with radioactive iodine thyroid hormones are no longer produced. RAI is commonly
(RAI) in the recommended for clients with Graves'
form of sodium iodide 131I. disease, especially the elderly. The treatment results in a "medical
Which of the following thyroidectomy." RAI is given in lieu of surgery, not before
statements by the nurse will surgery. RAI does not reduce uptake of thyroxine.
explain The outcome of giving RAI is the destruction of the thyroid follicular
to the client how the drug works? cells. It is possible to slow the production of thyroid hormones
1. "The RAI stabilizes the with RAI.
thyroid hormone levels before CN: Pharmacological and parenteral therapies; CL: Synthesize
a thyroidectomy."
2. "The RAI reduces
uptake of thyroxine and
thereby improves your
condition."
3. "The RAI lowers the levels of
thyroid hormones by slowing
your body's production of
them."
4. "The RAI destroys thyroid
tissue so that thyroid
hormones are no longer
produced."
9. After treatment with 3. The client needs to be educated about the need for lifelong
radioactive iodine (RAI) in the thyroid hormone replacement. Permanent hypothyroidism is the
form of sodium iodide 131I, the major complication of RAI 131I treatment.
nurse teaches the client to: Lifelong medical follow-up and thyroid replacement are warranted.
1. Monitor for signs The client needs to
and symptoms of monitor for signs and symptoms of hypothyroidism, not
hyperthyroidism. hyperthyroidism. Resting for 1 week is not necessary. Hypertension
answers
Questions in this set (100)
1. The nurse is 2. Graves' disease, the most common type of thyrotoxicosis, is a
completing a health state of hypermetabolism. The increased metabolic rate generates
assessment of a 42-year-old heat and produces tachycardia
female with suspected Graves' and fine muscle tremors. Anorexia is associated with
disease. The nurse should hypothyroidism. Loss of weight, despite a good appetite and
assess this client for: adequate caloric intake, is a common feature of
1. Anorexia. hyperthyroidism. Cold skin is associated with hypothyroidism.
2. Tachycardia. CN: Physiological adaptation; CL: Analyze
3. Weight gain.
4. Cold skin.
3. A change in the menstrual interval, diminished menstrual
flow (oligomenorrhea), or even the absence of menstruation
2. When conducting a health
(amenorrhea) may result from the
history with a female client with
hormonal imbalances of thyrotoxicosis. Oligomenorrhea in women
thyrotoxicosis, the nurse should
and decreased libido
ask about which of the following
and impotence in men are common features of thyrotoxicosis.
changes in the menstrual cycle?
Dysmenorrhea is painful
1. Dysmenorrhea.
menstruation. Metrorrhagia, blood loss between menstrual periods,
2. Metrorrhagia.
3. Oligomenorrhea.
is a symptom of hypothyroidism. Menorrhagia, excessive bleeding
4. Menorrhagia.
during menstrual periods, is a symptom of hypothyroidism.
CN: Physiological adaptation; CL: Analyze
,3. A 34-year-old female is 2, 3, 5, 6. Clients with hypothyroidism exhibit symptoms indicating a lack of
diagnosed with hypothyroidism. thyroid hormone. Bradycardia, decreased energy and lethargy,
The nurse should assess the memory problems, weight gain, coarse hair, constipation, and
client for which of the following? menorrhagia are common signs and symptoms of
Select all that apply. hypothyroidism.
1. Rapid pulse. CN: Physiological adaptation; CL: Analyze
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.
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
4. Propylthiouracil (PTU) is
promptly report to the health care provider signs and symptoms of
prescribed for a client with
infection, such as a
Graves' disease. The nurse
sore throat and fever. Clients having a sore throat and fever should
should teach the client to
have an immediate
immediately report which of
white blood cell count and differential performed, and the drug
the following?
must be withheld until
1. Sore throat.
2. Painful, excessive the results are obtained. Painful menstruation, constipation, and
menstruation. increased urine output
3. Constipation. are not associated with PTU therapy.
4. Increased urine output. CN: Pharmacological and parenteral therapies; CL: Synthesize
5. A client with thyrotoxicosis 2. A typical sign of thyrotoxicosis is irritability caused by
says to the nurse, "I am so the high levels of circulating thyroid hormones in the body.
irritable. I am having problems at This symptom decreases as the client responds
work because I lose my temper to therapy. Thyrotoxicosis does not cause confusion. The client may
very easily." Which of the be worried about her illness, and stress may influence her mood;
following responses by the however, irritability is a common symptom of thyrotoxicosis and the
nurse would give the client the client should be informed of that fact rather than blamed.
most accurate explanation of her CN: Psychosocial integrity; CL: Synthesize
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."
,6. The nurse is evaluating a 2. PTU is a prototype of thioamide antithyroid drugs. It inhibits
client with hyperthyroidism who production of thyroid hormones and peripheral conversion of T4
is taking Propylthiouracil (PTU) to the more active T3. A client taking
100 mg/day in three divided this antithyroid drug should be able to sleep and rest well at night
doses for maintenance therapy. since the level of thyroid hormones is reduced in the blood. Excess
Which of the following statements energy throughout the day, loss of weight and perspiring through
from the client indicates the the day are symptoms of hyperthyroidism indicating the
desired outcome of the drug? drug has not produced its outcome.
1. "I have excess energy CN: Pharmacological and parenteral therapies; CL: Evaluate.
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."
, 3. Treatment of mild ophthalmopathy that may accompany
thyrotoxicosis includes measures such as wearing sunglasses to
protect the eyes from corneal irritation. Treatment of
7. The nurse should teach ophthalmopathy should be performed in consultation with an
the client with Graves' ophthalmologist. Massaging the eyes will not help to protect
disease to prevent corneal the cornea. An ophthalmic
irritation from mild anesthetic is used to examine and possibly treat a painful eye, not
exophthalmos by: protect the cornea. Covering the eyes with moist gauze pads is not
1. Massaging the eyes at a satisfactory nursing measure to protect
regular intervals.
the eyes of a client with exophthalmos because treatment is not
2. Instilling an ophthalmic
focused on moisture to
anesthetic as prescribed.
the eye but rather on protecting the cornea and optic nerve. In
3. Wearing dark-colored
glasses. exophthalmos, the retrobulbar connective tissues and
4. Covering both eyes with extraocular muscle volume are expanded because of
moistened gauze pads. fluid retention. The pressure is also
increased. CN: Reduction of risk
potential; CL: Synthesize
8. A client with Graves' disease is 4. Sodium iodide 131I destroys the thyroid follicular cells, and
treated with radioactive iodine thyroid hormones are no longer produced. RAI is commonly
(RAI) in the recommended for clients with Graves'
form of sodium iodide 131I. disease, especially the elderly. The treatment results in a "medical
Which of the following thyroidectomy." RAI is given in lieu of surgery, not before
statements by the nurse will surgery. RAI does not reduce uptake of thyroxine.
explain The outcome of giving RAI is the destruction of the thyroid follicular
to the client how the drug works? cells. It is possible to slow the production of thyroid hormones
1. "The RAI stabilizes the with RAI.
thyroid hormone levels before CN: Pharmacological and parenteral therapies; CL: Synthesize
a thyroidectomy."
2. "The RAI reduces
uptake of thyroxine and
thereby improves your
condition."
3. "The RAI lowers the levels of
thyroid hormones by slowing
your body's production of
them."
4. "The RAI destroys thyroid
tissue so that thyroid
hormones are no longer
produced."
9. After treatment with 3. The client needs to be educated about the need for lifelong
radioactive iodine (RAI) in the thyroid hormone replacement. Permanent hypothyroidism is the
form of sodium iodide 131I, the major complication of RAI 131I treatment.
nurse teaches the client to: Lifelong medical follow-up and thyroid replacement are warranted.
1. Monitor for signs The client needs to
and symptoms of monitor for signs and symptoms of hypothyroidism, not
hyperthyroidism. hyperthyroidism. Resting for 1 week is not necessary. Hypertension
