CHAPTER 49 ENDOCRINE PROBLEMS MEDICAL
SURGICAL NURSING EXAM SCRIPT 2026
COMPLETE ANSWERS VERIFIED
◉ 1. Which information will the nurse teach a patient who has been
newly diagnosed with Graves' disease?
a. Exercise is contraindicated to avoid increasing metabolic rate.
b. Restriction of iodine intake is needed to reduce thyroid activity.
c. Antithyroid medications may take several months for full effect.
d. Surgery will eventually be required to remove the thyroid gland.
Answer: ANS: C
Medications used to block the synthesis of thyroid hormones may
take 2 to 3 months before the full effect is seen. Large doses of iodine
are used to inhibit the synthesis of thyroid hormones. Exercise using
large muscle groups is encouraged to decrease the irritability and
hyperactivity associated with high levels of thyroid hormones.
Radioactive iodine is the most common treatment for Graves'
disease, although surgery may be used.
◉ 11. A patient who had a subtotal thyroidectomy earlier today
develops laryngeal stridor and a cramp in the right hand upon
returning to the surgical nursing unit. Which collaborative action
will the nurse anticipate next?
a. Suction the patient's airway.
,b. Administer IV calcium gluconate.
c. Plan for emergency tracheostomy.
d. Prepare for endotracheal intubation. Answer: ANS: B
The patient's clinical manifestations of stridor and cramping are
consistent with tetany caused by hypocalcemia resulting from
damage to the parathyroid glands during surgery. Endotracheal
intubation or tracheostomy may be needed if the calcium does not
resolve the stridor. Suctioning will not correct the stridor.
◉ 12. Which nursing action will be included in the plan of care for a
patient with Graves' disease who has exophthalmos?
a. Place cold packs on the eyes to relieve pain and swelling.
b. Elevate the head of the patient's bed to reduce periorbital fluid.
c. Apply alternating eye patches to protect the corneas from
irritation.
d. Teach the patient to blink every few seconds to lubricate the
corneas. Answer: ANS: B
The patient should sit upright as much as possible to promote fluid
drainage from the periorbital area. With exophthalmos, the patient
is unable to close the eyes completely to blink. Lubrication of the
eyes, rather than eye patches, will protect the eyes from developing
corneal scarring. The swelling of the eye is not caused by excessive
blood flow to the eye, so cold packs will not be helpful.
, ◉ 13. A 62-yr-old patient with hyperthyroidism is to be treated with
radioactive iodine (RAI). The nurse instructs the patient
a. about radioactive precautions to take with all body secretions.
b. that symptoms of hyperthyroidism should be relieved in about a
week.
c. that symptoms of hypothyroidism may occur as the RAI therapy
takes effect.
d. to discontinue the antithyroid medications taken before the
radioactive therapy. Answer: ANS: C
There is a high incidence of postradiation hypothyroidism after RAI,
and the patient should be monitored for symptoms of
hypothyroidism. RAI has a delayed response, with the maximum
effect not seen for 2 to 3 months, and the patient will continue to
take antithyroid medications during this time. The therapeutic dose
of radioactive iodine is low enough that no radiation safety
precautions are needed.
◉ 14. Which nursing assessment of a 70-yr-old patient is most
important to make during initiation of thyroid replacement with
levothyroxine (Synthroid)?
a. Fluid balance
b. Apical pulse rate
c. Nutritional intake
d. Orientation and alertness Answer: ANS: B
SURGICAL NURSING EXAM SCRIPT 2026
COMPLETE ANSWERS VERIFIED
◉ 1. Which information will the nurse teach a patient who has been
newly diagnosed with Graves' disease?
a. Exercise is contraindicated to avoid increasing metabolic rate.
b. Restriction of iodine intake is needed to reduce thyroid activity.
c. Antithyroid medications may take several months for full effect.
d. Surgery will eventually be required to remove the thyroid gland.
Answer: ANS: C
Medications used to block the synthesis of thyroid hormones may
take 2 to 3 months before the full effect is seen. Large doses of iodine
are used to inhibit the synthesis of thyroid hormones. Exercise using
large muscle groups is encouraged to decrease the irritability and
hyperactivity associated with high levels of thyroid hormones.
Radioactive iodine is the most common treatment for Graves'
disease, although surgery may be used.
◉ 11. A patient who had a subtotal thyroidectomy earlier today
develops laryngeal stridor and a cramp in the right hand upon
returning to the surgical nursing unit. Which collaborative action
will the nurse anticipate next?
a. Suction the patient's airway.
,b. Administer IV calcium gluconate.
c. Plan for emergency tracheostomy.
d. Prepare for endotracheal intubation. Answer: ANS: B
The patient's clinical manifestations of stridor and cramping are
consistent with tetany caused by hypocalcemia resulting from
damage to the parathyroid glands during surgery. Endotracheal
intubation or tracheostomy may be needed if the calcium does not
resolve the stridor. Suctioning will not correct the stridor.
◉ 12. Which nursing action will be included in the plan of care for a
patient with Graves' disease who has exophthalmos?
a. Place cold packs on the eyes to relieve pain and swelling.
b. Elevate the head of the patient's bed to reduce periorbital fluid.
c. Apply alternating eye patches to protect the corneas from
irritation.
d. Teach the patient to blink every few seconds to lubricate the
corneas. Answer: ANS: B
The patient should sit upright as much as possible to promote fluid
drainage from the periorbital area. With exophthalmos, the patient
is unable to close the eyes completely to blink. Lubrication of the
eyes, rather than eye patches, will protect the eyes from developing
corneal scarring. The swelling of the eye is not caused by excessive
blood flow to the eye, so cold packs will not be helpful.
, ◉ 13. A 62-yr-old patient with hyperthyroidism is to be treated with
radioactive iodine (RAI). The nurse instructs the patient
a. about radioactive precautions to take with all body secretions.
b. that symptoms of hyperthyroidism should be relieved in about a
week.
c. that symptoms of hypothyroidism may occur as the RAI therapy
takes effect.
d. to discontinue the antithyroid medications taken before the
radioactive therapy. Answer: ANS: C
There is a high incidence of postradiation hypothyroidism after RAI,
and the patient should be monitored for symptoms of
hypothyroidism. RAI has a delayed response, with the maximum
effect not seen for 2 to 3 months, and the patient will continue to
take antithyroid medications during this time. The therapeutic dose
of radioactive iodine is low enough that no radiation safety
precautions are needed.
◉ 14. Which nursing assessment of a 70-yr-old patient is most
important to make during initiation of thyroid replacement with
levothyroxine (Synthroid)?
a. Fluid balance
b. Apical pulse rate
c. Nutritional intake
d. Orientation and alertness Answer: ANS: B
