EXAM
Exam Solution zm
Chapter 49 2026 A+ GRADE ASSURED COMPLETE SOLU zm zm zm zm zm zm zm
TIONS AND VERIFIED ANSWERS (2A484) zm zm zm zm
QUESTION 1 zm
Which information will the nurse teach a patient who has been newly diagnosed with
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Graves' disease? zm
a. Exercise is contraindicated to avoid increasing metabolic rate.
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b. Restriction of iodine intake is needed to reduce thyroid activity.
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c. Antithyroid medications may take several months for full effect.
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d. Surgery will eventually be required to remove the thyroid gland.
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ANSWER
C Medications used to block the synthesis of thyroid hormones may take 2 to 3 months before the f
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ull effect is seen. Large doses of iodine are used to inhibit the synthesis of thyroid hormones. Exerci
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se using large muscle groups is encouraged to decrease the irritability and hyperactivity associated
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with high levels of thyroid hormones. Radioactive iodine is the most common treatment for Graves'
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disease, although surgery may be used. DIF: Cognitive Level: Apply (application) REF: 1165 TOP: Nu
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rsing Process: Implementation MSC: NCLEX: Physiological Integrity
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QUESTION 2 zm
A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor a
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nd a cramp in the right hand upon returning to the surgical nursing unit. Which colla
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borative action will the nurse anticipate next?
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a. Suction the patient's airway.
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b. Administer IV calcium gluconate.
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c. Plan for emergency tracheostomy.
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d. Prepare for endotracheal intubation.
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ANSWER
B The patient's clinical manifestations of stridor and cramping are consistent with tetany caused by
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hypocalcemia resulting from damage to the parathyroid glands during surgery. Endotracheal intubati
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on or tracheostomy may be needed if the calcium does not resolve the stridor. Suctioning will not c
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orrect the stridor. DIF: Cognitive Level: Apply (application) REF: 1168 TOP: Nursing Process: Plannin
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g MSC: NCLEX: Physiological Integrity
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, QUESTION 3 zm
Which nursing action will be included in the plan of care for a patient with Graves' di
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sease who has exophthalmos?
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a. Place cold packs on the eyes to relieve pain and swelling.
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b. Elevate the head of the patient's bed to reduce periorbital fluid.
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c. Apply alternating eye patches to protect the corneas from irritation.
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d. Teach the patient to blink every few seconds to lubricate the corneas.
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ANSWER
B The patient should sit upright as much as possible to promote fluid drainage from the periorbital
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area. With exophthalmos, the patient is unable to close the eyes completely to blink. Lubrication of t
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he eyes, rather than eye patches, will protect the eyes from developing corneal scarring. The swellin
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g of the eye is not caused by excessive blood flow to the eye, so cold packs will not be helpful. DIF:
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mCognitive Level: Apply (application) REF: 1167 TOP: Nursing Process: Planning MSC: NCLEX: Physiol
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ogical Integrity zm
QUESTION 4 zm
Which nursing assessment of a 70-yr-
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old patient is most important to make during initiation of thyroid replacement with le
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vothyroxine (Synthroid)? zm
a. Fluid balance
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c. Nutritional intake
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b. Apical pulse rate
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d. Orientation and alertness
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ANSWER
B In older patients, initiation of levothyroxine therapy can increase myocardial oxygen demand and
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cause angina or dysrhythmias. The medication also is expected to improve mental status and fluid b
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alance and will increase metabolic rate and nutritional needs, but these changes will not result in po
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tentially life- zm
threatening complications. DIF: Cognitive Level: Analyze (analysis) REF: 1169 TOP: Nursing Process:
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Assessment MSC: NCLEX: Physiological Integrity zm zm zm zm
QUESTION 5 zm
An 82-yr-old patient in a long-
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term care facility is newly diagnosed with hypothyroidism. The nurse will need to con
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sult with the health care provider before administering the prescribed
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a. docusate (Colace).
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c. diazepam (Valium).
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b. ibuprofen (Motrin).
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d. cefoxitin (Mefoxin).
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ANSWER
Exam Solution zm
Chapter 49 2026 A+ GRADE ASSURED COMPLETE SOLU zm zm zm zm zm zm zm
TIONS AND VERIFIED ANSWERS (2A484) zm zm zm zm
QUESTION 1 zm
Which information will the nurse teach a patient who has been newly diagnosed with
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Graves' disease? zm
a. Exercise is contraindicated to avoid increasing metabolic rate.
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b. Restriction of iodine intake is needed to reduce thyroid activity.
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c. Antithyroid medications may take several months for full effect.
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d. Surgery will eventually be required to remove the thyroid gland.
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ANSWER
C Medications used to block the synthesis of thyroid hormones may take 2 to 3 months before the f
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ull effect is seen. Large doses of iodine are used to inhibit the synthesis of thyroid hormones. Exerci
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se using large muscle groups is encouraged to decrease the irritability and hyperactivity associated
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with high levels of thyroid hormones. Radioactive iodine is the most common treatment for Graves'
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disease, although surgery may be used. DIF: Cognitive Level: Apply (application) REF: 1165 TOP: Nu
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rsing Process: Implementation MSC: NCLEX: Physiological Integrity
zm zm zm zm zm zm
QUESTION 2 zm
A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor a
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nd a cramp in the right hand upon returning to the surgical nursing unit. Which colla
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borative action will the nurse anticipate next?
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a. Suction the patient's airway.
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b. Administer IV calcium gluconate.
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c. Plan for emergency tracheostomy.
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d. Prepare for endotracheal intubation.
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ANSWER
B The patient's clinical manifestations of stridor and cramping are consistent with tetany caused by
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hypocalcemia resulting from damage to the parathyroid glands during surgery. Endotracheal intubati
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on or tracheostomy may be needed if the calcium does not resolve the stridor. Suctioning will not c
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orrect the stridor. DIF: Cognitive Level: Apply (application) REF: 1168 TOP: Nursing Process: Plannin
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g MSC: NCLEX: Physiological Integrity
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, QUESTION 3 zm
Which nursing action will be included in the plan of care for a patient with Graves' di
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sease who has exophthalmos?
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a. Place cold packs on the eyes to relieve pain and swelling.
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b. Elevate the head of the patient's bed to reduce periorbital fluid.
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c. Apply alternating eye patches to protect the corneas from irritation.
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d. Teach the patient to blink every few seconds to lubricate the corneas.
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ANSWER
B The patient should sit upright as much as possible to promote fluid drainage from the periorbital
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area. With exophthalmos, the patient is unable to close the eyes completely to blink. Lubrication of t
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he eyes, rather than eye patches, will protect the eyes from developing corneal scarring. The swellin
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g of the eye is not caused by excessive blood flow to the eye, so cold packs will not be helpful. DIF:
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm z
mCognitive Level: Apply (application) REF: 1167 TOP: Nursing Process: Planning MSC: NCLEX: Physiol
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ogical Integrity zm
QUESTION 4 zm
Which nursing assessment of a 70-yr-
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old patient is most important to make during initiation of thyroid replacement with le
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vothyroxine (Synthroid)? zm
a. Fluid balance
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c. Nutritional intake
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b. Apical pulse rate
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d. Orientation and alertness
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ANSWER
B In older patients, initiation of levothyroxine therapy can increase myocardial oxygen demand and
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cause angina or dysrhythmias. The medication also is expected to improve mental status and fluid b
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alance and will increase metabolic rate and nutritional needs, but these changes will not result in po
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tentially life- zm
threatening complications. DIF: Cognitive Level: Analyze (analysis) REF: 1169 TOP: Nursing Process:
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Assessment MSC: NCLEX: Physiological Integrity zm zm zm zm
QUESTION 5 zm
An 82-yr-old patient in a long-
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term care facility is newly diagnosed with hypothyroidism. The nurse will need to con
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sult with the health care provider before administering the prescribed
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a. docusate (Colace).
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c. diazepam (Valium).
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b. ibuprofen (Motrin).
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d. cefoxitin (Mefoxin).
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ANSWER