MED-SURG BSN 266 | HESI Medical-Surgical
Nursing Exam Questions and Answers WITH
RATIONALES | Latest 2026–2027 Update | NGN
Study Guide
THIS EXAM INCLUDES:
✅ Comprehensive Medical-Surgical Nursing Review
✅ 400+ HESI-style practice questions
✅ Verified answers with detailed rationales
✅ Next Generation Nursing (NGN) case scenarios
✅ Prioritization and delegation questions
✅ Clinical judgment and patient safety exercises
✅ SATA, bow-tie, matrix, and unfolding case studies
✅ NCLEX-RN aligned content and test-taking strategies
,Question 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:
A. Anorexia
B. Tachycardia
C. Weight Gain
D. Cold Skin
Answer: B. Tachycardia
Rationale: Graves' disease is a form of hyperthyroidism characterized by
excessive thyroid hormone production. Thyroid hormones increase
metabolic rate and sympathetic nervous system activity, leading to
tachycardia, palpitations, and increased cardiac output. Anorexia, weight
gain, and cold skin are manifestations of hypothyroidism, not
hyperthyroidism. Clients with hyperthyroidism typically experience weight
loss, heat intolerance, and increased appetite.
Question 2
A 34-year-old female is diagnosed with hypothyroidism. The nurse should
assess the client for which of the following? Select all that apply.
A. Rapid pulse
B. Decreased energy and fatigue
C. Weight gain of 10 lb (4.5 kg)
D. Fine, thin hair with hair loss
E. Constipation
F. Menorrhagia
,Answer: B, C, E, F
Rationale: Hypothyroidism results from insufficient thyroid hormone
production, which slows metabolic processes throughout the body.
Decreased energy and fatigue (B) result from reduced cellular metabolism.
Weight gain (C) occurs due to decreased metabolic rate and fluid retention.
Constipation (E) results from decreased gastrointestinal motility.
Menorrhagia (F) occurs because thyroid hormones affect the hypothalamic-
pituitary-ovarian axis, and deficiency can cause menstrual irregularities.
Rapid pulse (A) and fine, thin hair (D) are characteristic of hyperthyroidism,
not hypothyroidism.
Question 3
Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The
nurse should teach the client to immediately report which of the following?
A. Sore throat
B. Painful, excessive menstruation
C. Constipation
D. Increased urine output
Answer: A. Sore throat
Rationale: PTU is an antithyroid medication that can cause
agranulocytosis, a potentially fatal complication characterized by a severe
decrease in white blood cells. Sore throat, fever, and chills are early signs of
agranulocytosis and should be reported immediately. PTU may also cause
hepatotoxicity and rash. Painful, excessive menstruation (B) is not a typical
, adverse effect of PTU. Constipation (C) and increased urine output (D) are
not associated with PTU therapy.
Question 4
A client with thyrotoxicosis (hyperthyroidism) 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?
A. "Your behavior is caused by temporary confusion brought on by your
illness."
B. "Your behavior is caused by the excess thyroid hormone in your system."
C. "Your behavior is caused by your worrying about the seriousness of your
illness."
D. "Your behavior is caused by your fear of the unknown."
Answer: B. "Your behavior is caused by the excess thyroid hormone in
your system."
Rationale: Hyperthyroidism causes increased sympathetic nervous system
stimulation, leading to emotional lability, irritability, and anxiety. The excess
thyroid hormone directly affects the central nervous system, causing these
behavioral changes. This explanation provides an accurate physiological
basis for the client's symptoms and validates that the behavior is disease-
related rather than psychological in origin. The other options do not
address the underlying pathophysiology.
Nursing Exam Questions and Answers WITH
RATIONALES | Latest 2026–2027 Update | NGN
Study Guide
THIS EXAM INCLUDES:
✅ Comprehensive Medical-Surgical Nursing Review
✅ 400+ HESI-style practice questions
✅ Verified answers with detailed rationales
✅ Next Generation Nursing (NGN) case scenarios
✅ Prioritization and delegation questions
✅ Clinical judgment and patient safety exercises
✅ SATA, bow-tie, matrix, and unfolding case studies
✅ NCLEX-RN aligned content and test-taking strategies
,Question 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:
A. Anorexia
B. Tachycardia
C. Weight Gain
D. Cold Skin
Answer: B. Tachycardia
Rationale: Graves' disease is a form of hyperthyroidism characterized by
excessive thyroid hormone production. Thyroid hormones increase
metabolic rate and sympathetic nervous system activity, leading to
tachycardia, palpitations, and increased cardiac output. Anorexia, weight
gain, and cold skin are manifestations of hypothyroidism, not
hyperthyroidism. Clients with hyperthyroidism typically experience weight
loss, heat intolerance, and increased appetite.
Question 2
A 34-year-old female is diagnosed with hypothyroidism. The nurse should
assess the client for which of the following? Select all that apply.
A. Rapid pulse
B. Decreased energy and fatigue
C. Weight gain of 10 lb (4.5 kg)
D. Fine, thin hair with hair loss
E. Constipation
F. Menorrhagia
,Answer: B, C, E, F
Rationale: Hypothyroidism results from insufficient thyroid hormone
production, which slows metabolic processes throughout the body.
Decreased energy and fatigue (B) result from reduced cellular metabolism.
Weight gain (C) occurs due to decreased metabolic rate and fluid retention.
Constipation (E) results from decreased gastrointestinal motility.
Menorrhagia (F) occurs because thyroid hormones affect the hypothalamic-
pituitary-ovarian axis, and deficiency can cause menstrual irregularities.
Rapid pulse (A) and fine, thin hair (D) are characteristic of hyperthyroidism,
not hypothyroidism.
Question 3
Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The
nurse should teach the client to immediately report which of the following?
A. Sore throat
B. Painful, excessive menstruation
C. Constipation
D. Increased urine output
Answer: A. Sore throat
Rationale: PTU is an antithyroid medication that can cause
agranulocytosis, a potentially fatal complication characterized by a severe
decrease in white blood cells. Sore throat, fever, and chills are early signs of
agranulocytosis and should be reported immediately. PTU may also cause
hepatotoxicity and rash. Painful, excessive menstruation (B) is not a typical
, adverse effect of PTU. Constipation (C) and increased urine output (D) are
not associated with PTU therapy.
Question 4
A client with thyrotoxicosis (hyperthyroidism) 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?
A. "Your behavior is caused by temporary confusion brought on by your
illness."
B. "Your behavior is caused by the excess thyroid hormone in your system."
C. "Your behavior is caused by your worrying about the seriousness of your
illness."
D. "Your behavior is caused by your fear of the unknown."
Answer: B. "Your behavior is caused by the excess thyroid hormone in
your system."
Rationale: Hyperthyroidism causes increased sympathetic nervous system
stimulation, leading to emotional lability, irritability, and anxiety. The excess
thyroid hormone directly affects the central nervous system, causing these
behavioral changes. This explanation provides an accurate physiological
basis for the client's symptoms and validates that the behavior is disease-
related rather than psychological in origin. The other options do not
address the underlying pathophysiology.
