Exam (elaborations)

BSN 246 HESI Review UPDATED 2024

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Course
BSN 246 HESI

Institution
Nightingale College

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. -Correct Answer 2. Graves' disease, the most common type of thyrotoxicosis, is a state of ...

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BSN 246 HESI Review

BSN 246 HESI Review UPDATED 2024
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. -Correct Answer ✔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. -Correct Answer ✔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

BSN 246 HESI Review

,BSN 246 HESI Review

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. -Correct Answer ✔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. -Correct Answer ✔1. The most serious adverse effects of PTU
are leukopenia and agranulocytosis,

BSN 246 HESI Review

,BSN 246 HESI Review

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." -Correct Answer ✔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

BSN 246 HESI Review

, BSN 246 HESI Review

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
drug?
1. "I have excess energy 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." -Correct Answer ✔2. PTU is a prototype of
thioamide antithyroid drugs. It inhibits production of
thyroid hormones and peripheral conversion of T4 to the more active T3. A client taking
this antithyroid drug should be able to sleep and rest well at night since the level of
thyroid hormones is reduced in the blood. Excess energy throughout the day, loss of
weight and perspiring through the day are symptoms of hyperthyroidism indicating the
drug has not produced its outcome.
CN: Pharmacological and parenteral therapies; CL: Evaluate.

7. The nurse should teach the client with Graves' disease to prevent corneal
irritation from mild exophthalmos by:
1. Massaging the eyes at regular intervals.
2. Instilling an ophthalmic anesthetic as prescribed.
3. Wearing dark-colored glasses.

4. Covering both eyes with moistened gauze pads. -Correct Answer ✔3. Treatment of
mild ophthalmopathy that may accompany thyrotoxicosis includes
measures such as wearing sunglasses to protect the eyes from corneal irritation.
Treatment of ophthalmopathy should be performed in consultation with an

BSN 246 HESI Review

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