NIGHTINGALE BSN 246 EXAMS A B

pg. 1 NIGHTINGALE BSN 246 EXAMS A & B

LATEST 2024-2025 (2 VERSIONS) BSN 246

EXAMS EACH WITH 100 QUESTIONS AND

100% CORRECT ANSWERS WITH

RATIONALES ALREADY GRADED A+ (NEW)

BSN 246 EXAM FORM A

• A client with Graves' disease is treated with radioactive iodine (RAI) in the

form of sodium iodide 131I. Which of the following statements by the nurse will explain to the client how the drug works?

• "The RAI stabilizes the thyroid hormone levels before a thyroidectomy."
• "The RAI reduces uptake of thyroxine and thereby improves your condition."
• "The RAI lowers the levels of thyroid hormones by slowing your body's

production of them."

• "The RAI destroys thyroid tissue so that thyroid hormones are no longer

produced." - ANSWER-4. Sodium iodide 131I destroys the thyroid follicular cells, and thyroid hormones are no longer produced. RAI is commonly recommended for clients with Graves' disease, especially the elderly. The treatment results in a "medical thyroidectomy." RAI is given in lieu of surgery, not before surgery. RAI does not reduce uptake of thyroxine.The outcome of giving RAI is the destruction of the thyroid follicular cells. It is possible to slow the production of thyroid hormones with RAI.CN: Pharmacological and parenteral therapies; CL: Synthesize 1 / 4

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• 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?

• Dysmenorrhea.
• Metrorrhagia.
• Oligomenorrhea.
• Menorrhagia. - 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 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

• A 34-year-old female is diagnosed with hypothyroidism. The nurse should

assess the client for which of the following? Select all that apply.

• Rapid pulse.
• Decreased energy and fatigue.
• Weight gain of 10 lb (4.5 kg).
• Fine, thin hair with hair loss.
• Constipation. 2 / 4

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• Menorrhagia. - 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

• Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse

should teach the client to immediately report which of the following?

• Sore throat.
• Painful, excessive menstruation.
• Constipation.
• Increased urine output. - ANSWER-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 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

• A client with thyrotoxicosis says to the nurse, "I am so irritable. I am having 3 / 4

pg. 4 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?

• "Your behavior is caused by temporary confusion brought on by your illness."
• "Your behavior is caused by the excess thyroid hormone in your system."
• "Your behavior is caused by your worrying about the seriousness of your

illness."

• "Your behavior is caused by the stress of trying to manage a career and cope

with illness." - 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

• 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?

• "I have excess energy throughout the day."
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