The nurse is evaluating a client prescribed methimazole three months ago for medication effectiveness. Which assessment findings indicate the medication is effective? Select 2 that apply

A. Cold intolerance: Cold intolerance is a symptom of hypothyroidism, not an expected outcome of methimazole therapy. Development of this symptom would suggest overmedication rather than effective control of hyperthyroidism. B. Weight gain: Methimazole reduces the excessive metabolism caused by hyperthyroidism, which often results in weight stabilization or gain. This indicates improvement since untreated hyperthyroidism commonly causes unintended weight loss. C. Decreased heart rate: Tachycardia is a hallmark of hyperthyroidism due to increased metabolic activity. A lowered heart rate after methimazole therapy shows that thyroid hormone levels are being controlled effectively. D. Increased respiratory rate: Hyperthyroidism typically causes tachypnea due to elevated metabolic demand. An increase in respiratory rate would not be expected after effective treatment and may suggest other complications. E. Alopecia: Hair loss can occur in both untreated thyroid disease and as an adverse effect of antithyroid medications, but it does not confirm effectiveness of therapy. It is not considered a reliable indicator of improved thyroid control. F. Amenorrhea: Menstrual irregularities often accompany hyperthyroidism and may persist if the disease is not well managed. Effective methimazole treatment usually improves menstrual function, so amenorrhea would not suggest therapeutic success.