Page 1 of 169
NUR209 EXAM 4 NUR 209 MEDICAL
SURGICAL NURSING II ACTUAL EXAM 4
LATEST 2026/2027 ACCURATE TEST
COMPLETE APPROVED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (100% CORRECT VERIFIED
SOLUTIONS) CURRENTLY UPDATED
VERSION |GUARANTEED PASS A+
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1. A patient with hyperthyroidism is admitted with a fever
of 104°F, tachycardia (HR 150), and agitation. What is the
priority nursing action?
A. Administer propylthiouracil
B. Prepare for thyroidectomy
C. Administer IV beta-blocker and cooling measures
D. Obtain a thyroid scan
Answer: C
Rationale: These symptoms suggest thyroid storm, a life-
threatening emergency. Priority is reducing sympathetic
overactivity (beta-blocker) and hyperpyrexia (cooling).
Propylthiouracil is given but not first-line emergent action.
2. A post-thyroidectomy patient reports tingling around the
mouth and fingers. What lab value should the nurse check
first?
A. Serum calcium
B. Serum sodium
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C. Serum potassium
D. Serum magnesium
Answer: A
Rationale: Post-thyroidectomy hypoparathyroidism leads to
hypocalcemia, causing paresthesias, tetany, and Chvostek’s
sign.
3. A diabetic patient with nausea and vomiting has blood
glucose of 480 mg/dL, pH 7.10, HCO3 10, and positive
urine ketones. Which intervention is most critical?
A. IV regular insulin bolus
B. IV fluid resuscitation with normal saline
C. Oral antiemetic
D. Subcutaneous glargine insulin
Answer: B
Rationale: In DKA, profound dehydration is the priority. Fluids
restore tissue perfusion, lower glucose indirectly, and correct
acidosis.
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4. Scenario: A patient with syndrome of inappropriate
antidiuretic hormone (SIADH) has a serum sodium of 118
mEq/L. The nurse expects which intervention?
A. 3% hypertonic saline infusion
B. Fluid restriction
C. IV furosemide
D. Oral sodium tablets
Answer: B
Rationale: First-line for mild to moderate SIADH is fluid
restriction (800–1000 mL/day). Hypertonic saline reserved for
severe neurological symptoms.
5. A patient with Addison’s disease presents with
hypotension, hyponatremia, hyperkalemia, and severe
weakness. What is the priority?
A. IV hydrocortisone
B. Oral fludrocortisone
C. IV potassium replacement
NUR209 EXAM 4 NUR 209 MEDICAL
SURGICAL NURSING II ACTUAL EXAM 4
LATEST 2026/2027 ACCURATE TEST
COMPLETE APPROVED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (100% CORRECT VERIFIED
SOLUTIONS) CURRENTLY UPDATED
VERSION |GUARANTEED PASS A+
,Page 2 of 169
1. A patient with hyperthyroidism is admitted with a fever
of 104°F, tachycardia (HR 150), and agitation. What is the
priority nursing action?
A. Administer propylthiouracil
B. Prepare for thyroidectomy
C. Administer IV beta-blocker and cooling measures
D. Obtain a thyroid scan
Answer: C
Rationale: These symptoms suggest thyroid storm, a life-
threatening emergency. Priority is reducing sympathetic
overactivity (beta-blocker) and hyperpyrexia (cooling).
Propylthiouracil is given but not first-line emergent action.
2. A post-thyroidectomy patient reports tingling around the
mouth and fingers. What lab value should the nurse check
first?
A. Serum calcium
B. Serum sodium
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C. Serum potassium
D. Serum magnesium
Answer: A
Rationale: Post-thyroidectomy hypoparathyroidism leads to
hypocalcemia, causing paresthesias, tetany, and Chvostek’s
sign.
3. A diabetic patient with nausea and vomiting has blood
glucose of 480 mg/dL, pH 7.10, HCO3 10, and positive
urine ketones. Which intervention is most critical?
A. IV regular insulin bolus
B. IV fluid resuscitation with normal saline
C. Oral antiemetic
D. Subcutaneous glargine insulin
Answer: B
Rationale: In DKA, profound dehydration is the priority. Fluids
restore tissue perfusion, lower glucose indirectly, and correct
acidosis.
, Page 4 of 169
4. Scenario: A patient with syndrome of inappropriate
antidiuretic hormone (SIADH) has a serum sodium of 118
mEq/L. The nurse expects which intervention?
A. 3% hypertonic saline infusion
B. Fluid restriction
C. IV furosemide
D. Oral sodium tablets
Answer: B
Rationale: First-line for mild to moderate SIADH is fluid
restriction (800–1000 mL/day). Hypertonic saline reserved for
severe neurological symptoms.
5. A patient with Addison’s disease presents with
hypotension, hyponatremia, hyperkalemia, and severe
weakness. What is the priority?
A. IV hydrocortisone
B. Oral fludrocortisone
C. IV potassium replacement
