PNR 201/PNR201 Exam 4 V2 | Medical-
Surgical Nursing Q&A with Rationale |
Fortis College
1. A nurse is caring for a patient diagnosed with Type 1 Diabetes Mellitus who is experiencing
tremors, diaphoresis, and confusion. Which action should the nurse prioritize?
A. Check the patient’s blood glucose level immediately.
B. Administer 10 units of regular insulin subcutaneous.
C. Provide a high-protein snack like peanut butter.
D. Notify the healthcare provider regarding the confusion.
Correct Answer: A
Expert Explanation: The patient is exhibiting classic signs of hypoglycemia, which require
immediate verification. Checking the blood glucose level is the first step in the nursing
process to confirm the diagnosis before intervention. Once confirmed, the nurse should
follow the protocol for rapid sugar replacement followed by a complex carbohydrate.
2. A patient with hyperthyroidism is scheduled for a subtotal thyroidectomy. Which
medication does the nurse expect to administer preoperatively to reduce the vascularity of
the gland?
A. Lugol’s solution (Iodine)
B. Propylthiouracil (PTU)
,C. Levothyroxine
D. Furosemide
Correct Answer: A
Expert Explanation: Lugol’s solution or saturated solution of potassium iodide (SSKI) is
commonly used to decrease the size and vascularity of the thyroid gland prior to surgery.
This reduces the risk of excessive intraoperative hemorrhage. The nurse must monitor the
patient for signs of iodism, such as a brassy taste in the mouth or burning in the throat.
3. The nurse is assessing a patient with Cushing’s syndrome. Which clinical manifestation is
most characteristic of this disorder?
A. Weight loss and hypotension
B. Hyperpigmentation of the skin
C. Trunkal obesity and moon face
D. Tachycardia and heat intolerance
Correct Answer: C
Expert Explanation: Cushing’s syndrome results from excessive cortisol production,
leading to fat redistribution such as trunkal obesity and a moon-shaped face. Patients also
frequently present with thin extremities and a buffalo hump on the upper back. Nursing
care involves monitoring for hyperglycemia and infection due to the immunosuppressive
effects of cortisol.
, 4. Which dietary instruction is most appropriate for a patient newly diagnosed with
Gastroesophageal Reflux Disease (GERD)?
A. Eat three large meals daily to maintain energy.
B. Lie down for 30 minutes immediately after eating.
C. Avoid caffeine, chocolate, and peppermint.
D. Increase intake of spicy foods to stimulate digestion.
Correct Answer: C
Expert Explanation: Caffeine, chocolate, and peppermint are known to relax the lower
esophageal sphincter (LES), which allows gastric contents to reflux. Patients should be
encouraged to eat small, frequent meals instead of large ones. Additionally, they should
remain upright for at least two hours after eating to prevent regurgitation.
5. A nurse is assessing a patient for Trousseau’s sign following a thyroidectomy. Which finding
indicates a positive result?
A. Facial twitching when the cheek is tapped.
B. Carpal spasm after inflating a blood pressure cuff.
C. Numbness and tingling in the toes.
D. Generalized seizure activity.
Correct Answer: B
Surgical Nursing Q&A with Rationale |
Fortis College
1. A nurse is caring for a patient diagnosed with Type 1 Diabetes Mellitus who is experiencing
tremors, diaphoresis, and confusion. Which action should the nurse prioritize?
A. Check the patient’s blood glucose level immediately.
B. Administer 10 units of regular insulin subcutaneous.
C. Provide a high-protein snack like peanut butter.
D. Notify the healthcare provider regarding the confusion.
Correct Answer: A
Expert Explanation: The patient is exhibiting classic signs of hypoglycemia, which require
immediate verification. Checking the blood glucose level is the first step in the nursing
process to confirm the diagnosis before intervention. Once confirmed, the nurse should
follow the protocol for rapid sugar replacement followed by a complex carbohydrate.
2. A patient with hyperthyroidism is scheduled for a subtotal thyroidectomy. Which
medication does the nurse expect to administer preoperatively to reduce the vascularity of
the gland?
A. Lugol’s solution (Iodine)
B. Propylthiouracil (PTU)
,C. Levothyroxine
D. Furosemide
Correct Answer: A
Expert Explanation: Lugol’s solution or saturated solution of potassium iodide (SSKI) is
commonly used to decrease the size and vascularity of the thyroid gland prior to surgery.
This reduces the risk of excessive intraoperative hemorrhage. The nurse must monitor the
patient for signs of iodism, such as a brassy taste in the mouth or burning in the throat.
3. The nurse is assessing a patient with Cushing’s syndrome. Which clinical manifestation is
most characteristic of this disorder?
A. Weight loss and hypotension
B. Hyperpigmentation of the skin
C. Trunkal obesity and moon face
D. Tachycardia and heat intolerance
Correct Answer: C
Expert Explanation: Cushing’s syndrome results from excessive cortisol production,
leading to fat redistribution such as trunkal obesity and a moon-shaped face. Patients also
frequently present with thin extremities and a buffalo hump on the upper back. Nursing
care involves monitoring for hyperglycemia and infection due to the immunosuppressive
effects of cortisol.
, 4. Which dietary instruction is most appropriate for a patient newly diagnosed with
Gastroesophageal Reflux Disease (GERD)?
A. Eat three large meals daily to maintain energy.
B. Lie down for 30 minutes immediately after eating.
C. Avoid caffeine, chocolate, and peppermint.
D. Increase intake of spicy foods to stimulate digestion.
Correct Answer: C
Expert Explanation: Caffeine, chocolate, and peppermint are known to relax the lower
esophageal sphincter (LES), which allows gastric contents to reflux. Patients should be
encouraged to eat small, frequent meals instead of large ones. Additionally, they should
remain upright for at least two hours after eating to prevent regurgitation.
5. A nurse is assessing a patient for Trousseau’s sign following a thyroidectomy. Which finding
indicates a positive result?
A. Facial twitching when the cheek is tapped.
B. Carpal spasm after inflating a blood pressure cuff.
C. Numbness and tingling in the toes.
D. Generalized seizure activity.
Correct Answer: B
