PNR 206/PNR206 Exam 2 V3 | Medical-
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is caring for a client with a suspected diagnosis of hyperthyroidism. Which of the
following clinical manifestations should the nurse expect to observe?
A. Bradycardia and weight gain
B. Hypotension and lethargy
C. Constipation and dry skin
D. Heat intolerance and tremors
Answer: D
Rationale: Hyperthyroidism results in a hypermetabolic state that leads to symptoms like
heat intolerance, tachycardia, and tremors. The excess thyroid hormone increases the
sensitivity of the sympathetic nervous system. Bradycardia, weight gain, and constipation
are typically associated with hypothyroidism rather than hyperthyroidism.
2. Which arterial blood gas (ABG) result would the nurse expect for a client experiencing an
exacerbation of COPD?
A. pH 7.48, PaCO2 32, HCO3 24
B. pH 7.30, PaCO2 55, HCO3 28
C. pH 7.32, PaCO2 38, HCO3 18
,D. pH 7.50, PaCO2 40, HCO3 30
Answer: B
Rationale: Clients with COPD often experience respiratory acidosis due to chronic air
trapping and carbon dioxide retention. A pH of 7.30 indicates acidosis, and a PaCO2 of 55
mmHg indicates a respiratory origin for the imbalance. The slightly elevated bicarbonate
(HCO3 28) represents the kidneys attempting to compensate for the chronic respiratory
condition.
3. A client with diabetes mellitus is scheduled for a CT scan with intravenous contrast. Which
medication should the nurse expect the provider to hold for 48 hours after the procedure?
A. Lispro insulin
B. Glipizide
C. Metformin
D. Pioglitazone
Answer: C
Rationale: Metformin must be withheld before and for 48 hours after the administration of
iodine-based contrast dye to prevent lactic acidosis. Contrast media can cause acute renal
failure, which would lead to an accumulation of metformin in the body. The nurse must
monitor the client’s creatinine levels before resuming the medication to ensure renal
function is stable.
, 4. When assessing a client with Cushing’s syndrome, which physical finding is most
characteristic of the disease?
A. Hyperpigmentation of the skin
B. Tremors and exophthalmos
C. Sunken eyeballs and poor skin turgor
D. Buffalo hump and moon face
Answer: D
Rationale: Cushing’s syndrome is caused by excessive cortisol, which leads to a
redistribution of fat in the body. This results in the characteristic ‘buffalo hump’ on the
upper back and a rounded ‘moon face.’ Other common findings include truncal obesity, thin
extremities, and purple striae on the abdomen.
5. A nurse is teaching a client about the dietary management of Gastroesophageal Reflux
Disease (GERD). Which instruction should the nurse include?
A. Avoid caffeine, chocolate, and peppermint
B. Eat three large meals a day rather than small snacks
C. Drink a glass of milk before bedtime to coat the stomach
D. Lie down for 30 minutes immediately after eating
Answer: A
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is caring for a client with a suspected diagnosis of hyperthyroidism. Which of the
following clinical manifestations should the nurse expect to observe?
A. Bradycardia and weight gain
B. Hypotension and lethargy
C. Constipation and dry skin
D. Heat intolerance and tremors
Answer: D
Rationale: Hyperthyroidism results in a hypermetabolic state that leads to symptoms like
heat intolerance, tachycardia, and tremors. The excess thyroid hormone increases the
sensitivity of the sympathetic nervous system. Bradycardia, weight gain, and constipation
are typically associated with hypothyroidism rather than hyperthyroidism.
2. Which arterial blood gas (ABG) result would the nurse expect for a client experiencing an
exacerbation of COPD?
A. pH 7.48, PaCO2 32, HCO3 24
B. pH 7.30, PaCO2 55, HCO3 28
C. pH 7.32, PaCO2 38, HCO3 18
,D. pH 7.50, PaCO2 40, HCO3 30
Answer: B
Rationale: Clients with COPD often experience respiratory acidosis due to chronic air
trapping and carbon dioxide retention. A pH of 7.30 indicates acidosis, and a PaCO2 of 55
mmHg indicates a respiratory origin for the imbalance. The slightly elevated bicarbonate
(HCO3 28) represents the kidneys attempting to compensate for the chronic respiratory
condition.
3. A client with diabetes mellitus is scheduled for a CT scan with intravenous contrast. Which
medication should the nurse expect the provider to hold for 48 hours after the procedure?
A. Lispro insulin
B. Glipizide
C. Metformin
D. Pioglitazone
Answer: C
Rationale: Metformin must be withheld before and for 48 hours after the administration of
iodine-based contrast dye to prevent lactic acidosis. Contrast media can cause acute renal
failure, which would lead to an accumulation of metformin in the body. The nurse must
monitor the client’s creatinine levels before resuming the medication to ensure renal
function is stable.
, 4. When assessing a client with Cushing’s syndrome, which physical finding is most
characteristic of the disease?
A. Hyperpigmentation of the skin
B. Tremors and exophthalmos
C. Sunken eyeballs and poor skin turgor
D. Buffalo hump and moon face
Answer: D
Rationale: Cushing’s syndrome is caused by excessive cortisol, which leads to a
redistribution of fat in the body. This results in the characteristic ‘buffalo hump’ on the
upper back and a rounded ‘moon face.’ Other common findings include truncal obesity, thin
extremities, and purple striae on the abdomen.
5. A nurse is teaching a client about the dietary management of Gastroesophageal Reflux
Disease (GERD). Which instruction should the nurse include?
A. Avoid caffeine, chocolate, and peppermint
B. Eat three large meals a day rather than small snacks
C. Drink a glass of milk before bedtime to coat the stomach
D. Lie down for 30 minutes immediately after eating
Answer: A
