NU 157 Exam 4 V2 | NU 157 Medical-
Surgical Nursing I-A | NCLEX (NGN) Q&A
with Rationale (NU157 Exam 4) | Galen
1. A nurse is teaching a client who was recently diagnosed with type 1 diabetes mellitus
about self-management. Which instructions should the nurse include in the teaching? (Select
all that apply.)
A. Monitor blood glucose levels before meals and at bedtime.
B. Rotate insulin injection sites within one anatomic area.
C. Decrease fluid intake if blood glucose levels are above 250 mg/dL.
D. Wear well-fitting shoes and inspect feet daily for any injuries.
E. Carry a source of fast-acting carbohydrate at all times.
Correct Answer: ABDE
Explanation: Type 1 diabetes management requires frequent glucose monitoring to adjust
insulin therapy appropriately. Rotating injection sites within the same region helps
maintain consistent absorption while preventing lipodystrophy. Daily foot inspections and
immediate treatment of hypoglycemia with fast-acting carbohydrates are essential safety
measures for diabetic clients.
,2. The nurse is caring for a client with hyperthyroidism who is scheduled for a thyroidectomy.
Which medication should the nurse expect to administer to decrease the vascularity of the
thyroid gland before surgery?
A. Lugol’s solution
B. Levothyroxine
C. Propylthiouracil
D. Atenolol
Correct Answer: A
Explanation: Lugol’s solution, an iodine preparation, is administered preoperatively to
reduce the size and vascularity of the thyroid gland. This intervention helps minimize the
risk of intraoperative and postoperative hemorrhage. Other medications like
propylthiouracil block hormone synthesis but do not specifically target vascularity.
3. A nurse is assessing a client with Cushing’s syndrome. Which clinical manifestations should
the nurse expect to observe? (Select all that apply.)
A. Truncal obesity
B. Hyperpigmentation of the skin
C. Hirsutism
D. Purple striae on the abdomen
E. Hypotension
, F. Buffalo hump
Correct Answer: ACDF
Explanation: Cushing’s syndrome is characterized by an excess of cortisol, leading to
truncal obesity, a buffalo hump, and purple striae. Hirsutism is common due to increased
androgen production in some cases of adrenal hyperplasia. Hyperpigmentation and
hypotension are typically associated with Addison’s disease rather than Cushing’s
syndrome.
4. A client is prescribed timolol eye drops for the treatment of primary open-angle glaucoma.
Which condition in the client’s medical history should the nurse recognize as a
contraindication for this medication?
A. Hypertension
B. Hypothyroidism
C. Diabetes mellitus
D. Asthma
Correct Answer: D
Explanation: Timolol is a non-selective beta-adrenergic blocker used to reduce intraocular
pressure. It can cause bronchospasm and is therefore contraindicated in clients with a
history of asthma or severe COPD. The nurse must assess the client’s respiratory history
before initiating this therapy.
Surgical Nursing I-A | NCLEX (NGN) Q&A
with Rationale (NU157 Exam 4) | Galen
1. A nurse is teaching a client who was recently diagnosed with type 1 diabetes mellitus
about self-management. Which instructions should the nurse include in the teaching? (Select
all that apply.)
A. Monitor blood glucose levels before meals and at bedtime.
B. Rotate insulin injection sites within one anatomic area.
C. Decrease fluid intake if blood glucose levels are above 250 mg/dL.
D. Wear well-fitting shoes and inspect feet daily for any injuries.
E. Carry a source of fast-acting carbohydrate at all times.
Correct Answer: ABDE
Explanation: Type 1 diabetes management requires frequent glucose monitoring to adjust
insulin therapy appropriately. Rotating injection sites within the same region helps
maintain consistent absorption while preventing lipodystrophy. Daily foot inspections and
immediate treatment of hypoglycemia with fast-acting carbohydrates are essential safety
measures for diabetic clients.
,2. The nurse is caring for a client with hyperthyroidism who is scheduled for a thyroidectomy.
Which medication should the nurse expect to administer to decrease the vascularity of the
thyroid gland before surgery?
A. Lugol’s solution
B. Levothyroxine
C. Propylthiouracil
D. Atenolol
Correct Answer: A
Explanation: Lugol’s solution, an iodine preparation, is administered preoperatively to
reduce the size and vascularity of the thyroid gland. This intervention helps minimize the
risk of intraoperative and postoperative hemorrhage. Other medications like
propylthiouracil block hormone synthesis but do not specifically target vascularity.
3. A nurse is assessing a client with Cushing’s syndrome. Which clinical manifestations should
the nurse expect to observe? (Select all that apply.)
A. Truncal obesity
B. Hyperpigmentation of the skin
C. Hirsutism
D. Purple striae on the abdomen
E. Hypotension
, F. Buffalo hump
Correct Answer: ACDF
Explanation: Cushing’s syndrome is characterized by an excess of cortisol, leading to
truncal obesity, a buffalo hump, and purple striae. Hirsutism is common due to increased
androgen production in some cases of adrenal hyperplasia. Hyperpigmentation and
hypotension are typically associated with Addison’s disease rather than Cushing’s
syndrome.
4. A client is prescribed timolol eye drops for the treatment of primary open-angle glaucoma.
Which condition in the client’s medical history should the nurse recognize as a
contraindication for this medication?
A. Hypertension
B. Hypothyroidism
C. Diabetes mellitus
D. Asthma
Correct Answer: D
Explanation: Timolol is a non-selective beta-adrenergic blocker used to reduce intraocular
pressure. It can cause bronchospasm and is therefore contraindicated in clients with a
history of asthma or severe COPD. The nurse must assess the client’s respiratory history
before initiating this therapy.
