NUR 201/NUR201 Exam 3 V1 | Medical-Surgical
Nursing I Q&A with Rationale | Fortis College
1. A nurse is assessing a client with Cushing’s syndrome. Which clinical manifestation should
the nurse expect to observe?
A. Postural hypotension
B. Hyperpigmentation of the skin
C. Weight loss and decreased appetite
D. Trunkal obesity with thin extremities
Correct Answer: D
Explanation: Cushing’s syndrome is characterized by an excess of cortisol, which leads to a
redistribution of fat resulting in trunkal obesity and a ‘buffalo hump.’ The extremities
remain thin due to muscle wasting and protein catabolism. Other classic signs include a
‘moon face’ and purple striae on the abdomen.
2. Which laboratory value should the nurse prioritize when caring for a client with Addisonian
crisis?
A. Serum potassium 6.2 mEq/L
B. Serum sodium 150 mEq/L
C. Blood glucose 120 mg/dL
D. Serum calcium 10.5 mg/dL
,Correct Answer: A
Explanation: In an Addisonian crisis, the lack of aldosterone causes the kidneys to retain
potassium and excrete sodium. A serum potassium level of 6.2 mEq/L is critically high and
poses a significant risk for cardiac dysrhythmias. Immediate intervention is required to
lower potassium and replace missing adrenal hormones.
3. A client is diagnosed with Hyperosmolar Hyperglycemic Syndrome (HHS). What is the
primary initial goal of treatment?
A. Correction of metabolic acidosis
B. Fluid replacement to correct dehydration
C. Rapid administration of IV insulin
D. Normalization of serum potassium levels
Correct Answer: B
Explanation: HHS causes profound dehydration due to osmotic diuresis caused by extreme
hyperglycemia. The priority is to restore circulating volume and tissue perfusion through
aggressive fluid resuscitation, typically with 0.9% or 0.45% normal saline. While insulin
and electrolyte management are important, they follow the stabilization of the client’s fluid
status.
4. Which symptom should the nurse instruct a client with Graves’ disease to report
immediately?
A. Occasional palpitations
, B. Increased appetite
C. Soft, loose stools
D. Temperature elevation of 1 degree Fahrenheit
Correct Answer: D
Explanation: Hyperthyroidism or Graves’ disease carries the risk of thyroid storm, a life-
threatening emergency. A sudden rise in temperature, even by one degree, can indicate the
onset of a thyroid crisis. The client must report this immediately so that rapid intervention
can prevent cardiovascular collapse.
5. A client with Diabetes Insipidus (DI) is receiving desmopressin (DDAVP). Which finding
indicates the medication is effective?
A. Urine output of 300 mL/hr
B. Increased serum sodium levels
C. Urine specific gravity of 1.015
D. Decrease in skin turgor
Correct Answer: C
Explanation: Desmopressin is a synthetic form of ADH that helps the kidneys retain water.
Effectiveness is demonstrated by a decrease in urine output and an increase in urine
concentration, represented by a specific gravity within the normal range (1.005–1.030). A
specific gravity of 1.015 indicates that the kidneys are successfully concentrating urine.
Nursing I Q&A with Rationale | Fortis College
1. A nurse is assessing a client with Cushing’s syndrome. Which clinical manifestation should
the nurse expect to observe?
A. Postural hypotension
B. Hyperpigmentation of the skin
C. Weight loss and decreased appetite
D. Trunkal obesity with thin extremities
Correct Answer: D
Explanation: Cushing’s syndrome is characterized by an excess of cortisol, which leads to a
redistribution of fat resulting in trunkal obesity and a ‘buffalo hump.’ The extremities
remain thin due to muscle wasting and protein catabolism. Other classic signs include a
‘moon face’ and purple striae on the abdomen.
2. Which laboratory value should the nurse prioritize when caring for a client with Addisonian
crisis?
A. Serum potassium 6.2 mEq/L
B. Serum sodium 150 mEq/L
C. Blood glucose 120 mg/dL
D. Serum calcium 10.5 mg/dL
,Correct Answer: A
Explanation: In an Addisonian crisis, the lack of aldosterone causes the kidneys to retain
potassium and excrete sodium. A serum potassium level of 6.2 mEq/L is critically high and
poses a significant risk for cardiac dysrhythmias. Immediate intervention is required to
lower potassium and replace missing adrenal hormones.
3. A client is diagnosed with Hyperosmolar Hyperglycemic Syndrome (HHS). What is the
primary initial goal of treatment?
A. Correction of metabolic acidosis
B. Fluid replacement to correct dehydration
C. Rapid administration of IV insulin
D. Normalization of serum potassium levels
Correct Answer: B
Explanation: HHS causes profound dehydration due to osmotic diuresis caused by extreme
hyperglycemia. The priority is to restore circulating volume and tissue perfusion through
aggressive fluid resuscitation, typically with 0.9% or 0.45% normal saline. While insulin
and electrolyte management are important, they follow the stabilization of the client’s fluid
status.
4. Which symptom should the nurse instruct a client with Graves’ disease to report
immediately?
A. Occasional palpitations
, B. Increased appetite
C. Soft, loose stools
D. Temperature elevation of 1 degree Fahrenheit
Correct Answer: D
Explanation: Hyperthyroidism or Graves’ disease carries the risk of thyroid storm, a life-
threatening emergency. A sudden rise in temperature, even by one degree, can indicate the
onset of a thyroid crisis. The client must report this immediately so that rapid intervention
can prevent cardiovascular collapse.
5. A client with Diabetes Insipidus (DI) is receiving desmopressin (DDAVP). Which finding
indicates the medication is effective?
A. Urine output of 300 mL/hr
B. Increased serum sodium levels
C. Urine specific gravity of 1.015
D. Decrease in skin turgor
Correct Answer: C
Explanation: Desmopressin is a synthetic form of ADH that helps the kidneys retain water.
Effectiveness is demonstrated by a decrease in urine output and an increase in urine
concentration, represented by a specific gravity within the normal range (1.005–1.030). A
specific gravity of 1.015 indicates that the kidneys are successfully concentrating urine.
