NUR 201/NUR201 Exam 4 V3 | Medical-Surgical
Nursing I Q&A with Rationale | Fortis College
1. A nurse is caring for a client with Type 1 Diabetes Mellitus who is experiencing Kussmaul
respirations. What is the primary physiological purpose of this breathing pattern?
A. To increase the oxygen saturation in the blood
B. To facilitate the excretion of glucose through the lungs
C. To reduce the amount of carbon dioxide in the body
D. To compensate for respiratory alkalosis
Correct Answer: C
Explanation: Kussmaul respirations are deep and rapid breaths that occur as a
compensatory mechanism for metabolic acidosis. By increasing the rate and depth of
breathing, the body attempts to blow off excess carbon dioxide to raise the pH level. This is
a classic finding in clients experiencing diabetic ketoacidosis (DKA).
2. Which clinical manifestation should the nurse prioritize when assessing a client suspected
of having Graves’ disease?
A. Weight gain and bradycardia
B. Cold intolerance and lethargy
C. Periorbital edema and dry skin
D. Exophthalmos and tachycardia
,Correct Answer: D
Explanation: Graves’ disease is a form of hyperthyroidism characterized by an overactive
thyroid gland. Tachycardia is a common cardiovascular symptom due to the increased
metabolic rate, and exophthalmos (bulging eyes) is a specific ocular sign. The other options
describe symptoms more commonly associated with hypothyroidism.
3. A client is 12 hours post-total thyroidectomy. The nurse notes that the client has a positive
Chvostek’s sign. Which medication should the nurse prepare to administer?
A. Sodium polystyrene sulfonate
B. Potassium chloride
C. Calcium gluconate
D. Magnesium sulfate
Correct Answer: C
Explanation: A positive Chvostek’s sign indicates hypocalcemia, which can occur after
thyroid surgery if the parathyroid glands are accidentally damaged or removed. Calcium
gluconate is the emergency treatment used to restore serum calcium levels and prevent
tetany. The nurse must monitor the client closely for airway obstruction due to potential
laryngeal spasms.
4. The nurse is providing education to a client with Cushing’s syndrome. Which dietary
modification should the nurse recommend?
A. Decreased sodium and increased protein
, B. Increased sodium and decreased protein
C. High carbohydrate and low potassium
D. Low calorie and high sodium
Correct Answer: A
Explanation: Cushing’s syndrome involves an excess of cortisol, which leads to sodium and
water retention as well as protein wasting. Reducing sodium intake helps manage fluid
retention and hypertension, while increasing protein helps combat muscle wasting. These
dietary changes are essential for managing the systemic effects of hypercortisolism.
5. A client with Addison’s disease is admitted for an elective procedure. Which medication
does the nurse expect to be increased during the perioperative period?
A. Hydrocortisone
B. Insulin
C. Furosemide
D. Levothyroxine
Correct Answer: A
Explanation: Clients with Addison’s disease have adrenal insufficiency and cannot produce
enough cortisol to respond to the stress of surgery. To prevent an Addisonian crisis, the
dose of glucocorticoids like hydrocortisone is typically increased during periods of physical
Nursing I Q&A with Rationale | Fortis College
1. A nurse is caring for a client with Type 1 Diabetes Mellitus who is experiencing Kussmaul
respirations. What is the primary physiological purpose of this breathing pattern?
A. To increase the oxygen saturation in the blood
B. To facilitate the excretion of glucose through the lungs
C. To reduce the amount of carbon dioxide in the body
D. To compensate for respiratory alkalosis
Correct Answer: C
Explanation: Kussmaul respirations are deep and rapid breaths that occur as a
compensatory mechanism for metabolic acidosis. By increasing the rate and depth of
breathing, the body attempts to blow off excess carbon dioxide to raise the pH level. This is
a classic finding in clients experiencing diabetic ketoacidosis (DKA).
2. Which clinical manifestation should the nurse prioritize when assessing a client suspected
of having Graves’ disease?
A. Weight gain and bradycardia
B. Cold intolerance and lethargy
C. Periorbital edema and dry skin
D. Exophthalmos and tachycardia
,Correct Answer: D
Explanation: Graves’ disease is a form of hyperthyroidism characterized by an overactive
thyroid gland. Tachycardia is a common cardiovascular symptom due to the increased
metabolic rate, and exophthalmos (bulging eyes) is a specific ocular sign. The other options
describe symptoms more commonly associated with hypothyroidism.
3. A client is 12 hours post-total thyroidectomy. The nurse notes that the client has a positive
Chvostek’s sign. Which medication should the nurse prepare to administer?
A. Sodium polystyrene sulfonate
B. Potassium chloride
C. Calcium gluconate
D. Magnesium sulfate
Correct Answer: C
Explanation: A positive Chvostek’s sign indicates hypocalcemia, which can occur after
thyroid surgery if the parathyroid glands are accidentally damaged or removed. Calcium
gluconate is the emergency treatment used to restore serum calcium levels and prevent
tetany. The nurse must monitor the client closely for airway obstruction due to potential
laryngeal spasms.
4. The nurse is providing education to a client with Cushing’s syndrome. Which dietary
modification should the nurse recommend?
A. Decreased sodium and increased protein
, B. Increased sodium and decreased protein
C. High carbohydrate and low potassium
D. Low calorie and high sodium
Correct Answer: A
Explanation: Cushing’s syndrome involves an excess of cortisol, which leads to sodium and
water retention as well as protein wasting. Reducing sodium intake helps manage fluid
retention and hypertension, while increasing protein helps combat muscle wasting. These
dietary changes are essential for managing the systemic effects of hypercortisolism.
5. A client with Addison’s disease is admitted for an elective procedure. Which medication
does the nurse expect to be increased during the perioperative period?
A. Hydrocortisone
B. Insulin
C. Furosemide
D. Levothyroxine
Correct Answer: A
Explanation: Clients with Addison’s disease have adrenal insufficiency and cannot produce
enough cortisol to respond to the stress of surgery. To prevent an Addisonian crisis, the
dose of glucocorticoids like hydrocortisone is typically increased during periods of physical
