NRSG 110 Exam 4 V1 | NRSG 110 Medical Surgical
Nursing II | Actual Q&A with Rationale (NRSG110
Exam 4) | Ivy Tech
1. A patient is admitted with a suspected diagnosis of Addison’s disease. Which of the
following clinical manifestations should the nurse expect to find during the assessment?
A. Hypertension and weight gain
B. Hyperpigmentation and hypotension
C. Hyperglycemia and moon face
D. Hypernatremia and hypokalemia
Correct Answer: B
Explanation: Addison’s disease is characterized by the hypofunction of the adrenal cortex,
leading to a deficiency in cortisol and aldosterone. The lack of cortisol stimulates the
pituitary to release more ACTH, which also stimulates melanocytes, causing
hyperpigmentation of the skin. Hypotension occurs due to the lack of aldosterone, leading
to sodium loss and fluid depletion.
2. The nurse is providing discharge teaching for a patient with Type 1 Diabetes Mellitus.
Which symptoms should the nurse instruct the patient to identify as indicative of
hypoglycemia?
A. Extreme thirst and fruity breath
B. Abdominal pain and rapid breathing
,C. Hot, dry skin and polyuria
D. Nervousness, diaphoresis, and confusion
E. Blurred vision and bradycardia
Correct Answer: D
Explanation: Hypoglycemia occurs when blood glucose levels fall below normal, typically
resulting in sympathetic nervous system activation. This leads to clinical manifestations
such as diaphoresis, tremors, and nervousness as the body attempts to raise glucose levels.
Confusion and irritability occur because the brain is highly dependent on glucose for
energy and is the first organ affected by its deficiency.
3. A nurse is caring for a patient post-thyroidectomy. The patient reports numbness and
tingling in the fingers and around the mouth. What should be the nurse’s priority action?
A. Assess for Chvostek’s sign and notify the physician
B. Check the patient’s blood pressure
C. Administer a dose of levothyroxine as ordered
D. Encourage the patient to cough and deep breathe
E. Place the patient in a prone position
F. Increase the IV infusion rate of normal saline
Correct Answer: A
, Explanation: Numbness and tingling are early signs of hypocalcemia, which can occur if
the parathyroid glands are accidentally damaged or removed during a thyroidectomy.
Chvostek’s sign is an assessment technique where tapping on the facial nerve elicits a
twitch, indicating neuromuscular irritability. The nurse must prioritize this assessment and
notify the provider because severe hypocalcemia can lead to laryngeal spasms and airway
obstruction.
4. Which lab value is most diagnostic for a patient being evaluated for primary
hypothyroidism?
A. Decreased TSH and increased T4
B. Increased TSH and decreased T4
C. Increased TSH and increased T3
D. Decreased TSH and decreased T3
Correct Answer: B
Explanation: In primary hypothyroidism, the thyroid gland itself is unable to produce
sufficient thyroid hormones (T3 and T4). In an attempt to stimulate the failing thyroid
gland, the pituitary gland increases the secretion of Thyroid Stimulating Hormone (TSH).
Therefore, a high TSH level combined with low levels of T4 confirms the diagnosis of
primary hypothyroidism.
Nursing II | Actual Q&A with Rationale (NRSG110
Exam 4) | Ivy Tech
1. A patient is admitted with a suspected diagnosis of Addison’s disease. Which of the
following clinical manifestations should the nurse expect to find during the assessment?
A. Hypertension and weight gain
B. Hyperpigmentation and hypotension
C. Hyperglycemia and moon face
D. Hypernatremia and hypokalemia
Correct Answer: B
Explanation: Addison’s disease is characterized by the hypofunction of the adrenal cortex,
leading to a deficiency in cortisol and aldosterone. The lack of cortisol stimulates the
pituitary to release more ACTH, which also stimulates melanocytes, causing
hyperpigmentation of the skin. Hypotension occurs due to the lack of aldosterone, leading
to sodium loss and fluid depletion.
2. The nurse is providing discharge teaching for a patient with Type 1 Diabetes Mellitus.
Which symptoms should the nurse instruct the patient to identify as indicative of
hypoglycemia?
A. Extreme thirst and fruity breath
B. Abdominal pain and rapid breathing
,C. Hot, dry skin and polyuria
D. Nervousness, diaphoresis, and confusion
E. Blurred vision and bradycardia
Correct Answer: D
Explanation: Hypoglycemia occurs when blood glucose levels fall below normal, typically
resulting in sympathetic nervous system activation. This leads to clinical manifestations
such as diaphoresis, tremors, and nervousness as the body attempts to raise glucose levels.
Confusion and irritability occur because the brain is highly dependent on glucose for
energy and is the first organ affected by its deficiency.
3. A nurse is caring for a patient post-thyroidectomy. The patient reports numbness and
tingling in the fingers and around the mouth. What should be the nurse’s priority action?
A. Assess for Chvostek’s sign and notify the physician
B. Check the patient’s blood pressure
C. Administer a dose of levothyroxine as ordered
D. Encourage the patient to cough and deep breathe
E. Place the patient in a prone position
F. Increase the IV infusion rate of normal saline
Correct Answer: A
, Explanation: Numbness and tingling are early signs of hypocalcemia, which can occur if
the parathyroid glands are accidentally damaged or removed during a thyroidectomy.
Chvostek’s sign is an assessment technique where tapping on the facial nerve elicits a
twitch, indicating neuromuscular irritability. The nurse must prioritize this assessment and
notify the provider because severe hypocalcemia can lead to laryngeal spasms and airway
obstruction.
4. Which lab value is most diagnostic for a patient being evaluated for primary
hypothyroidism?
A. Decreased TSH and increased T4
B. Increased TSH and decreased T4
C. Increased TSH and increased T3
D. Decreased TSH and decreased T3
Correct Answer: B
Explanation: In primary hypothyroidism, the thyroid gland itself is unable to produce
sufficient thyroid hormones (T3 and T4). In an attempt to stimulate the failing thyroid
gland, the pituitary gland increases the secretion of Thyroid Stimulating Hormone (TSH).
Therefore, a high TSH level combined with low levels of T4 confirms the diagnosis of
primary hypothyroidism.
