PNR 201/PNR201 Exam 4 V1 | Medical-
Surgical Nursing Q&A with Rationale |
Fortis College
1. A nurse is caring for a patient diagnosed with Type 1 Diabetes Mellitus who is found
unresponsive. What is the priority action for the nurse to perform first?
A. Administer 10 units of regular insulin subcutaneously.
B. Notify the healthcare provider immediately.
C. Provide 4 ounces of orange juice by mouth.
D. Check the patient’s capillary blood glucose level.
Correct Answer: D
Expert Explanation: Assessment is always the first step in the nursing process when a
patient’s status changes. Checking the blood glucose level allows the nurse to differentiate
between hypoglycemia and hyperglycemia. Once the level is known, appropriate
interventions like glucagon or insulin can be safely administered.
2. A patient with hypothyroidism is prescribed Levothyroxine. Which instruction should the
nurse include in the discharge teaching?
A. Take the medication with a full meal to avoid gastric upset.
B. Stop the medication once your energy levels return to normal.
C. Check your heart rate once a week and report if it is below 100 bpm.
,D. Take the medication on an empty stomach 30-60 minutes before breakfast.
Correct Answer: D
Expert Explanation: Levothyroxine absorption is maximized when taken on an empty
stomach before other medications or food. Patients must understand that this is typically a
lifelong therapy and should not be discontinued. Reporting tachycardia (a sign of over-
replacement) is important, but the administration timing is the primary education point.
3. A nurse is assessing a patient with Graves’ disease. Which clinical manifestation is most
characteristic of this condition?
A. Weight gain and bradycardia.
B. Dry, scaly skin and brittle nails.
C. Exophthalmos and heat intolerance.
D. Hypotension and lethargy.
Correct Answer: C
Expert Explanation: Graves’ disease is a form of hyperthyroidism characterized by an
overactive metabolism. Exophthalmos (bulging eyes) and heat intolerance are classic signs
due to the excessive production of thyroid hormones. Other signs include weight loss,
tachycardia, and diarrhea.
4. When caring for a patient 24 hours post-thyroidectomy, the nurse notes the patient has
positive Trousseau’s and Chvostek’s signs. Which lab value does the nurse anticipate?
A. Sodium 130 mEq/L
, B. Potassium 5.5 mEq/L
C. Calcium 6.8 mg/dL
D. Magnesium 1.2 mg/dL
Correct Answer: C
Expert Explanation: Positive Trousseau’s and Chvostek’s signs are classic indicators of
hypocalcemia. This can occur after a thyroidectomy if the parathyroid glands are
accidentally damaged or removed. The nurse must monitor for tetany and have calcium
gluconate available for emergency use.
5. A patient is admitted with a diagnosis of Cushing’s Syndrome. What physical assessment
finding should the nurse expect?
A. Extreme weight loss and sunken eyes.
B. Bronze-colored skin and hypotension.
C. Truncal obesity and a ‘buffalo hump’.
D. Tall stature and long extremities.
Correct Answer: C
Expert Explanation: Cushing’s Syndrome results from chronic exposure to excess
corticosteroids. Typical physical findings include a ‘moon face,’ truncal obesity, and a fat
pad on the upper back known as a buffalo hump. These symptoms contrast with Addison’s
disease, which causes weight loss and hyperpigmentation.
Surgical Nursing Q&A with Rationale |
Fortis College
1. A nurse is caring for a patient diagnosed with Type 1 Diabetes Mellitus who is found
unresponsive. What is the priority action for the nurse to perform first?
A. Administer 10 units of regular insulin subcutaneously.
B. Notify the healthcare provider immediately.
C. Provide 4 ounces of orange juice by mouth.
D. Check the patient’s capillary blood glucose level.
Correct Answer: D
Expert Explanation: Assessment is always the first step in the nursing process when a
patient’s status changes. Checking the blood glucose level allows the nurse to differentiate
between hypoglycemia and hyperglycemia. Once the level is known, appropriate
interventions like glucagon or insulin can be safely administered.
2. A patient with hypothyroidism is prescribed Levothyroxine. Which instruction should the
nurse include in the discharge teaching?
A. Take the medication with a full meal to avoid gastric upset.
B. Stop the medication once your energy levels return to normal.
C. Check your heart rate once a week and report if it is below 100 bpm.
,D. Take the medication on an empty stomach 30-60 minutes before breakfast.
Correct Answer: D
Expert Explanation: Levothyroxine absorption is maximized when taken on an empty
stomach before other medications or food. Patients must understand that this is typically a
lifelong therapy and should not be discontinued. Reporting tachycardia (a sign of over-
replacement) is important, but the administration timing is the primary education point.
3. A nurse is assessing a patient with Graves’ disease. Which clinical manifestation is most
characteristic of this condition?
A. Weight gain and bradycardia.
B. Dry, scaly skin and brittle nails.
C. Exophthalmos and heat intolerance.
D. Hypotension and lethargy.
Correct Answer: C
Expert Explanation: Graves’ disease is a form of hyperthyroidism characterized by an
overactive metabolism. Exophthalmos (bulging eyes) and heat intolerance are classic signs
due to the excessive production of thyroid hormones. Other signs include weight loss,
tachycardia, and diarrhea.
4. When caring for a patient 24 hours post-thyroidectomy, the nurse notes the patient has
positive Trousseau’s and Chvostek’s signs. Which lab value does the nurse anticipate?
A. Sodium 130 mEq/L
, B. Potassium 5.5 mEq/L
C. Calcium 6.8 mg/dL
D. Magnesium 1.2 mg/dL
Correct Answer: C
Expert Explanation: Positive Trousseau’s and Chvostek’s signs are classic indicators of
hypocalcemia. This can occur after a thyroidectomy if the parathyroid glands are
accidentally damaged or removed. The nurse must monitor for tetany and have calcium
gluconate available for emergency use.
5. A patient is admitted with a diagnosis of Cushing’s Syndrome. What physical assessment
finding should the nurse expect?
A. Extreme weight loss and sunken eyes.
B. Bronze-colored skin and hypotension.
C. Truncal obesity and a ‘buffalo hump’.
D. Tall stature and long extremities.
Correct Answer: C
Expert Explanation: Cushing’s Syndrome results from chronic exposure to excess
corticosteroids. Typical physical findings include a ‘moon face,’ truncal obesity, and a fat
pad on the upper back known as a buffalo hump. These symptoms contrast with Addison’s
disease, which causes weight loss and hyperpigmentation.
