NSG223/NSG 223 Exam 3 V2 | Medical-
Surgical Nursing II Q&A with Rationale |
Herzing University
1. A patient is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory result should the nurse expect to find?
A. Serum potassium of 5.8 mEq/L
B. Serum sodium of 124 mEq/L
C. Serum osmolality of 310 mOsm/kg
D. Urine specific gravity of 1.002
Correct Answer: B
Rationale: In SIADH, excessive ADH leads to water retention and dilutional hyponatremia.
A serum sodium level of 124 mEq/L is significantly below the normal range, reflecting this
imbalance. The nurse should also anticipate high urine specific gravity and low serum
osmolality.
2. A nurse is caring for a patient with Diabetes Insipidus (DI). Which clinical manifestation is
most characteristic of this condition?
A. Weight gain and peripheral edema
B. Excessive thirst and high urine output
C. Increased urine specific gravity
,D. Hypotension and bradycardia
Correct Answer: B
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to the
excretion of large volumes of dilute urine. This massive fluid loss results in compensatory
polydipsia or excessive thirst. Patients are at high risk for dehydration and hypovolemic
shock if intake does not match output.
3. Which assessment finding would the nurse expect in a patient diagnosed with Cushing’s
Syndrome?
A. Hyperpigmentation of the skin
B. Weight loss and hypoglycemia
C. Hypotension and tachycardia
D. Presence of a ‘buffalo hump’ and moon face
Correct Answer: D
Rationale: Cushing’s Syndrome results from an excess of cortisol, which causes fat
redistribution to the upper back and face. The presence of a buffalo hump and a rounded
moon face are classic physical hallmarks of the disease. Nurses should also monitor for
hyperglycemia and hypertension in these patients.
4. A patient with Addison’s disease is being discharged. Which instruction is essential for the
nurse to include in the teaching plan?
A. Limit sodium intake to 2 grams per day
, B. Discontinue medications if nausea occurs
C. Carry an emergency kit with injectable hydrocortisone
D. Increase potassium-rich foods in the diet
Correct Answer: C
Rationale: Patients with Addison’s disease require lifelong hormone replacement therapy
and must be prepared for an adrenal crisis. Carrying an emergency hydrocortisone kit
allows for immediate treatment during periods of high stress or illness. Abruptly stopping
steroids can trigger a life-threatening Addisonian crisis.
5. A patient is scheduled for a thyroidectomy. What is the priority nursing intervention in the
immediate postoperative period?
A. Check for Chvostek’s and Trousseau’s signs
B. Monitor for signs of airway obstruction
C. Encourage the patient to cough and deep breathe
D. Assess for surgical site infection
Correct Answer: B
Rationale: After thyroid surgery, the most critical complication is airway obstruction due
to edema or hematoma. The nurse must keep a tracheostomy tray at the bedside and assess
for stridor or respiratory distress. While hypocalcemia is a concern, maintaining a patent
airway is the highest priority.
Surgical Nursing II Q&A with Rationale |
Herzing University
1. A patient is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory result should the nurse expect to find?
A. Serum potassium of 5.8 mEq/L
B. Serum sodium of 124 mEq/L
C. Serum osmolality of 310 mOsm/kg
D. Urine specific gravity of 1.002
Correct Answer: B
Rationale: In SIADH, excessive ADH leads to water retention and dilutional hyponatremia.
A serum sodium level of 124 mEq/L is significantly below the normal range, reflecting this
imbalance. The nurse should also anticipate high urine specific gravity and low serum
osmolality.
2. A nurse is caring for a patient with Diabetes Insipidus (DI). Which clinical manifestation is
most characteristic of this condition?
A. Weight gain and peripheral edema
B. Excessive thirst and high urine output
C. Increased urine specific gravity
,D. Hypotension and bradycardia
Correct Answer: B
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to the
excretion of large volumes of dilute urine. This massive fluid loss results in compensatory
polydipsia or excessive thirst. Patients are at high risk for dehydration and hypovolemic
shock if intake does not match output.
3. Which assessment finding would the nurse expect in a patient diagnosed with Cushing’s
Syndrome?
A. Hyperpigmentation of the skin
B. Weight loss and hypoglycemia
C. Hypotension and tachycardia
D. Presence of a ‘buffalo hump’ and moon face
Correct Answer: D
Rationale: Cushing’s Syndrome results from an excess of cortisol, which causes fat
redistribution to the upper back and face. The presence of a buffalo hump and a rounded
moon face are classic physical hallmarks of the disease. Nurses should also monitor for
hyperglycemia and hypertension in these patients.
4. A patient with Addison’s disease is being discharged. Which instruction is essential for the
nurse to include in the teaching plan?
A. Limit sodium intake to 2 grams per day
, B. Discontinue medications if nausea occurs
C. Carry an emergency kit with injectable hydrocortisone
D. Increase potassium-rich foods in the diet
Correct Answer: C
Rationale: Patients with Addison’s disease require lifelong hormone replacement therapy
and must be prepared for an adrenal crisis. Carrying an emergency hydrocortisone kit
allows for immediate treatment during periods of high stress or illness. Abruptly stopping
steroids can trigger a life-threatening Addisonian crisis.
5. A patient is scheduled for a thyroidectomy. What is the priority nursing intervention in the
immediate postoperative period?
A. Check for Chvostek’s and Trousseau’s signs
B. Monitor for signs of airway obstruction
C. Encourage the patient to cough and deep breathe
D. Assess for surgical site infection
Correct Answer: B
Rationale: After thyroid surgery, the most critical complication is airway obstruction due
to edema or hematoma. The nurse must keep a tracheostomy tray at the bedside and assess
for stridor or respiratory distress. While hypocalcemia is a concern, maintaining a patent
airway is the highest priority.
