NSG223/NSG 223 Exam 2 V2 | Medical-
Surgical Nursing II Q&A with Rationale |
Herzing University
1. A patient is admitted with a blood glucose of 650 mg/dL, arterial pH of 7.25, and presence
of ketones in the urine. Which condition does the nurse suspect?
A. Hyperosmolar Hyperglycemic Syndrome (HHS)
B. Diabetes Insipidus
C. Metabolic Alkalosis
D. Diabetic Ketoacidosis (DKA)
Correct Answer: D
Rationale: Diabetic Ketoacidosis is characterized by hyperglycemia, metabolic acidosis,
and the presence of ketones in the urine or blood. This condition typically occurs in Type 1
Diabetes but can occur in Type 2 during severe stress or illness. HHS is distinguished from
DKA by the lack of significant ketosis and a higher blood glucose level.
2. The nurse is caring for a patient post-thyroidectomy. Which assessment finding requires
immediate intervention?
A. Sore throat when speaking
B. Incisional pain
C. Laryngeal stridor
,D. Drowsiness
Correct Answer: C
Rationale: Laryngeal stridor is a harsh, high-pitched sound indicating airway obstruction
from edema or nerve damage. This is a life-threatening emergency that requires immediate
notification of the surgeon and preparation for tracheostomy. Other findings like sore
throat or incisional pain are expected postoperative occurrences.
3. A patient with Grave’s disease is experiencing a ‘thyroid storm.’ Which medication should
the nurse expect to administer to block the peripheral effects of thyroid hormones?
A. Levothyroxine
B. Methimazole
C. Propylthiouracil (PTU)
D. Propranolol
Correct Answer: D
Rationale: Propranolol is a beta-blocker used in thyroid storm to control sympathetic
nervous system symptoms like tachycardia and hypertension. While PTU and Methimazole
inhibit hormone production, they do not block the immediate peripheral effects.
Levothyroxine is contraindicated as it is a thyroid hormone replacement.
4. Which clinical manifestation would the nurse expect to find in a patient with Cushing’s
Syndrome?
A. Hypotension
, B. Hyperpigmentation of the skin
C. Weight loss
D. Thinning of the extremities
Correct Answer: D
Rationale: Cushing’s Syndrome involves excessive cortisol, leading to muscle wasting in
the extremities and central obesity. Patients often exhibit a ‘buffalo hump’ and ‘moon face’
due to fat redistribution. Hypotension and hyperpigmentation are more characteristic of
Addison’s Disease, which is adrenal insufficiency.
5. A patient with Addison’s disease is admitted to the ER with hypotension, tachycardia, and
hyponatremia. What is the priority nursing action?
A. Administer IV insulin
B. Encourage a low-sodium diet
C. Monitor for hypoglycemia
D. Administer rapid IV fluid replacement and hydrocortisone
Correct Answer: D
Rationale: The patient is experiencing an Addisonian crisis, which is a medical emergency
characterized by severe glucocorticoid and mineralocorticoid deficiency. Immediate
treatment involves vigorous fluid resuscitation and high-dose corticosteroid replacement
Surgical Nursing II Q&A with Rationale |
Herzing University
1. A patient is admitted with a blood glucose of 650 mg/dL, arterial pH of 7.25, and presence
of ketones in the urine. Which condition does the nurse suspect?
A. Hyperosmolar Hyperglycemic Syndrome (HHS)
B. Diabetes Insipidus
C. Metabolic Alkalosis
D. Diabetic Ketoacidosis (DKA)
Correct Answer: D
Rationale: Diabetic Ketoacidosis is characterized by hyperglycemia, metabolic acidosis,
and the presence of ketones in the urine or blood. This condition typically occurs in Type 1
Diabetes but can occur in Type 2 during severe stress or illness. HHS is distinguished from
DKA by the lack of significant ketosis and a higher blood glucose level.
2. The nurse is caring for a patient post-thyroidectomy. Which assessment finding requires
immediate intervention?
A. Sore throat when speaking
B. Incisional pain
C. Laryngeal stridor
,D. Drowsiness
Correct Answer: C
Rationale: Laryngeal stridor is a harsh, high-pitched sound indicating airway obstruction
from edema or nerve damage. This is a life-threatening emergency that requires immediate
notification of the surgeon and preparation for tracheostomy. Other findings like sore
throat or incisional pain are expected postoperative occurrences.
3. A patient with Grave’s disease is experiencing a ‘thyroid storm.’ Which medication should
the nurse expect to administer to block the peripheral effects of thyroid hormones?
A. Levothyroxine
B. Methimazole
C. Propylthiouracil (PTU)
D. Propranolol
Correct Answer: D
Rationale: Propranolol is a beta-blocker used in thyroid storm to control sympathetic
nervous system symptoms like tachycardia and hypertension. While PTU and Methimazole
inhibit hormone production, they do not block the immediate peripheral effects.
Levothyroxine is contraindicated as it is a thyroid hormone replacement.
4. Which clinical manifestation would the nurse expect to find in a patient with Cushing’s
Syndrome?
A. Hypotension
, B. Hyperpigmentation of the skin
C. Weight loss
D. Thinning of the extremities
Correct Answer: D
Rationale: Cushing’s Syndrome involves excessive cortisol, leading to muscle wasting in
the extremities and central obesity. Patients often exhibit a ‘buffalo hump’ and ‘moon face’
due to fat redistribution. Hypotension and hyperpigmentation are more characteristic of
Addison’s Disease, which is adrenal insufficiency.
5. A patient with Addison’s disease is admitted to the ER with hypotension, tachycardia, and
hyponatremia. What is the priority nursing action?
A. Administer IV insulin
B. Encourage a low-sodium diet
C. Monitor for hypoglycemia
D. Administer rapid IV fluid replacement and hydrocortisone
Correct Answer: D
Rationale: The patient is experiencing an Addisonian crisis, which is a medical emergency
characterized by severe glucocorticoid and mineralocorticoid deficiency. Immediate
treatment involves vigorous fluid resuscitation and high-dose corticosteroid replacement
