PNR 206/PNR206 Exam 4 V1 | Medical-
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is caring for a patient diagnosed with Addison’s disease. Which of the following
electrolyte imbalances should the nurse expect to find in the laboratory results?
A. Hypokalemia and hypernatremia
B. Hypermagnesemia and hypocalcemia
C. Hyperkalemia and hyponatremia
D. Hypochloremia and hypercalcemia
Answer: C
Rationale: Addison’s disease involves a deficiency in mineralocorticoids like aldosterone,
which leads to the retention of potassium and excretion of sodium. This results in the
clinical presentation of hyperkalemia and hyponatremia. Monitoring cardiac rhythm is
essential due to the high potassium levels.
2. Which clinical manifestation would a nurse anticipate in a patient experiencing a thyroid
storm?
A. Severe tachycardia and hyperthermia
B. Bradycardia and hypothermia
C. Lethargy and weight gain
,D. Hypotension and dry skin
Answer: A
Rationale: Thyroid storm is an acute, life-threatening emergency caused by excessive
thyroid hormone release. Symptoms include severe tachycardia, extreme hyperthermia,
and agitation or delirium. Immediate intervention is required to reduce the metabolic rate
and heart rate.
3. A patient with suspected Diabetes Insipidus (DI) is undergoing a water deprivation test.
What is the characteristic finding for DI in this test?
A. High urine specific gravity
B. Glycosuria
C. Low urine specific gravity
D. Positive ketones in the urine
Answer: C
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to the
inability of the kidneys to concentrate urine. Even when water is withheld, the patient
continues to excrete large volumes of dilute urine with a low specific gravity. Nurses must
monitor these patients closely for severe dehydration during testing.
4. A nurse is assessing a patient with Cushing’s syndrome. Which physical assessment finding
is consistent with this diagnosis?
A. Sunken cheeks and weight loss
, B. Bronze-colored skin
C. Thin, elongated extremities
D. Pendulous abdomen with purple striae
Answer: D
Rationale: Cushing’s syndrome results from excessive cortisol, causing abnormal fat
distribution. Classic signs include a moon face, buffalo hump, and a pendulous abdomen
with purple striae. Patients also frequently experience thin skin and fragile capillaries that
bruise easily.
5. A patient is prescribed levothyroxine for hypothyroidism. What instruction should the
nurse provide regarding its administration?
A. Take the medication on an empty stomach in the morning
B. Take the medication with a full meal at bedtime
C. Take the medication only when feeling sluggish or cold
D. Mix the medication with a high-fiber supplement
Answer: A
Rationale: Levothyroxine absorption is maximized when taken on an empty stomach,
ideally 30 to 60 minutes before breakfast. Fiber and calcium can interfere with the drug’s
absorption, so they should be spaced out. Consistency in timing is vital to maintain
therapeutic hormone levels.
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is caring for a patient diagnosed with Addison’s disease. Which of the following
electrolyte imbalances should the nurse expect to find in the laboratory results?
A. Hypokalemia and hypernatremia
B. Hypermagnesemia and hypocalcemia
C. Hyperkalemia and hyponatremia
D. Hypochloremia and hypercalcemia
Answer: C
Rationale: Addison’s disease involves a deficiency in mineralocorticoids like aldosterone,
which leads to the retention of potassium and excretion of sodium. This results in the
clinical presentation of hyperkalemia and hyponatremia. Monitoring cardiac rhythm is
essential due to the high potassium levels.
2. Which clinical manifestation would a nurse anticipate in a patient experiencing a thyroid
storm?
A. Severe tachycardia and hyperthermia
B. Bradycardia and hypothermia
C. Lethargy and weight gain
,D. Hypotension and dry skin
Answer: A
Rationale: Thyroid storm is an acute, life-threatening emergency caused by excessive
thyroid hormone release. Symptoms include severe tachycardia, extreme hyperthermia,
and agitation or delirium. Immediate intervention is required to reduce the metabolic rate
and heart rate.
3. A patient with suspected Diabetes Insipidus (DI) is undergoing a water deprivation test.
What is the characteristic finding for DI in this test?
A. High urine specific gravity
B. Glycosuria
C. Low urine specific gravity
D. Positive ketones in the urine
Answer: C
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to the
inability of the kidneys to concentrate urine. Even when water is withheld, the patient
continues to excrete large volumes of dilute urine with a low specific gravity. Nurses must
monitor these patients closely for severe dehydration during testing.
4. A nurse is assessing a patient with Cushing’s syndrome. Which physical assessment finding
is consistent with this diagnosis?
A. Sunken cheeks and weight loss
, B. Bronze-colored skin
C. Thin, elongated extremities
D. Pendulous abdomen with purple striae
Answer: D
Rationale: Cushing’s syndrome results from excessive cortisol, causing abnormal fat
distribution. Classic signs include a moon face, buffalo hump, and a pendulous abdomen
with purple striae. Patients also frequently experience thin skin and fragile capillaries that
bruise easily.
5. A patient is prescribed levothyroxine for hypothyroidism. What instruction should the
nurse provide regarding its administration?
A. Take the medication on an empty stomach in the morning
B. Take the medication with a full meal at bedtime
C. Take the medication only when feeling sluggish or cold
D. Mix the medication with a high-fiber supplement
Answer: A
Rationale: Levothyroxine absorption is maximized when taken on an empty stomach,
ideally 30 to 60 minutes before breakfast. Fiber and calcium can interfere with the drug’s
absorption, so they should be spaced out. Consistency in timing is vital to maintain
therapeutic hormone levels.
