PNR 206/PNR206 Exam 2 V1 | Medical-
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A patient with Type 1 Diabetes Mellitus presents to the ER with Kussmaul respirations and
a fruity breath odor. Which condition should the nurse suspect?
A. Hypoglycemic reaction
B. Diabetic Ketoacidosis (DKA)
C. Hyperglycemic Hyperosmolar State (HHS)
D. Metabolic Alkalosis
Answer: B
Rationale: Kussmaul respirations and fruity breath are classic indicators of Diabetic
Ketoacidosis due to the body’s attempt to compensate for metabolic acidosis. This
condition typically occurs in Type 1 diabetics when there is a profound deficiency of
insulin. The nurse must prioritize fluid resuscitation and insulin administration to stabilize
the patient.
2. A nurse is providing discharge instructions to a patient newly diagnosed with
Hypothyroidism. Which instruction regarding Levothyroxine is most accurate?
A. Take the medication with a full meal to avoid GI upset
B. Take the medication on an empty stomach in the morning
,C. Expect the medication to take effect within 24 hours
D. Stop the medication once energy levels return to normal
Answer: B
Rationale: Levothyroxine absorption is optimized when taken on an empty stomach,
usually 30 to 60 minutes before breakfast. It is a lifelong medication that should never be
discontinued abruptly without medical supervision. Patients should also be taught that it
may take several weeks to see a full therapeutic effect on their symptoms.
3. Which clinical manifestation should the nurse anticipate in a patient diagnosed with
Cushing’s Syndrome?
A. Trunkal obesity and moon face
B. Hyperpigmentation of the skin
C. Weight loss and hypotension
D. Hypoglycemia and polyuria
Answer: A
Rationale: Cushing’s Syndrome is characterized by an excess of cortisol, which leads to fat
redistribution to the face and trunk. This results in the classic ‘moon face,’ ‘buffalo hump,’
and abdominal obesity often seen in clinical practice. The nurse should also monitor for
associated symptoms like hypertension and thinning skin with purple striae.
, 4. A patient is scheduled for a subtotal thyroidectomy. Which item is most critical for the
nurse to have at the bedside postoperatively?
A. Padded tongue blade
B. Incentive spirometer
C. Tracheostomy tray
D. Heating pad
Answer: C
Rationale: Post-thyroidectomy patients are at risk for airway obstruction due to edema or
laryngeal nerve damage. Having a tracheostomy tray at the bedside is a standard safety
protocol to manage emergency respiratory distress. The nurse must also monitor for signs
of hypocalcemia, which can cause laryngospasms.
5. A patient with Addison’s Disease is being educated on preventing an Addisonian Crisis.
Which statement indicates a need for further teaching?
A. I can skip a dose of my steroid if I feel nauseated.
B. I should increase my salt intake during hot weather.
C. I will wear a medical alert bracelet at all times.
D. I need to notify my doctor if I experience high stress.
Answer: A
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A patient with Type 1 Diabetes Mellitus presents to the ER with Kussmaul respirations and
a fruity breath odor. Which condition should the nurse suspect?
A. Hypoglycemic reaction
B. Diabetic Ketoacidosis (DKA)
C. Hyperglycemic Hyperosmolar State (HHS)
D. Metabolic Alkalosis
Answer: B
Rationale: Kussmaul respirations and fruity breath are classic indicators of Diabetic
Ketoacidosis due to the body’s attempt to compensate for metabolic acidosis. This
condition typically occurs in Type 1 diabetics when there is a profound deficiency of
insulin. The nurse must prioritize fluid resuscitation and insulin administration to stabilize
the patient.
2. A nurse is providing discharge instructions to a patient newly diagnosed with
Hypothyroidism. Which instruction regarding Levothyroxine is most accurate?
A. Take the medication with a full meal to avoid GI upset
B. Take the medication on an empty stomach in the morning
,C. Expect the medication to take effect within 24 hours
D. Stop the medication once energy levels return to normal
Answer: B
Rationale: Levothyroxine absorption is optimized when taken on an empty stomach,
usually 30 to 60 minutes before breakfast. It is a lifelong medication that should never be
discontinued abruptly without medical supervision. Patients should also be taught that it
may take several weeks to see a full therapeutic effect on their symptoms.
3. Which clinical manifestation should the nurse anticipate in a patient diagnosed with
Cushing’s Syndrome?
A. Trunkal obesity and moon face
B. Hyperpigmentation of the skin
C. Weight loss and hypotension
D. Hypoglycemia and polyuria
Answer: A
Rationale: Cushing’s Syndrome is characterized by an excess of cortisol, which leads to fat
redistribution to the face and trunk. This results in the classic ‘moon face,’ ‘buffalo hump,’
and abdominal obesity often seen in clinical practice. The nurse should also monitor for
associated symptoms like hypertension and thinning skin with purple striae.
, 4. A patient is scheduled for a subtotal thyroidectomy. Which item is most critical for the
nurse to have at the bedside postoperatively?
A. Padded tongue blade
B. Incentive spirometer
C. Tracheostomy tray
D. Heating pad
Answer: C
Rationale: Post-thyroidectomy patients are at risk for airway obstruction due to edema or
laryngeal nerve damage. Having a tracheostomy tray at the bedside is a standard safety
protocol to manage emergency respiratory distress. The nurse must also monitor for signs
of hypocalcemia, which can cause laryngospasms.
5. A patient with Addison’s Disease is being educated on preventing an Addisonian Crisis.
Which statement indicates a need for further teaching?
A. I can skip a dose of my steroid if I feel nauseated.
B. I should increase my salt intake during hot weather.
C. I will wear a medical alert bracelet at all times.
D. I need to notify my doctor if I experience high stress.
Answer: A
