PNR 206/PNR206 Exam 4 V2 | Medical-Surgical
Nursing II Q&A with Rationale | Fortis College
1. A nurse is caring for a client with Addison’s disease. Which of the following skin
manifestations should the nurse expect to find during the assessment?
A. Purple striae on the abdomen
B. Bronze-like pigmentation
C. Extreme facial flushing
D. Butterfly rash across the nose
Correct Answer: B
Explanation: Addison’s disease is characterized by an increase in melanocyte-stimulating
hormone, which leads to a bronze or hyperpigmented skin tone. This occurs because the
pituitary gland overproduces ACTH in response to low cortisol levels, and ACTH shares a
precursor with melanocyte-stimulating hormone. Purple striae are more indicative of
Cushing’s syndrome rather than Addison’s.
2. A client is diagnosed with Cushing’s syndrome. Which laboratory finding should the nurse
anticipate?
A. Hypoglycemia
B. Hyponatremia
C. Hyperkalemia
,D. Hyperglycemia
Correct Answer: D
Explanation: Cushing’s syndrome involves an excess of cortisol, which promotes
gluconeogenesis and interferes with insulin action, leading to high blood glucose levels.
Clients often also experience hypernatremia and hypokalemia due to the mineralocorticoid
effects of excess cortisol. Monitoring blood sugar is a priority nursing intervention for these
patients.
3. A client with Type 1 Diabetes Mellitus presents with Kussmaul respirations and a fruity
breath odor. The nurse should identify these as signs of which condition?
A. Hyperosmolar Hyperglycemic State (HHS)
B. Hypoglycemic Reaction
C. Diabetes Insipidus
D. Diabetic Ketoacidosis (DKA)
Correct Answer: D
Explanation: Kussmaul respirations and fruity breath are classic signs of Diabetic
Ketoacidosis (DKA) caused by the buildup of ketones in the blood. The body attempts to
blow off excess carbon dioxide to compensate for the metabolic acidosis. This condition is a
medical emergency that requires rapid fluid resuscitation and intravenous insulin therapy.
, 4. Which clinical manifestation should a nurse expect to find in a client with Diabetes
Insipidus?
A. Excessive thirst and large volumes of dilute urine
B. Fluid volume excess
C. High urine specific gravity
D. Peripheral edema
Correct Answer: A
Explanation: Diabetes Insipidus is caused by a deficiency of Antidiuretic Hormone (ADH),
leading to the excretion of massive amounts of very dilute urine. This excessive water loss
results in polyuria and intense polydipsia as the body tries to maintain hydration. The
urine specific gravity is typically very low, usually below 1.005.
5. A nurse is teaching a client about a scheduled radioactive iodine uptake (RAIU) test. Which
statement indicates the client understands the procedure?
A. I will need to be isolated for 24 hours after the test.
B. I must avoid all liquids for 12 hours after taking the capsule.
C. I should stop taking my thyroid medications several days before the test.
D. The test will tell me if I have a bacterial infection in my thyroid.
Correct Answer: C
Nursing II Q&A with Rationale | Fortis College
1. A nurse is caring for a client with Addison’s disease. Which of the following skin
manifestations should the nurse expect to find during the assessment?
A. Purple striae on the abdomen
B. Bronze-like pigmentation
C. Extreme facial flushing
D. Butterfly rash across the nose
Correct Answer: B
Explanation: Addison’s disease is characterized by an increase in melanocyte-stimulating
hormone, which leads to a bronze or hyperpigmented skin tone. This occurs because the
pituitary gland overproduces ACTH in response to low cortisol levels, and ACTH shares a
precursor with melanocyte-stimulating hormone. Purple striae are more indicative of
Cushing’s syndrome rather than Addison’s.
2. A client is diagnosed with Cushing’s syndrome. Which laboratory finding should the nurse
anticipate?
A. Hypoglycemia
B. Hyponatremia
C. Hyperkalemia
,D. Hyperglycemia
Correct Answer: D
Explanation: Cushing’s syndrome involves an excess of cortisol, which promotes
gluconeogenesis and interferes with insulin action, leading to high blood glucose levels.
Clients often also experience hypernatremia and hypokalemia due to the mineralocorticoid
effects of excess cortisol. Monitoring blood sugar is a priority nursing intervention for these
patients.
3. A client with Type 1 Diabetes Mellitus presents with Kussmaul respirations and a fruity
breath odor. The nurse should identify these as signs of which condition?
A. Hyperosmolar Hyperglycemic State (HHS)
B. Hypoglycemic Reaction
C. Diabetes Insipidus
D. Diabetic Ketoacidosis (DKA)
Correct Answer: D
Explanation: Kussmaul respirations and fruity breath are classic signs of Diabetic
Ketoacidosis (DKA) caused by the buildup of ketones in the blood. The body attempts to
blow off excess carbon dioxide to compensate for the metabolic acidosis. This condition is a
medical emergency that requires rapid fluid resuscitation and intravenous insulin therapy.
, 4. Which clinical manifestation should a nurse expect to find in a client with Diabetes
Insipidus?
A. Excessive thirst and large volumes of dilute urine
B. Fluid volume excess
C. High urine specific gravity
D. Peripheral edema
Correct Answer: A
Explanation: Diabetes Insipidus is caused by a deficiency of Antidiuretic Hormone (ADH),
leading to the excretion of massive amounts of very dilute urine. This excessive water loss
results in polyuria and intense polydipsia as the body tries to maintain hydration. The
urine specific gravity is typically very low, usually below 1.005.
5. A nurse is teaching a client about a scheduled radioactive iodine uptake (RAIU) test. Which
statement indicates the client understands the procedure?
A. I will need to be isolated for 24 hours after the test.
B. I must avoid all liquids for 12 hours after taking the capsule.
C. I should stop taking my thyroid medications several days before the test.
D. The test will tell me if I have a bacterial infection in my thyroid.
Correct Answer: C
