PNR 201/PNR201 Exam 4 V3 | Medical-Surgical
Nursing Q&A with Rationale | Fortis College
1. A nurse is assessing a client with hyperthyroidism. Which of the following clinical
manifestations should the nurse expect to find?
A. Exophthalmos and tremors
B. Bradycardia and cold intolerance
C. Lethargy and weight gain
D. Constipation and dry skin
Correct Answer: A
Explanation: Exophthalmos, or bulging of the eyes, is a classic sign of Grave’s disease, a
common cause of hyperthyroidism. The increased metabolic rate also leads to fine tremors
and heat intolerance. This condition is characterized by an overactive thyroid gland
producing excessive hormones.
2. A client is diagnosed with Addison’s disease. The nurse should monitor the client for which
of the following electrolyte imbalances?
A. Hypernatremia and hypokalemia
B. Hypocalcemia and hypermagnesemia
C. Hyponatremia and hyperkalemia
D. Hypercalcemia and hypophosphatemia
,Correct Answer: C
Explanation: Addison’s disease involves adrenal insufficiency, leading to a deficiency in
aldosterone and cortisol. Aldosterone deficiency causes the kidneys to excrete sodium and
retain potassium, resulting in hyponatremia and hyperkalemia. Monitoring these levels is
critical to prevent life-threatening cardiac arrhythmias or addisonian crisis.
3. A nurse is caring for a client who is 24 hours postoperative following a subtotal
thyroidectomy. Which of the following is the priority assessment?
A. Assessing for Chvostek’s sign
B. Monitoring for laryngeal stridor
C. Inspecting the dressing for bleeding
D. Monitoring the client’s voice quality
Correct Answer: B
Explanation: Laryngeal stridor is a harsh, high-pitched sound heard on inspiration that
indicates acute airway obstruction. This is a medical emergency that can occur due to
edema or nerve damage after thyroid surgery. While bleeding and calcium levels are
important, airway patency is always the highest priority.
4. A nurse is teaching a client with Type 1 diabetes about exercise. Which instruction should
the nurse include?
A. Exercise when insulin peaks for maximum effect
B. Exercise only in the late evening
, C. Increase insulin dosage before vigorous activity
D. Avoid exercise if blood glucose is less than 100 mg/dL
Correct Answer: D
Explanation: Exercising with a low blood glucose level increases the risk of severe
hypoglycemia. Clients should consume a carbohydrate snack if their glucose is below 100
mg/dL before starting physical activity. Clients should also avoid exercise during peak
insulin times to prevent rapid glucose drops.
5. A client presents with ‘moon face,’ ‘buffalo hump,’ and truncal obesity. Which condition
does the nurse suspect?
A. Pheochromocytoma
B. Diabetes Insipidus
C. Hypoparathyroidism
D. Cushing’s Syndrome
Correct Answer: D
Explanation: Cushing’s Syndrome results from an excess of cortisol, which causes a
redistribution of fat to the face, neck, and trunk. Other symptoms include thin extremities
and purple striae on the abdomen. The nurse must assess for complications such as
hypertension and hyperglycemia associated with this disorder.
Nursing Q&A with Rationale | Fortis College
1. A nurse is assessing a client with hyperthyroidism. Which of the following clinical
manifestations should the nurse expect to find?
A. Exophthalmos and tremors
B. Bradycardia and cold intolerance
C. Lethargy and weight gain
D. Constipation and dry skin
Correct Answer: A
Explanation: Exophthalmos, or bulging of the eyes, is a classic sign of Grave’s disease, a
common cause of hyperthyroidism. The increased metabolic rate also leads to fine tremors
and heat intolerance. This condition is characterized by an overactive thyroid gland
producing excessive hormones.
2. A client is diagnosed with Addison’s disease. The nurse should monitor the client for which
of the following electrolyte imbalances?
A. Hypernatremia and hypokalemia
B. Hypocalcemia and hypermagnesemia
C. Hyponatremia and hyperkalemia
D. Hypercalcemia and hypophosphatemia
,Correct Answer: C
Explanation: Addison’s disease involves adrenal insufficiency, leading to a deficiency in
aldosterone and cortisol. Aldosterone deficiency causes the kidneys to excrete sodium and
retain potassium, resulting in hyponatremia and hyperkalemia. Monitoring these levels is
critical to prevent life-threatening cardiac arrhythmias or addisonian crisis.
3. A nurse is caring for a client who is 24 hours postoperative following a subtotal
thyroidectomy. Which of the following is the priority assessment?
A. Assessing for Chvostek’s sign
B. Monitoring for laryngeal stridor
C. Inspecting the dressing for bleeding
D. Monitoring the client’s voice quality
Correct Answer: B
Explanation: Laryngeal stridor is a harsh, high-pitched sound heard on inspiration that
indicates acute airway obstruction. This is a medical emergency that can occur due to
edema or nerve damage after thyroid surgery. While bleeding and calcium levels are
important, airway patency is always the highest priority.
4. A nurse is teaching a client with Type 1 diabetes about exercise. Which instruction should
the nurse include?
A. Exercise when insulin peaks for maximum effect
B. Exercise only in the late evening
, C. Increase insulin dosage before vigorous activity
D. Avoid exercise if blood glucose is less than 100 mg/dL
Correct Answer: D
Explanation: Exercising with a low blood glucose level increases the risk of severe
hypoglycemia. Clients should consume a carbohydrate snack if their glucose is below 100
mg/dL before starting physical activity. Clients should also avoid exercise during peak
insulin times to prevent rapid glucose drops.
5. A client presents with ‘moon face,’ ‘buffalo hump,’ and truncal obesity. Which condition
does the nurse suspect?
A. Pheochromocytoma
B. Diabetes Insipidus
C. Hypoparathyroidism
D. Cushing’s Syndrome
Correct Answer: D
Explanation: Cushing’s Syndrome results from an excess of cortisol, which causes a
redistribution of fat to the face, neck, and trunk. Other symptoms include thin extremities
and purple striae on the abdomen. The nurse must assess for complications such as
hypertension and hyperglycemia associated with this disorder.
