PNR 201/PNR201 Exam 4 V2 | Medical-Surgical
Nursing Q&A with Rationale | Fortis College
1. A nurse is assessing a patient with Diabetes Insipidus (DI). Which clinical finding should the
nurse anticipate during the assessment?
A. Urine specific gravity of 1.002
B. Urine specific gravity of 1.030
C. Serum sodium of 130 mEq/L
D. Fluid volume excess
Correct Answer: A
Explanation: Diabetes Insipidus is characterized by a deficiency of Antidiuretic Hormone
(ADH), which leads to the excretion of large amounts of dilute urine. A specific gravity of
1.002 is typical as the kidneys cannot concentrate urine without ADH. The nurse must
monitor for signs of severe dehydration and hypernatremia in these patients.
2. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which nursing intervention is a priority?
A. Implementing strict fluid restriction
B. Administering a bolus of IV Normal Saline
C. Increase fluid intake to 3000 mL/day
D. Encouraging the consumption of low-sodium foods
,Correct Answer: A
Explanation: SIADH involves the excessive release of ADH, causing the body to retain
water and develop dilutional hyponatremia. Restricting fluid intake is the primary
treatment to prevent further dilution of serum sodium levels. The nurse should also
monitor for neurological changes associated with hyponatremia.
3. Which physical characteristic is most indicative of Cushing’s Syndrome in a female patient?
A. Sunken eyes and dry skin
B. Bronze skin pigmentation
C. Truncal obesity and moon face
D. Weight loss and hypotension
Correct Answer: C
Explanation: Cushing’s Syndrome results from an excess of cortisol, which leads to
characteristic fat redistribution such as truncal obesity and a rounded ‘moon’ face. Other
signs include a buffalo hump and purple striae on the abdomen. The nurse should also
assess for hypertension and elevated blood glucose levels.
4. A nurse is caring for a patient with Addison’s Disease. What is a key education point
regarding medication management during times of stress?
A. Decrease the dose of corticosteroids
B. Skip doses if nausea occurs
, C. Stop the medication once symptoms improve
D. The dose of corticosteroids may need to be increased
Correct Answer: D
Explanation: In Addison’s Disease, the adrenal glands do not produce enough cortisol to
handle physical or emotional stress. Patients must be taught to increase their steroid
dosage during illness or surgery to prevent an Addisonian crisis. Stopping the medication
abruptly can lead to life-threatening adrenal insufficiency.
5. A patient in the Emergency Department presents with Kussmaul respirations, a blood
glucose of 550 mg/dL, and fruity-smelling breath. Which condition does the nurse suspect?
A. Diabetic Ketoacidosis (DKA)
B. Hypoglycemic reaction
C. Hyperglycemic Hyperosmolar State (HHS)
D. Respiratory Alkalosis
Correct Answer: A
Explanation: Kussmaul respirations and fruity breath are hallmark signs of DKA, caused
by the breakdown of fats into ketones and the resulting metabolic acidosis. DKA typically
occurs in Type 1 Diabetes and requires immediate IV insulin and fluid resuscitation. HHS,
while also involving high glucose, usually lacks significant ketosis and fruity breath.
Nursing Q&A with Rationale | Fortis College
1. A nurse is assessing a patient with Diabetes Insipidus (DI). Which clinical finding should the
nurse anticipate during the assessment?
A. Urine specific gravity of 1.002
B. Urine specific gravity of 1.030
C. Serum sodium of 130 mEq/L
D. Fluid volume excess
Correct Answer: A
Explanation: Diabetes Insipidus is characterized by a deficiency of Antidiuretic Hormone
(ADH), which leads to the excretion of large amounts of dilute urine. A specific gravity of
1.002 is typical as the kidneys cannot concentrate urine without ADH. The nurse must
monitor for signs of severe dehydration and hypernatremia in these patients.
2. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which nursing intervention is a priority?
A. Implementing strict fluid restriction
B. Administering a bolus of IV Normal Saline
C. Increase fluid intake to 3000 mL/day
D. Encouraging the consumption of low-sodium foods
,Correct Answer: A
Explanation: SIADH involves the excessive release of ADH, causing the body to retain
water and develop dilutional hyponatremia. Restricting fluid intake is the primary
treatment to prevent further dilution of serum sodium levels. The nurse should also
monitor for neurological changes associated with hyponatremia.
3. Which physical characteristic is most indicative of Cushing’s Syndrome in a female patient?
A. Sunken eyes and dry skin
B. Bronze skin pigmentation
C. Truncal obesity and moon face
D. Weight loss and hypotension
Correct Answer: C
Explanation: Cushing’s Syndrome results from an excess of cortisol, which leads to
characteristic fat redistribution such as truncal obesity and a rounded ‘moon’ face. Other
signs include a buffalo hump and purple striae on the abdomen. The nurse should also
assess for hypertension and elevated blood glucose levels.
4. A nurse is caring for a patient with Addison’s Disease. What is a key education point
regarding medication management during times of stress?
A. Decrease the dose of corticosteroids
B. Skip doses if nausea occurs
, C. Stop the medication once symptoms improve
D. The dose of corticosteroids may need to be increased
Correct Answer: D
Explanation: In Addison’s Disease, the adrenal glands do not produce enough cortisol to
handle physical or emotional stress. Patients must be taught to increase their steroid
dosage during illness or surgery to prevent an Addisonian crisis. Stopping the medication
abruptly can lead to life-threatening adrenal insufficiency.
5. A patient in the Emergency Department presents with Kussmaul respirations, a blood
glucose of 550 mg/dL, and fruity-smelling breath. Which condition does the nurse suspect?
A. Diabetic Ketoacidosis (DKA)
B. Hypoglycemic reaction
C. Hyperglycemic Hyperosmolar State (HHS)
D. Respiratory Alkalosis
Correct Answer: A
Explanation: Kussmaul respirations and fruity breath are hallmark signs of DKA, caused
by the breakdown of fats into ketones and the resulting metabolic acidosis. DKA typically
occurs in Type 1 Diabetes and requires immediate IV insulin and fluid resuscitation. HHS,
while also involving high glucose, usually lacks significant ketosis and fruity breath.
