PNR 206/PNR206 Exam 4 V2 | Medical-
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is reviewing the glycosylated hemoglobin (HbA1c) level of a client with type 2
diabetes mellitus. Which of the following values indicates the client’s blood glucose has been
well-managed over the past three months?
A. 6.0%
B. 8.5%
C. 10.2%
D. 12.0%
Answer: A
Rationale: The HbA1c test measures the average blood glucose levels over the preceding 2
to 3 months. A value below 7% is typically the goal for most non-pregnant adults with
diabetes to reduce the risk of complications. A level of 6% indicates excellent glycemic
control and suggests that the client’s current treatment plan is effective.
2. When teaching a client with type 1 diabetes about foot care, which instruction should the
nurse include?
A. Soak feet daily in hot water to improve circulation.
B. Apply moisturizing lotion between the toes.
,C. Walk barefoot indoors to allow the skin to breathe.
D. Inspect feet daily for redness, blisters, or cuts.
Answer: D
Rationale: Clients with diabetes often suffer from neuropathy, which reduces sensation
and makes them prone to unnoticed injuries. Daily inspection is vital to identify early signs
of skin breakdown and prevent serious infections or ulcers. Patients should avoid soaking
feet, applying lotion between toes, or walking barefoot as these actions increase the risk of
maceration and injury.
3. A client is prescribed levothyroxine for hypothyroidism. At which time should the nurse
instruct the client to take this medication?
A. Immediately after lunch.
B. At bedtime with a snack.
C. In the morning on an empty stomach.
D. With the largest meal of the day.
Answer: C
Rationale: Levothyroxine absorption is most effective when taken on an empty stomach,
ideally 30 to 60 minutes before breakfast. Food and certain supplements, like calcium or
iron, can significantly interfere with the absorption of the hormone. Consistent timing is
essential to maintain therapeutic blood levels and manage hypothyroid symptoms
effectively.
, 4. The nurse is assessing a client for Chvostek’s sign following a subtotal thyroidectomy.
Which finding indicates a positive response?
A. Carpal spasm when a blood pressure cuff is inflated.
B. Numbness and tingling in the extremities.
C. Facial twitching when the facial nerve is tapped.
D. Hyperactive deep tendon reflexes.
Answer: C
Rationale: Chvostek’s sign is an assessment for hypocalcemia, which can occur if the
parathyroid glands are accidentally damaged or removed during a thyroidectomy. A
positive sign is characterized by a twitching of the facial muscles following a light tap over
the facial nerve just anterior to the ear. This neuromuscular irritability indicates that the
client’s calcium levels may be dangerously low.
5. Which clinical manifestation should the nurse expect to observe in a client diagnosed with
Cushing’s syndrome?
A. Moon face and buffalo hump.
B. Bronze skin pigmentation.
C. Weight loss and hypotension.
D. Thin, lean extremities with high muscle mass.
Answer: A
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is reviewing the glycosylated hemoglobin (HbA1c) level of a client with type 2
diabetes mellitus. Which of the following values indicates the client’s blood glucose has been
well-managed over the past three months?
A. 6.0%
B. 8.5%
C. 10.2%
D. 12.0%
Answer: A
Rationale: The HbA1c test measures the average blood glucose levels over the preceding 2
to 3 months. A value below 7% is typically the goal for most non-pregnant adults with
diabetes to reduce the risk of complications. A level of 6% indicates excellent glycemic
control and suggests that the client’s current treatment plan is effective.
2. When teaching a client with type 1 diabetes about foot care, which instruction should the
nurse include?
A. Soak feet daily in hot water to improve circulation.
B. Apply moisturizing lotion between the toes.
,C. Walk barefoot indoors to allow the skin to breathe.
D. Inspect feet daily for redness, blisters, or cuts.
Answer: D
Rationale: Clients with diabetes often suffer from neuropathy, which reduces sensation
and makes them prone to unnoticed injuries. Daily inspection is vital to identify early signs
of skin breakdown and prevent serious infections or ulcers. Patients should avoid soaking
feet, applying lotion between toes, or walking barefoot as these actions increase the risk of
maceration and injury.
3. A client is prescribed levothyroxine for hypothyroidism. At which time should the nurse
instruct the client to take this medication?
A. Immediately after lunch.
B. At bedtime with a snack.
C. In the morning on an empty stomach.
D. With the largest meal of the day.
Answer: C
Rationale: Levothyroxine absorption is most effective when taken on an empty stomach,
ideally 30 to 60 minutes before breakfast. Food and certain supplements, like calcium or
iron, can significantly interfere with the absorption of the hormone. Consistent timing is
essential to maintain therapeutic blood levels and manage hypothyroid symptoms
effectively.
, 4. The nurse is assessing a client for Chvostek’s sign following a subtotal thyroidectomy.
Which finding indicates a positive response?
A. Carpal spasm when a blood pressure cuff is inflated.
B. Numbness and tingling in the extremities.
C. Facial twitching when the facial nerve is tapped.
D. Hyperactive deep tendon reflexes.
Answer: C
Rationale: Chvostek’s sign is an assessment for hypocalcemia, which can occur if the
parathyroid glands are accidentally damaged or removed during a thyroidectomy. A
positive sign is characterized by a twitching of the facial muscles following a light tap over
the facial nerve just anterior to the ear. This neuromuscular irritability indicates that the
client’s calcium levels may be dangerously low.
5. Which clinical manifestation should the nurse expect to observe in a client diagnosed with
Cushing’s syndrome?
A. Moon face and buffalo hump.
B. Bronze skin pigmentation.
C. Weight loss and hypotension.
D. Thin, lean extremities with high muscle mass.
Answer: A
