NUR 3300 Exam 4 V2 | NUR 3300 Nursing
Practice II | Q&A with Rationale (NUR3300
Exam 4) | William Paterson University
1. A nurse is caring for a client with type 1 diabetes mellitus who is reporting feeling shaky
and diaphoretic. Which action should the nurse take first?
A. Check the client’s blood glucose level.
B. Administer 15 grams of rapid-acting carbohydrates.
C. Call the healthcare provider immediately.
D. Give the client’s scheduled dose of insulin.
Answer: A
Rationale: The first action the nurse should take is to confirm the blood glucose level to
determine the severity of hypoglycemia. This assessment allows the nurse to choose the
appropriate intervention based on the institutional protocol. Once the level is confirmed,
providing glucose-rich food or liquid would be the next clinical priority.
2. A client is diagnosed with Cushing’s syndrome. Which of the following assessment findings
should the nurse expect to observe?
A. Truncal obesity and a buffalo hump.
B. Hyperpigmentation of the skin.
C. Hypotension and weight loss.
,D. Low blood glucose levels.
Answer: A
Rationale: Cushing’s syndrome is characterized by an overproduction of cortisol, which
leads to fat redistribution. This results in clinical manifestations such as truncal obesity, a
rounded ‘moon face,’ and a ‘buffalo hump’ on the upper back. The nurse should also
monitor for secondary issues like hypertension and hyperglycemia related to excessive
glucocorticoids.
3. The nurse is providing discharge instructions to a client who had a subtotal thyroidectomy.
Which symptom should the nurse instruct the client to report immediately?
A. Occasional hoarseness when speaking.
B. Mild pain at the incision site.
C. Tingling around the mouth or in the fingertips.
D. Fatigue and a need for more rest.
Answer: C
Rationale: Tingling around the mouth (circumoral paresthesia) or in the fingers is a sign of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy. This is a medical emergency because low calcium can
lead to tetany and respiratory distress. The nurse must educate the client on identifying
these signs of neuromuscular irritability early.
, 4. A client with Addison’s disease is admitted to the hospital with a suspected Addisonian
crisis. Which laboratory result should the nurse anticipate?
A. Serum potassium of 5.8 mEq/L.
B. Serum sodium of 150 mEq/L.
C. Blood glucose of 180 mg/dL.
D. Serum calcium of 8.2 mg/dL.
Answer: A
Rationale: In Addisonian crisis, the lack of aldosterone leads to the excretion of sodium
and the retention of potassium. Consequently, the nurse should expect to see hyperkalemia
and hyponatremia in the lab results. Immediate treatment with IV fluids and high-dose
steroids is necessary to stabilize the patient’s cardiovascular status.
5. Which clinical manifestation should the nurse expect in a client diagnosed with Diabetes
Insipidus?
A. Low urine output and high specific gravity.
B. Peripheral edema and weight gain.
C. High serum sodium and fluid volume overload.
D. High urine output and low specific gravity.
Answer: D
Practice II | Q&A with Rationale (NUR3300
Exam 4) | William Paterson University
1. A nurse is caring for a client with type 1 diabetes mellitus who is reporting feeling shaky
and diaphoretic. Which action should the nurse take first?
A. Check the client’s blood glucose level.
B. Administer 15 grams of rapid-acting carbohydrates.
C. Call the healthcare provider immediately.
D. Give the client’s scheduled dose of insulin.
Answer: A
Rationale: The first action the nurse should take is to confirm the blood glucose level to
determine the severity of hypoglycemia. This assessment allows the nurse to choose the
appropriate intervention based on the institutional protocol. Once the level is confirmed,
providing glucose-rich food or liquid would be the next clinical priority.
2. A client is diagnosed with Cushing’s syndrome. Which of the following assessment findings
should the nurse expect to observe?
A. Truncal obesity and a buffalo hump.
B. Hyperpigmentation of the skin.
C. Hypotension and weight loss.
,D. Low blood glucose levels.
Answer: A
Rationale: Cushing’s syndrome is characterized by an overproduction of cortisol, which
leads to fat redistribution. This results in clinical manifestations such as truncal obesity, a
rounded ‘moon face,’ and a ‘buffalo hump’ on the upper back. The nurse should also
monitor for secondary issues like hypertension and hyperglycemia related to excessive
glucocorticoids.
3. The nurse is providing discharge instructions to a client who had a subtotal thyroidectomy.
Which symptom should the nurse instruct the client to report immediately?
A. Occasional hoarseness when speaking.
B. Mild pain at the incision site.
C. Tingling around the mouth or in the fingertips.
D. Fatigue and a need for more rest.
Answer: C
Rationale: Tingling around the mouth (circumoral paresthesia) or in the fingers is a sign of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy. This is a medical emergency because low calcium can
lead to tetany and respiratory distress. The nurse must educate the client on identifying
these signs of neuromuscular irritability early.
, 4. A client with Addison’s disease is admitted to the hospital with a suspected Addisonian
crisis. Which laboratory result should the nurse anticipate?
A. Serum potassium of 5.8 mEq/L.
B. Serum sodium of 150 mEq/L.
C. Blood glucose of 180 mg/dL.
D. Serum calcium of 8.2 mg/dL.
Answer: A
Rationale: In Addisonian crisis, the lack of aldosterone leads to the excretion of sodium
and the retention of potassium. Consequently, the nurse should expect to see hyperkalemia
and hyponatremia in the lab results. Immediate treatment with IV fluids and high-dose
steroids is necessary to stabilize the patient’s cardiovascular status.
5. Which clinical manifestation should the nurse expect in a client diagnosed with Diabetes
Insipidus?
A. Low urine output and high specific gravity.
B. Peripheral edema and weight gain.
C. High serum sodium and fluid volume overload.
D. High urine output and low specific gravity.
Answer: D
