PNR 201/PNR201 Exam 3 V3 | Medical-Surgical
Nursing Q&A with Rationale | Fortis College
1. A nurse is assessing a client with Type 1 Diabetes Mellitus who is experiencing Kussmaul
respirations. Which of the following conditions is the most likely cause of this breathing
pattern?
A. Metabolic Alkalosis
B. Respiratory Acidosis
C. Hyperosmolar Hyperglycemic Syndrome (HHS)
D. Diabetic Ketoacidosis (DKA)
Correct Answer: D
Explanation: Kussmaul respirations are deep, rapid breaths that occur as the body
attempts to blow off excess carbon dioxide to compensate for metabolic acidosis. This is a
hallmark clinical sign of Diabetic Ketoacidosis (DKA) in patients with Type 1 Diabetes.
Without sufficient insulin, the body breaks down fats for energy, leading to the production
of acidic ketones.
2. A patient is diagnosed with Diabetes Insipidus (DI). Which clinical manifestation should the
nurse anticipate during the assessment?
A. High urine specific gravity
B. Fluid volume overload
,C. Excessive thirst and polyuria
D. Bradycardia and hypertension
Correct Answer: C
Explanation: Diabetes Insipidus is characterized by a deficiency in Antidiuretic Hormone
(ADH), leading to the excretion of large volumes of dilute urine. The patient typically
experiences extreme thirst (polydipsia) and frequent urination (polyuria) as a result of the
inability of the kidneys to concentrate urine. Urine specific gravity in these patients is
usually very low, typically less than 1.005.
3. Which laboratory result is most indicative of a diagnosis of Hyperthyroidism?
A. Decreased T3 and T4 levels
B. Elevated Thyroid Stimulating Hormone (TSH) level
C. Low TSH and elevated T4 levels
D. Decreased Serum Calcium level
Correct Answer: C
Explanation: In primary hyperthyroidism, the thyroid gland overproduces hormones,
which sends negative feedback to the pituitary gland. This results in suppressed or low
levels of Thyroid Stimulating Hormone (TSH). Conversely, the circulating levels of T3 and
T4 will be significantly elevated in the bloodstream.
, 4. The nurse is providing education to a client prescribed Levothyroxine for hypothyroidism.
Which instruction is essential to include?
A. Take the medication on an empty stomach, 30-60 minutes before breakfast.
B. Take the medication with a full meal to avoid gastric upset.
C. Discontinue the medication once symptoms improve.
D. Take the dose at bedtime with a glass of milk.
Correct Answer: A
Explanation: Levothyroxine is best absorbed when taken on an empty stomach, ideally 30
to 60 minutes before the first meal of the day. Consuming it with food or certain minerals
like calcium can significantly decrease its absorption and efficacy. Patients must be
educated that this is a lifelong hormone replacement therapy and should not be stopped
without medical supervision.
5. A client presents with ‘moon face,’ ‘buffalo hump,’ and abdominal striae. Which endocrine
disorder does the nurse suspect?
A. Addison’s Disease
B. Cushing’s Syndrome
C. Hypoparathyroidism
D. Diabetes Mellitus
Correct Answer: B
Nursing Q&A with Rationale | Fortis College
1. A nurse is assessing a client with Type 1 Diabetes Mellitus who is experiencing Kussmaul
respirations. Which of the following conditions is the most likely cause of this breathing
pattern?
A. Metabolic Alkalosis
B. Respiratory Acidosis
C. Hyperosmolar Hyperglycemic Syndrome (HHS)
D. Diabetic Ketoacidosis (DKA)
Correct Answer: D
Explanation: Kussmaul respirations are deep, rapid breaths that occur as the body
attempts to blow off excess carbon dioxide to compensate for metabolic acidosis. This is a
hallmark clinical sign of Diabetic Ketoacidosis (DKA) in patients with Type 1 Diabetes.
Without sufficient insulin, the body breaks down fats for energy, leading to the production
of acidic ketones.
2. A patient is diagnosed with Diabetes Insipidus (DI). Which clinical manifestation should the
nurse anticipate during the assessment?
A. High urine specific gravity
B. Fluid volume overload
,C. Excessive thirst and polyuria
D. Bradycardia and hypertension
Correct Answer: C
Explanation: Diabetes Insipidus is characterized by a deficiency in Antidiuretic Hormone
(ADH), leading to the excretion of large volumes of dilute urine. The patient typically
experiences extreme thirst (polydipsia) and frequent urination (polyuria) as a result of the
inability of the kidneys to concentrate urine. Urine specific gravity in these patients is
usually very low, typically less than 1.005.
3. Which laboratory result is most indicative of a diagnosis of Hyperthyroidism?
A. Decreased T3 and T4 levels
B. Elevated Thyroid Stimulating Hormone (TSH) level
C. Low TSH and elevated T4 levels
D. Decreased Serum Calcium level
Correct Answer: C
Explanation: In primary hyperthyroidism, the thyroid gland overproduces hormones,
which sends negative feedback to the pituitary gland. This results in suppressed or low
levels of Thyroid Stimulating Hormone (TSH). Conversely, the circulating levels of T3 and
T4 will be significantly elevated in the bloodstream.
, 4. The nurse is providing education to a client prescribed Levothyroxine for hypothyroidism.
Which instruction is essential to include?
A. Take the medication on an empty stomach, 30-60 minutes before breakfast.
B. Take the medication with a full meal to avoid gastric upset.
C. Discontinue the medication once symptoms improve.
D. Take the dose at bedtime with a glass of milk.
Correct Answer: A
Explanation: Levothyroxine is best absorbed when taken on an empty stomach, ideally 30
to 60 minutes before the first meal of the day. Consuming it with food or certain minerals
like calcium can significantly decrease its absorption and efficacy. Patients must be
educated that this is a lifelong hormone replacement therapy and should not be stopped
without medical supervision.
5. A client presents with ‘moon face,’ ‘buffalo hump,’ and abdominal striae. Which endocrine
disorder does the nurse suspect?
A. Addison’s Disease
B. Cushing’s Syndrome
C. Hypoparathyroidism
D. Diabetes Mellitus
Correct Answer: B
