Galen College NU 185 Exam 4 (pdf) | 2026/2027 | Med-Surg II Q&A |
Medical-Surgical Nursing
1. A client is admitted for removal of a goiter. Which nursing intervention
should receive priority during the postoperative period?
A) Monitoring the client's blood pressure every 15 minutes
B) Assessing the client's airway for patency and signs of respiratory distress
C) Administering prescribed pain medication
D) Encouraging the client to cough and deep breathe
Correct Answer: Assessing the client's airway for patency and signs of
respiratory distress
Rationale: Airway assessment is the priority after thyroid surgery due to the
risk of edema, hematoma, or laryngeal nerve damage causing airway
compromise. While blood pressure monitoring, pain management, and
respiratory exercises are important, maintaining a patent airway takes
precedence in the immediate postoperative period.
2. A client with Addison's disease will most likely exhibit which symptom?
A) Weight gain and edema
B) Bronze pigmentation of the skin
C) Truncal obesity and moon face
D) Hypertension and tachycardia
Correct Answer: Bronze pigmentation of the skin
Rationale: Bronze or hyperpigmentation of the skin is a classic sign of
Addison's disease (primary adrenal insufficiency) due to increased ACTH and
melanocyte-stimulating hormone. Weight gain, truncal obesity, and moon
face are characteristic of Cushing's syndrome, not Addison's disease.
,3. A client with Cushing's syndrome should be instructed to do which of the
following?
A) Increase sodium intake
B) Limit sodium in the diet
C) Increase potassium intake
D) Avoid all physical activity
Correct Answer: Limit sodium in the diet
Rationale: Cushing's syndrome causes excess cortisol, leading to sodium and
water retention, hypertension, and edema. Clients should be instructed to
limit sodium intake to help manage fluid retention and blood pressure.
Potassium supplementation may be needed due to hypokalemia.
4. The nurse is caring for a client with a suspected pituitary tumor. Which
symptom would the nurse most likely expect?
A) Alteration in visual acuity
B) Decreased appetite
C) Hypotension
D) Bradycardia
Correct Answer: Alteration in visual acuity
Rationale: Pituitary tumors often compress the optic chiasm, leading to visual
disturbances such as bitemporal hemianopsia or other visual acuity changes.
This occurs because the pituitary gland is located near the optic nerves.
,5. A client with diabetes experiences Somogyi's effect. To prevent this
complication, the nurse should instruct the client to:
A) Increase the evening insulin dose
B) Eat a protein and carbohydrate snack at bedtime
C) Skip the evening meal
D) Avoid all carbohydrates in the evening
Correct Answer: Eat a protein and carbohydrate snack at bedtime
Rationale: Somogyi's effect is rebound hyperglycemia following
hypoglycemia during the night. A bedtime snack containing protein and
carbohydrates helps prevent nocturnal hypoglycemia and subsequent
rebound hyperglycemia. This is a key teaching point for diabetic clients
experiencing this phenomenon.
6. A client with acromegaly will most likely experience which symptom?
A) Decreased bone density
B) Bone pain
C) Increased height
D) Joint laxity
Correct Answer: Bone pain
Rationale: Acromegaly is caused by excess growth hormone in adulthood,
leading to bone and soft tissue overgrowth. Bone pain is a common symptom
due to the effects of excess growth hormone on skeletal structures. Height
does not increase in adulthood as epiphyseal plates are closed.
7. A diabetic client is taking Lantus insulin for regulation of blood glucose.
The nurse should know that this insulin will most likely be administered:
, A) Before each meal
B) At night (bedtime)
C) With the morning dose
D) After meals
Correct Answer: At night (bedtime)
Rationale: Lantus (insulin glargine) is a long-acting insulin typically
administered once daily, often at bedtime, to provide a basal level of insulin
for 24 hours. It should not be mixed with other insulins and provides
consistent glucose control throughout the day and night.
8. A client with polyuria, polydipsia, and polyphagia is diagnosed with
diabetes mellitus. The nurse would expect that these symptoms are related
to:
A) Hypoglycemia
B) Hyperglycemia
C) Ketoacidosis
D) Insulin overdose
Correct Answer: Hyperglycemia
Rationale: Polyuria, polydipsia, and polyphagia are the classic "three P's" of
diabetes mellitus, resulting from hyperglycemia. Elevated blood glucose
exceeds the renal threshold, causing glucose to spill into the urine with water
(polyuria), leading to dehydration and thirst (polydipsia), and cellular
starvation triggering hunger (polyphagia).
9. Which laboratory test conducted on a client with diabetes mellitus
indicates compliance with treatment?
Medical-Surgical Nursing
1. A client is admitted for removal of a goiter. Which nursing intervention
should receive priority during the postoperative period?
A) Monitoring the client's blood pressure every 15 minutes
B) Assessing the client's airway for patency and signs of respiratory distress
C) Administering prescribed pain medication
D) Encouraging the client to cough and deep breathe
Correct Answer: Assessing the client's airway for patency and signs of
respiratory distress
Rationale: Airway assessment is the priority after thyroid surgery due to the
risk of edema, hematoma, or laryngeal nerve damage causing airway
compromise. While blood pressure monitoring, pain management, and
respiratory exercises are important, maintaining a patent airway takes
precedence in the immediate postoperative period.
2. A client with Addison's disease will most likely exhibit which symptom?
A) Weight gain and edema
B) Bronze pigmentation of the skin
C) Truncal obesity and moon face
D) Hypertension and tachycardia
Correct Answer: Bronze pigmentation of the skin
Rationale: Bronze or hyperpigmentation of the skin is a classic sign of
Addison's disease (primary adrenal insufficiency) due to increased ACTH and
melanocyte-stimulating hormone. Weight gain, truncal obesity, and moon
face are characteristic of Cushing's syndrome, not Addison's disease.
,3. A client with Cushing's syndrome should be instructed to do which of the
following?
A) Increase sodium intake
B) Limit sodium in the diet
C) Increase potassium intake
D) Avoid all physical activity
Correct Answer: Limit sodium in the diet
Rationale: Cushing's syndrome causes excess cortisol, leading to sodium and
water retention, hypertension, and edema. Clients should be instructed to
limit sodium intake to help manage fluid retention and blood pressure.
Potassium supplementation may be needed due to hypokalemia.
4. The nurse is caring for a client with a suspected pituitary tumor. Which
symptom would the nurse most likely expect?
A) Alteration in visual acuity
B) Decreased appetite
C) Hypotension
D) Bradycardia
Correct Answer: Alteration in visual acuity
Rationale: Pituitary tumors often compress the optic chiasm, leading to visual
disturbances such as bitemporal hemianopsia or other visual acuity changes.
This occurs because the pituitary gland is located near the optic nerves.
,5. A client with diabetes experiences Somogyi's effect. To prevent this
complication, the nurse should instruct the client to:
A) Increase the evening insulin dose
B) Eat a protein and carbohydrate snack at bedtime
C) Skip the evening meal
D) Avoid all carbohydrates in the evening
Correct Answer: Eat a protein and carbohydrate snack at bedtime
Rationale: Somogyi's effect is rebound hyperglycemia following
hypoglycemia during the night. A bedtime snack containing protein and
carbohydrates helps prevent nocturnal hypoglycemia and subsequent
rebound hyperglycemia. This is a key teaching point for diabetic clients
experiencing this phenomenon.
6. A client with acromegaly will most likely experience which symptom?
A) Decreased bone density
B) Bone pain
C) Increased height
D) Joint laxity
Correct Answer: Bone pain
Rationale: Acromegaly is caused by excess growth hormone in adulthood,
leading to bone and soft tissue overgrowth. Bone pain is a common symptom
due to the effects of excess growth hormone on skeletal structures. Height
does not increase in adulthood as epiphyseal plates are closed.
7. A diabetic client is taking Lantus insulin for regulation of blood glucose.
The nurse should know that this insulin will most likely be administered:
, A) Before each meal
B) At night (bedtime)
C) With the morning dose
D) After meals
Correct Answer: At night (bedtime)
Rationale: Lantus (insulin glargine) is a long-acting insulin typically
administered once daily, often at bedtime, to provide a basal level of insulin
for 24 hours. It should not be mixed with other insulins and provides
consistent glucose control throughout the day and night.
8. A client with polyuria, polydipsia, and polyphagia is diagnosed with
diabetes mellitus. The nurse would expect that these symptoms are related
to:
A) Hypoglycemia
B) Hyperglycemia
C) Ketoacidosis
D) Insulin overdose
Correct Answer: Hyperglycemia
Rationale: Polyuria, polydipsia, and polyphagia are the classic "three P's" of
diabetes mellitus, resulting from hyperglycemia. Elevated blood glucose
exceeds the renal threshold, causing glucose to spill into the urine with water
(polyuria), leading to dehydration and thirst (polydipsia), and cellular
starvation triggering hunger (polyphagia).
9. Which laboratory test conducted on a client with diabetes mellitus
indicates compliance with treatment?
