NURS 120 | NURS120 Exam 3: Med Surg 1 - WCU
Updated and Latest Questions and Correct
Answers with Rationale
1. A nurse is providing dietary teaching to a client diagnosed with Gastroesophageal Reflux
Disease (GERD). Which food choice by the client indicates an understanding of the
instructions?
A. Chocolate pudding
B. Peppermint tea
C. Baked chicken breast
D. Tomato-based pasta sauce
Correct Answer: C
Rationale: GERD management focuses on avoiding foods that relax the lower esophageal
sphincter. Fatty meats, chocolate, caffeine, and peppermint should be strictly limited to
prevent reflux symptoms. Baked chicken is a lean protein that is generally well-tolerated by
patients with this condition. Tomato products are acidic and can exacerbate esophageal
irritation and heartburn. Following a low-fat diet is a key component of effective long-term
GERD management.
2. A client with Type 1 Diabetes Mellitus is found sweaty, shaky, and complaining of a
headache. What should be the nurse’s first action?
A. Administer 15g of simple carbohydrates
B. Call the healthcare provider immediately
C. Administer the scheduled dose of insulin
D. Check the client’s blood glucose level
Correct Answer: D
Rationale: The client is exhibiting classic symptoms of hypoglycemia which require
immediate assessment. Checking the blood glucose level is the priority to confirm the
condition before intervention. If the blood sugar is low, the nurse should then provide a
simple carbohydrate source. Administering insulin would worsen the situation by further
lowering the blood sugar. Quick assessment and action are vital to prevent neurological
damage from severe hypoglycemia.
3. The nurse is caring for a client with a history of renal calculi who is experiencing severe
flank pain. Which nursing intervention is the priority?
A. Administering prescribed analgesic medication
,B. Encouraging oral fluid intake
C. Straining all urine for stones
D. Assisting the client with ambulation
Correct Answer: A
Rationale: Pain management is the primary concern for a client currently experiencing
renal colic from a stone. Severe pain can cause significant physiological stress and should
be addressed before other tasks. Once pain is controlled, the nurse can focus on hydration
to help pass the stone. Straining urine is important for diagnostic purposes but does not
take precedence over pain relief. Ambulation may help the stone move but is secondary to
immediate comfort measures.
4. A nurse is assessing a client for signs of Cushing’s Syndrome. Which physical finding is
consistent with this diagnosis?
A. Buffalo hump and moon face
B. Weight loss and hypotension
C. Hyperpigmentation of the skin
D. Exophthalmos and tremors
Correct Answer: A
Rationale: Cushing’s Syndrome results from an excess of cortisol in the body’s system.
Characteristic findings include a moon face, buffalo hump, and truncal obesity with thin
extremities. These symptoms are caused by the redistribution of fat and protein wasting. In
contrast, Addison’s disease typically presents with hyperpigmentation and weight loss.
Monitoring for fluid retention and hypertension is also a critical part of nursing care for
these clients.
5. Which laboratory value should the nurse monitor most closely for a client receiving
parenteral nutrition (PN)?
A. Blood glucose levels
B. Serum creatinine
C. Hemoglobin and hematocrit
D. Prothrombin time
Correct Answer: A
Rationale: Parenteral nutrition contains a high concentration of dextrose which increases
the risk of hyperglycemia. Regular blood glucose monitoring is required to ensure the
client is tolerating the glucose load. Serum creatinine monitors renal function but is not the
primary concern with PN administration. Hemoglobin levels are monitored for anemia but
, are not directly affected by PN components. Frequent monitoring allows for timely
adjustments in insulin or the PN formula composition.
6. A client is diagnosed with Acute Kidney Injury (AKI) and is in the oliguric phase. Which
finding should the nurse expect?
A. Urinary output of 2,000 mL/day
B. Metabolic alkalosis
C. Decreased blood urea nitrogen (BUN)
D. Increased serum potassium levels
Correct Answer: D
Rationale: The oliguric phase of AKI is characterized by a significant decrease in urine
output. During this phase, the kidneys are unable to excrete potassium, leading to
hyperkalemia. BUN and creatinine levels typically rise rather than fall during this period of
dysfunction. Metabolic acidosis usually occurs due to the failure to excrete hydrogen ions
and reabsorb bicarbonate. Constant cardiac monitoring is necessary due to the risk of
arrhythmias from elevated potassium.
7. A nurse is teaching a client about the prevention of urinary tract infections (UTIs). Which
instruction is most appropriate?
A. Limit fluid intake to reduce the urge to void
B. Wipe from back to front after bowel movements
C. Void immediately following sexual intercourse
D. Wear nylon underwear to keep the area dry
Correct Answer: C
Rationale: Voiding after intercourse helps flush bacteria out of the urethra that may have
entered during activity. Clients should be encouraged to increase fluid intake to ensure
frequent flushing of the bladder. Wiping should always be done from front to back to
prevent E. coli contamination. Cotton underwear is preferred over nylon to allow for better
airflow and moisture control. These simple lifestyle changes can significantly decrease the
frequency of recurrent urinary infections.
8. Which medication is commonly prescribed to treat hyperthyroidism by inhibiting the
synthesis of thyroid hormones?
A. Propylthiouracil (PTU)
B. Levothyroxine
C. Hydrocortisone
D. Desmopressin
Updated and Latest Questions and Correct
Answers with Rationale
1. A nurse is providing dietary teaching to a client diagnosed with Gastroesophageal Reflux
Disease (GERD). Which food choice by the client indicates an understanding of the
instructions?
A. Chocolate pudding
B. Peppermint tea
C. Baked chicken breast
D. Tomato-based pasta sauce
Correct Answer: C
Rationale: GERD management focuses on avoiding foods that relax the lower esophageal
sphincter. Fatty meats, chocolate, caffeine, and peppermint should be strictly limited to
prevent reflux symptoms. Baked chicken is a lean protein that is generally well-tolerated by
patients with this condition. Tomato products are acidic and can exacerbate esophageal
irritation and heartburn. Following a low-fat diet is a key component of effective long-term
GERD management.
2. A client with Type 1 Diabetes Mellitus is found sweaty, shaky, and complaining of a
headache. What should be the nurse’s first action?
A. Administer 15g of simple carbohydrates
B. Call the healthcare provider immediately
C. Administer the scheduled dose of insulin
D. Check the client’s blood glucose level
Correct Answer: D
Rationale: The client is exhibiting classic symptoms of hypoglycemia which require
immediate assessment. Checking the blood glucose level is the priority to confirm the
condition before intervention. If the blood sugar is low, the nurse should then provide a
simple carbohydrate source. Administering insulin would worsen the situation by further
lowering the blood sugar. Quick assessment and action are vital to prevent neurological
damage from severe hypoglycemia.
3. The nurse is caring for a client with a history of renal calculi who is experiencing severe
flank pain. Which nursing intervention is the priority?
A. Administering prescribed analgesic medication
,B. Encouraging oral fluid intake
C. Straining all urine for stones
D. Assisting the client with ambulation
Correct Answer: A
Rationale: Pain management is the primary concern for a client currently experiencing
renal colic from a stone. Severe pain can cause significant physiological stress and should
be addressed before other tasks. Once pain is controlled, the nurse can focus on hydration
to help pass the stone. Straining urine is important for diagnostic purposes but does not
take precedence over pain relief. Ambulation may help the stone move but is secondary to
immediate comfort measures.
4. A nurse is assessing a client for signs of Cushing’s Syndrome. Which physical finding is
consistent with this diagnosis?
A. Buffalo hump and moon face
B. Weight loss and hypotension
C. Hyperpigmentation of the skin
D. Exophthalmos and tremors
Correct Answer: A
Rationale: Cushing’s Syndrome results from an excess of cortisol in the body’s system.
Characteristic findings include a moon face, buffalo hump, and truncal obesity with thin
extremities. These symptoms are caused by the redistribution of fat and protein wasting. In
contrast, Addison’s disease typically presents with hyperpigmentation and weight loss.
Monitoring for fluid retention and hypertension is also a critical part of nursing care for
these clients.
5. Which laboratory value should the nurse monitor most closely for a client receiving
parenteral nutrition (PN)?
A. Blood glucose levels
B. Serum creatinine
C. Hemoglobin and hematocrit
D. Prothrombin time
Correct Answer: A
Rationale: Parenteral nutrition contains a high concentration of dextrose which increases
the risk of hyperglycemia. Regular blood glucose monitoring is required to ensure the
client is tolerating the glucose load. Serum creatinine monitors renal function but is not the
primary concern with PN administration. Hemoglobin levels are monitored for anemia but
, are not directly affected by PN components. Frequent monitoring allows for timely
adjustments in insulin or the PN formula composition.
6. A client is diagnosed with Acute Kidney Injury (AKI) and is in the oliguric phase. Which
finding should the nurse expect?
A. Urinary output of 2,000 mL/day
B. Metabolic alkalosis
C. Decreased blood urea nitrogen (BUN)
D. Increased serum potassium levels
Correct Answer: D
Rationale: The oliguric phase of AKI is characterized by a significant decrease in urine
output. During this phase, the kidneys are unable to excrete potassium, leading to
hyperkalemia. BUN and creatinine levels typically rise rather than fall during this period of
dysfunction. Metabolic acidosis usually occurs due to the failure to excrete hydrogen ions
and reabsorb bicarbonate. Constant cardiac monitoring is necessary due to the risk of
arrhythmias from elevated potassium.
7. A nurse is teaching a client about the prevention of urinary tract infections (UTIs). Which
instruction is most appropriate?
A. Limit fluid intake to reduce the urge to void
B. Wipe from back to front after bowel movements
C. Void immediately following sexual intercourse
D. Wear nylon underwear to keep the area dry
Correct Answer: C
Rationale: Voiding after intercourse helps flush bacteria out of the urethra that may have
entered during activity. Clients should be encouraged to increase fluid intake to ensure
frequent flushing of the bladder. Wiping should always be done from front to back to
prevent E. coli contamination. Cotton underwear is preferred over nylon to allow for better
airflow and moisture control. These simple lifestyle changes can significantly decrease the
frequency of recurrent urinary infections.
8. Which medication is commonly prescribed to treat hyperthyroidism by inhibiting the
synthesis of thyroid hormones?
A. Propylthiouracil (PTU)
B. Levothyroxine
C. Hydrocortisone
D. Desmopressin
