NU 189 Medical-Surgical Nursing II Exam 2 v2
Questions with Correct Answers and Expert
Explanation for Each Question
1. A nurse is caring for a client with Diabetes Insipidus (DI). Which clinical
manifestation should the nurse expect to find?
A. High urine specific gravity
B. Excessive thirst and polyuria
C. Fluid volume overload
D. Serum hyponatremia
Correct Answer: B
Expert Explanation: Diabetes Insipidus is characterized by a deficiency of ADH,
leading to the excretion of large amounts of dilute urine. Clients often experience
extreme thirst (polydipsia) and outputting 5 to 20 liters of urine per day. The nurse
would also observe a low urine specific gravity and increased serum osmolality.
2. Which medication should the nurse anticipate administering to a client diagnosed
with SIADH?
A. Furosemide
B. Desmopressin
C. Vasopressin
,D. Synthetic ADH
Correct Answer: A
Expert Explanation: SIADH involves excessive ADH, which causes water retention
and dilutional hyponatremia. Furosemide is a loop diuretic used to promote the
excretion of excess water if the sodium level is at least 125 mEq/L. Treatments like
Vasopressin or Desmopressin would worsen the condition because they mimic ADH.
3. A client is admitted with a suspected Addisonian Crisis. Which of the following
provider orders should the nurse prioritize?
A. Teaching the client about long-term steroid use
B. Administering oral fludrocortisone
C. Obtaining a 24-hour urine collection for cortisol
D. Starting an IV infusion of normal saline and hydrocortisone
Correct Answer: D
Expert Explanation: Addisonian crisis is a life-threatening emergency caused by a
sudden drop in adrenocortical hormones. Immediate management requires rapid
fluid replacement with 0.9% saline and high-dose IV corticosteroids to prevent
circulatory collapse. Oral medications are not appropriate during the acute, unstable
phase.
,4. A nurse is assessing a client with Cushing’s Syndrome. Which physical finding is
most characteristic of this condition?
A. Weight loss and hyperpigmentation
B. Thin, frail appearance with hypotension
C. Trunkal obesity and moon face
D. Tachycardia and exophthalmos
Correct Answer: C
Expert Explanation: Cushing’s Syndrome is caused by an excess of corticosteroids,
specifically glucocorticoids. Common signs include central obesity, a rounded ‘moon’
face, and a ‘buffalo hump’ on the upper back. Hyperpigmentation and weight loss
are actually signs of Addison’s disease, which is the opposite condition.
5. Following a thyroidectomy, a client develops tingling in the fingers and around the
mouth. Which action should the nurse take first?
A. Check the client’s potassium level
B. Assess for Chvostek’s or Trousseau’s sign
C. Administer a dose of levothyroxine
D. Apply a warm compress to the neck
Correct Answer: B
, Expert Explanation: Tingling around the mouth (circumoral paresthesia) and in
the extremities are early signs of hypocalcemia, which can occur if the parathyroid
glands are accidentally damaged or removed during a thyroidectomy. The nurse
should assess for neuromuscular irritability using Chvostek’s or Trousseau’s sign. If
positive, the nurse must prepare to administer IV calcium gluconate.
6. A client has a serum potassium level of 6.8 mEq/L and is showing peaked T-waves
on the EKG. Which medication is given to protect the heart from dysrhythmias?
A. Calcium Gluconate
B. Insulin with Dextrose
C. Sodium polystyrene sulfonate
D. Albuterol nebulizer
Correct Answer: A
Expert Explanation: While several medications help lower potassium, IV calcium
gluconate is administered specifically to stabilize the cardiac cell membrane and
prevent life-threatening dysrhythmias. Sodium polystyrene sulfonate removes
potassium from the body but takes time to work. Insulin and dextrose shift
potassium into the cells but do not provide immediate cardiac protection.
Questions with Correct Answers and Expert
Explanation for Each Question
1. A nurse is caring for a client with Diabetes Insipidus (DI). Which clinical
manifestation should the nurse expect to find?
A. High urine specific gravity
B. Excessive thirst and polyuria
C. Fluid volume overload
D. Serum hyponatremia
Correct Answer: B
Expert Explanation: Diabetes Insipidus is characterized by a deficiency of ADH,
leading to the excretion of large amounts of dilute urine. Clients often experience
extreme thirst (polydipsia) and outputting 5 to 20 liters of urine per day. The nurse
would also observe a low urine specific gravity and increased serum osmolality.
2. Which medication should the nurse anticipate administering to a client diagnosed
with SIADH?
A. Furosemide
B. Desmopressin
C. Vasopressin
,D. Synthetic ADH
Correct Answer: A
Expert Explanation: SIADH involves excessive ADH, which causes water retention
and dilutional hyponatremia. Furosemide is a loop diuretic used to promote the
excretion of excess water if the sodium level is at least 125 mEq/L. Treatments like
Vasopressin or Desmopressin would worsen the condition because they mimic ADH.
3. A client is admitted with a suspected Addisonian Crisis. Which of the following
provider orders should the nurse prioritize?
A. Teaching the client about long-term steroid use
B. Administering oral fludrocortisone
C. Obtaining a 24-hour urine collection for cortisol
D. Starting an IV infusion of normal saline and hydrocortisone
Correct Answer: D
Expert Explanation: Addisonian crisis is a life-threatening emergency caused by a
sudden drop in adrenocortical hormones. Immediate management requires rapid
fluid replacement with 0.9% saline and high-dose IV corticosteroids to prevent
circulatory collapse. Oral medications are not appropriate during the acute, unstable
phase.
,4. A nurse is assessing a client with Cushing’s Syndrome. Which physical finding is
most characteristic of this condition?
A. Weight loss and hyperpigmentation
B. Thin, frail appearance with hypotension
C. Trunkal obesity and moon face
D. Tachycardia and exophthalmos
Correct Answer: C
Expert Explanation: Cushing’s Syndrome is caused by an excess of corticosteroids,
specifically glucocorticoids. Common signs include central obesity, a rounded ‘moon’
face, and a ‘buffalo hump’ on the upper back. Hyperpigmentation and weight loss
are actually signs of Addison’s disease, which is the opposite condition.
5. Following a thyroidectomy, a client develops tingling in the fingers and around the
mouth. Which action should the nurse take first?
A. Check the client’s potassium level
B. Assess for Chvostek’s or Trousseau’s sign
C. Administer a dose of levothyroxine
D. Apply a warm compress to the neck
Correct Answer: B
, Expert Explanation: Tingling around the mouth (circumoral paresthesia) and in
the extremities are early signs of hypocalcemia, which can occur if the parathyroid
glands are accidentally damaged or removed during a thyroidectomy. The nurse
should assess for neuromuscular irritability using Chvostek’s or Trousseau’s sign. If
positive, the nurse must prepare to administer IV calcium gluconate.
6. A client has a serum potassium level of 6.8 mEq/L and is showing peaked T-waves
on the EKG. Which medication is given to protect the heart from dysrhythmias?
A. Calcium Gluconate
B. Insulin with Dextrose
C. Sodium polystyrene sulfonate
D. Albuterol nebulizer
Correct Answer: A
Expert Explanation: While several medications help lower potassium, IV calcium
gluconate is administered specifically to stabilize the cardiac cell membrane and
prevent life-threatening dysrhythmias. Sodium polystyrene sulfonate removes
potassium from the body but takes time to work. Insulin and dextrose shift
potassium into the cells but do not provide immediate cardiac protection.
