NUR201 | NUR201 Medical Surgical Exam 3
Version 2 Questions with Correct Answers and
Expert Explanation for Each Question
1. A patient with type 1 diabetes is found unresponsive with a blood glucose level of
42 mg/dL. Which medication should the nurse prepare to administer immediately?
A. Subcutaneous Glucagon
B. 15 grams of simple carbohydrates orally
C. Regular insulin intravenously
D. Metformin orally
Correct Answer: A
Expert Explanation: In an unresponsive patient with severe hypoglycemia, the oral
route is unsafe due to the risk of aspiration. Glucagon is the standard emergency
treatment to rapidly increase blood glucose by stimulating the liver to release
glucose. The nurse must also ensure the patient is turned on their side to prevent
aspiration if vomiting occurs. Once the patient regains consciousness and can
swallow, follow-up with complex carbohydrates is necessary. This intervention
focuses on immediate safety and stabilization of blood sugar levels.
2. Which clinical manifestation should the nurse prioritize when assessing a patient
suspected of having a Thyroid Storm?
A. Bradycardia and constipation
,B. Severe tachycardia and hyperpyrexia
C. Weight gain and lethargy
D. Hypotension and dry skin
Correct Answer: B
Expert Explanation: Thyroid storm is a life-threatening health condition that is
associated with untreated or undertreated hyperthyroidism. During this crisis, the
patient’s heart rate, blood pressure, and body temperature can soar to dangerously
high levels. Tachycardia and extreme fever are hallmark signs that require
immediate medical intervention to prevent heart failure. Management typically
involves cooling the patient and administering beta-blockers and antithyroid
medications. Identifying these symptoms early is critical for positive patient
outcomes and survival.
3. The nurse is providing education to a patient newly diagnosed with Hypothyroidism
who is starting Levothyroxine. Which instruction is most important?
A. Take the medication with a full meal to avoid GI upset
B. Expect the medication to take full effect within 24 hours
C. Take the medication on an empty stomach at the same time every morning
D. Stop the medication once your energy levels return to normal
,Correct Answer: C
Expert Explanation: Levothyroxine absorption is best when taken on an empty
stomach at least 30 to 60 minutes before breakfast. Consistency is key to
maintaining steady therapeutic blood levels of the hormone. Patients must be taught
that this is usually a lifelong replacement therapy and should not be discontinued. It
may take several weeks for the patient to notice a significant improvement in
symptoms. Educating the patient on these specifics ensures medication efficacy and
prevents complications from fluctuating hormone levels.
4. A patient with Diabetes Insipidus (DI) is receiving Desmopressin. Which finding
indicates the medication is effective?
A. Increased urine output and low urine specific gravity
B. Decreased urine output and increased urine specific gravity
C. Increased serum sodium and weight loss
D. Persistent thirst and high serum osmolality
Correct Answer: B
Expert Explanation: Diabetes Insipidus is characterized by a deficiency of ADH,
leading to massive output of dilute urine. Desmopressin acts as a synthetic
replacement for ADH, helping the kidneys reabsorb water. Effectiveness is
demonstrated by a reduction in urinary volume and a concentration of the urine,
, reflected in higher specific gravity. The nurse should monitor for signs of fluid
volume excess during treatment. Successful management results in the stabilization
of fluid and electrolyte balances within the body.
5. What is the primary pathophysiology behind Type 2 Diabetes Mellitus?
A. Absolute insulin deficiency due to autoimmune destruction of beta cells
B. Excessive glucagon production by the alpha cells
C. Insulin resistance and relative insulin deficiency
D. Increased sensitivity to insulin at the cellular level
Correct Answer: C
Expert Explanation: Type 2 Diabetes involves a combination of the body’s cells
becoming resistant to insulin and the pancreas failing to produce enough insulin to
overcome this resistance. Unlike Type 1, which is an autoimmune destruction of
insulin-producing cells, Type 2 is often linked to lifestyle factors and genetics. Over
time, the beta cells become exhausted, leading to chronically elevated blood glucose.
Initial management often focuses on diet, exercise, and oral medications to improve
sensitivity. Understanding this mechanism is vital for teaching patients about their
disease progression and treatment goals.
Version 2 Questions with Correct Answers and
Expert Explanation for Each Question
1. A patient with type 1 diabetes is found unresponsive with a blood glucose level of
42 mg/dL. Which medication should the nurse prepare to administer immediately?
A. Subcutaneous Glucagon
B. 15 grams of simple carbohydrates orally
C. Regular insulin intravenously
D. Metformin orally
Correct Answer: A
Expert Explanation: In an unresponsive patient with severe hypoglycemia, the oral
route is unsafe due to the risk of aspiration. Glucagon is the standard emergency
treatment to rapidly increase blood glucose by stimulating the liver to release
glucose. The nurse must also ensure the patient is turned on their side to prevent
aspiration if vomiting occurs. Once the patient regains consciousness and can
swallow, follow-up with complex carbohydrates is necessary. This intervention
focuses on immediate safety and stabilization of blood sugar levels.
2. Which clinical manifestation should the nurse prioritize when assessing a patient
suspected of having a Thyroid Storm?
A. Bradycardia and constipation
,B. Severe tachycardia and hyperpyrexia
C. Weight gain and lethargy
D. Hypotension and dry skin
Correct Answer: B
Expert Explanation: Thyroid storm is a life-threatening health condition that is
associated with untreated or undertreated hyperthyroidism. During this crisis, the
patient’s heart rate, blood pressure, and body temperature can soar to dangerously
high levels. Tachycardia and extreme fever are hallmark signs that require
immediate medical intervention to prevent heart failure. Management typically
involves cooling the patient and administering beta-blockers and antithyroid
medications. Identifying these symptoms early is critical for positive patient
outcomes and survival.
3. The nurse is providing education to a patient newly diagnosed with Hypothyroidism
who is starting Levothyroxine. Which instruction is most important?
A. Take the medication with a full meal to avoid GI upset
B. Expect the medication to take full effect within 24 hours
C. Take the medication on an empty stomach at the same time every morning
D. Stop the medication once your energy levels return to normal
,Correct Answer: C
Expert Explanation: Levothyroxine absorption is best when taken on an empty
stomach at least 30 to 60 minutes before breakfast. Consistency is key to
maintaining steady therapeutic blood levels of the hormone. Patients must be taught
that this is usually a lifelong replacement therapy and should not be discontinued. It
may take several weeks for the patient to notice a significant improvement in
symptoms. Educating the patient on these specifics ensures medication efficacy and
prevents complications from fluctuating hormone levels.
4. A patient with Diabetes Insipidus (DI) is receiving Desmopressin. Which finding
indicates the medication is effective?
A. Increased urine output and low urine specific gravity
B. Decreased urine output and increased urine specific gravity
C. Increased serum sodium and weight loss
D. Persistent thirst and high serum osmolality
Correct Answer: B
Expert Explanation: Diabetes Insipidus is characterized by a deficiency of ADH,
leading to massive output of dilute urine. Desmopressin acts as a synthetic
replacement for ADH, helping the kidneys reabsorb water. Effectiveness is
demonstrated by a reduction in urinary volume and a concentration of the urine,
, reflected in higher specific gravity. The nurse should monitor for signs of fluid
volume excess during treatment. Successful management results in the stabilization
of fluid and electrolyte balances within the body.
5. What is the primary pathophysiology behind Type 2 Diabetes Mellitus?
A. Absolute insulin deficiency due to autoimmune destruction of beta cells
B. Excessive glucagon production by the alpha cells
C. Insulin resistance and relative insulin deficiency
D. Increased sensitivity to insulin at the cellular level
Correct Answer: C
Expert Explanation: Type 2 Diabetes involves a combination of the body’s cells
becoming resistant to insulin and the pancreas failing to produce enough insulin to
overcome this resistance. Unlike Type 1, which is an autoimmune destruction of
insulin-producing cells, Type 2 is often linked to lifestyle factors and genetics. Over
time, the beta cells become exhausted, leading to chronically elevated blood glucose.
Initial management often focuses on diet, exercise, and oral medications to improve
sensitivity. Understanding this mechanism is vital for teaching patients about their
disease progression and treatment goals.
