NURS 201 Medical-Surgical Nursing Week 7 Quiz 2026 |WCU
1. A patient with Type 1 Diabetes Mellitus is admitted with a blood glucose of
580 mg/dL, positive ketonuria, and arterial pH of 7.25. Which intervention
should the nurse prioritize first?
A. Administering a bolus of 10 units of Regular insulin intravenously
B. Administering sodium bicarbonate to correct the metabolic acidosis
C. Starting a potassium chloride drip to prevent hypokalemia
D. Initiating intravenous infusion of 0.9% Normal Saline at 1 L/hr
Answer: D
Rationale: In Diabetic Ketoacidosis (DKA), the immediate priority is fluid resuscitation to
restore circulatory volume and renal perfusion. Insulin is started after or concurrent with
initial fluid boluses, and potassium is monitored closely as insulin will shift it into cells.
2. A nurse is caring for a patient post-thyroidectomy. The patient reports
tingling in the fingertips and around the mouth. Which assessment should the
nurse perform immediately?
A. Measure the patient’s body temperature for thyroid storm
B. Monitor the surgical dressing for signs of hemorrhage
C. Evaluate the patient’s voice for laryngeal nerve damage
D. Assess for Chvostek’s sign by tapping the facial nerve
Answer: D
Rationale: Tingling around the mouth and fingertips are early signs of hypocalcemia,
which can occur if the parathyroid glands are accidentally damaged or removed during a
thyroidectomy. Chvostek’s sign is a clinical indicator of hypocalcemia.
,3. Which clinical manifestation is most characteristic of Hyperosmolar
Hyperglycemic Syndrome (HHS) compared to Diabetic Ketoacidosis (DKA)?
A. Presence of Kussmaul respirations
B. Blood glucose levels typically exceeding 600 mg/dL
C. A fruity breath odor due to acetone production
D. Significant metabolic acidosis with a pH below 7.3
Answer: B
Rationale: HHS is characterized by extreme hyperglycemia (often >600 mg/dL) and
profound dehydration without significant ketoacidosis or Kussmaul respirations, which are
hallmarks of DKA.
4. A patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone) has
a serum sodium level of 118 mEq/L. Which nursing intervention is most critical?
A. Encouraging oral fluid intake up to 3000 mL/day
B. Providing a diet low in sodium and high in potassium
C. Administering 3% hypertonic saline as ordered with a pump
D. Initiating a rapid infusion of 0.45% normal saline
Answer: C
Rationale: Severe hyponatremia (below 120 mEq/L) in SIADH requires careful
administration of hypertonic saline to raise sodium levels slowly and prevent neurological
damage. Fluid restriction, not increased intake, is standard for SIADH.
5. Which hormone deficiency is responsible for the symptoms of Diabetes
Insipidus (DI)?
A. Insulin
B. Aldosterone
C. Antidiuretic Hormone (ADH)
D. Cortisol
Answer: C
, Rationale: Diabetes Insipidus is caused by a deficiency of Antidiuretic Hormone (ADH) or a
decreased renal response to ADH, leading to the excretion of large volumes of dilute urine.
6. A patient is diagnosed with Pheochromocytoma. Which assessment finding
should the nurse prioritize as a life-threatening complication?
A. Report of a mild headache and palpitations
B. A blood glucose level of 140 mg/dL
C. A blood pressure reading of 210/110 mmHg
D. Abdominal pain radiating to the flank
Answer: C
Rationale: Pheochromocytoma is a catecholamine-secreting tumor of the adrenal medulla
that causes severe hypertension. Hypertensive crisis is the most immediate life-threatening
risk.
7. A nurse is reviewing the lab results for a patient with Cushing’s Syndrome.
Which of the following sets of results is expected?
A. Hypoglycemia, Hyperkalemia, and Hyponatremia
B. Hypoglycemia, Hypokalemia, and Hyponatremia
C. Hyperglycemia, Hypokalemia, and Hypernatremia
D. Hyperglycemia, Hyperkalemia, and Hypernatremia
Answer: C
Rationale: Cushing’s Syndrome involves excess cortisol, which leads to hyperglycemia.
Excess mineralocorticoid activity (aldosterone-like) leads to sodium retention
(hypernatremia) and potassium excretion (hypokalemia).
1. A patient with Type 1 Diabetes Mellitus is admitted with a blood glucose of
580 mg/dL, positive ketonuria, and arterial pH of 7.25. Which intervention
should the nurse prioritize first?
A. Administering a bolus of 10 units of Regular insulin intravenously
B. Administering sodium bicarbonate to correct the metabolic acidosis
C. Starting a potassium chloride drip to prevent hypokalemia
D. Initiating intravenous infusion of 0.9% Normal Saline at 1 L/hr
Answer: D
Rationale: In Diabetic Ketoacidosis (DKA), the immediate priority is fluid resuscitation to
restore circulatory volume and renal perfusion. Insulin is started after or concurrent with
initial fluid boluses, and potassium is monitored closely as insulin will shift it into cells.
2. A nurse is caring for a patient post-thyroidectomy. The patient reports
tingling in the fingertips and around the mouth. Which assessment should the
nurse perform immediately?
A. Measure the patient’s body temperature for thyroid storm
B. Monitor the surgical dressing for signs of hemorrhage
C. Evaluate the patient’s voice for laryngeal nerve damage
D. Assess for Chvostek’s sign by tapping the facial nerve
Answer: D
Rationale: Tingling around the mouth and fingertips are early signs of hypocalcemia,
which can occur if the parathyroid glands are accidentally damaged or removed during a
thyroidectomy. Chvostek’s sign is a clinical indicator of hypocalcemia.
,3. Which clinical manifestation is most characteristic of Hyperosmolar
Hyperglycemic Syndrome (HHS) compared to Diabetic Ketoacidosis (DKA)?
A. Presence of Kussmaul respirations
B. Blood glucose levels typically exceeding 600 mg/dL
C. A fruity breath odor due to acetone production
D. Significant metabolic acidosis with a pH below 7.3
Answer: B
Rationale: HHS is characterized by extreme hyperglycemia (often >600 mg/dL) and
profound dehydration without significant ketoacidosis or Kussmaul respirations, which are
hallmarks of DKA.
4. A patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone) has
a serum sodium level of 118 mEq/L. Which nursing intervention is most critical?
A. Encouraging oral fluid intake up to 3000 mL/day
B. Providing a diet low in sodium and high in potassium
C. Administering 3% hypertonic saline as ordered with a pump
D. Initiating a rapid infusion of 0.45% normal saline
Answer: C
Rationale: Severe hyponatremia (below 120 mEq/L) in SIADH requires careful
administration of hypertonic saline to raise sodium levels slowly and prevent neurological
damage. Fluid restriction, not increased intake, is standard for SIADH.
5. Which hormone deficiency is responsible for the symptoms of Diabetes
Insipidus (DI)?
A. Insulin
B. Aldosterone
C. Antidiuretic Hormone (ADH)
D. Cortisol
Answer: C
, Rationale: Diabetes Insipidus is caused by a deficiency of Antidiuretic Hormone (ADH) or a
decreased renal response to ADH, leading to the excretion of large volumes of dilute urine.
6. A patient is diagnosed with Pheochromocytoma. Which assessment finding
should the nurse prioritize as a life-threatening complication?
A. Report of a mild headache and palpitations
B. A blood glucose level of 140 mg/dL
C. A blood pressure reading of 210/110 mmHg
D. Abdominal pain radiating to the flank
Answer: C
Rationale: Pheochromocytoma is a catecholamine-secreting tumor of the adrenal medulla
that causes severe hypertension. Hypertensive crisis is the most immediate life-threatening
risk.
7. A nurse is reviewing the lab results for a patient with Cushing’s Syndrome.
Which of the following sets of results is expected?
A. Hypoglycemia, Hyperkalemia, and Hyponatremia
B. Hypoglycemia, Hypokalemia, and Hyponatremia
C. Hyperglycemia, Hypokalemia, and Hypernatremia
D. Hyperglycemia, Hyperkalemia, and Hypernatremia
Answer: C
Rationale: Cushing’s Syndrome involves excess cortisol, which leads to hyperglycemia.
Excess mineralocorticoid activity (aldosterone-like) leads to sodium retention
(hypernatremia) and potassium excretion (hypokalemia).
