PNR 206/PNR206 Final Exam V1 | Medical-
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is assessing a patient with a suspected diagnosis of Diabetes Insipidus (DI). Which
clinical finding should the nurse anticipate?
A. Urine specific gravity of 1.030
B. Serum sodium level of 130 mEq/L
C. Urine specific gravity of 1.002
D. Elevated blood glucose levels
Correct Answer: C
Expert Explanation: Diabetes Insipidus is characterized by a deficiency of antidiuretic
hormone (ADH), leading to the excretion of large amounts of very dilute urine. A urine
specific gravity of 1.002 is significantly lower than the normal range (1.005 to 1.030),
reflecting this dilution. The nurse must monitor for dehydration and electrolyte
imbalances, specifically hypernatremia rather than hyponatremia.
2. When assessing a patient with Cushing’s Syndrome, which physical characteristic is most
expected?
A. Weight loss and hypotension
B. Bronze-colored skin and salt craving
,C. Exophthalmos and tremors
D. Trunkal obesity and a ‘buffalo hump’
Correct Answer: D
Expert Explanation: Cushing’s Syndrome results from an excess of cortisol, which leads to
a redistribution of fat in the body. Classic signs include trunkal obesity, a moon-shaped
face, and a fat pad on the upper back known as a buffalo hump. Other common findings
include thin skin, purple striae, and muscle wasting in the extremities.
3. A patient is admitted with Acute Pancreatitis. Which laboratory result is most diagnostic of
this condition?
A. Elevated serum lipase
B. Decreased serum amylase
C. Decreased white blood cell count
D. Elevated serum calcium
Correct Answer: A
Expert Explanation: Serum lipase is the most specific enzyme for diagnosing acute
pancreatitis because it stays elevated longer than amylase. In pancreatitis, autodigestion of
the pancreas leads to the release of these enzymes into the bloodstream. Serum amylase
also rises but returns to normal within 24 to 72 hours, whereas lipase remains elevated for
up to two weeks.
, 4. A nurse is providing discharge instructions to a patient who underwent a Thyroidectomy.
Which symptom should the patient report immediately?
A. Tingling in the fingers and toes
B. Slight swelling at the incision site
C. Mild hoarseness when speaking
D. Fatigue and sleepiness
Correct Answer: A
Expert Explanation: Tingling in the fingers and toes is a sign of hypocalcemia, which can
occur if the parathyroid glands are accidentally damaged or removed during thyroid
surgery. Hypocalcemia can lead to tetany and life-threatening laryngospasms if not treated
promptly. The nurse should also assess for Trousseau’s and Chvostek’s signs to confirm
neuromuscular irritability.
5. In the Rule of Nines for an adult burn victim, what percentage of the total body surface
area (TBSA) is assigned to the entire right leg?
A. 18%
B. 9%
C. 4.5%
D. 1%
Correct Answer: A
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is assessing a patient with a suspected diagnosis of Diabetes Insipidus (DI). Which
clinical finding should the nurse anticipate?
A. Urine specific gravity of 1.030
B. Serum sodium level of 130 mEq/L
C. Urine specific gravity of 1.002
D. Elevated blood glucose levels
Correct Answer: C
Expert Explanation: Diabetes Insipidus is characterized by a deficiency of antidiuretic
hormone (ADH), leading to the excretion of large amounts of very dilute urine. A urine
specific gravity of 1.002 is significantly lower than the normal range (1.005 to 1.030),
reflecting this dilution. The nurse must monitor for dehydration and electrolyte
imbalances, specifically hypernatremia rather than hyponatremia.
2. When assessing a patient with Cushing’s Syndrome, which physical characteristic is most
expected?
A. Weight loss and hypotension
B. Bronze-colored skin and salt craving
,C. Exophthalmos and tremors
D. Trunkal obesity and a ‘buffalo hump’
Correct Answer: D
Expert Explanation: Cushing’s Syndrome results from an excess of cortisol, which leads to
a redistribution of fat in the body. Classic signs include trunkal obesity, a moon-shaped
face, and a fat pad on the upper back known as a buffalo hump. Other common findings
include thin skin, purple striae, and muscle wasting in the extremities.
3. A patient is admitted with Acute Pancreatitis. Which laboratory result is most diagnostic of
this condition?
A. Elevated serum lipase
B. Decreased serum amylase
C. Decreased white blood cell count
D. Elevated serum calcium
Correct Answer: A
Expert Explanation: Serum lipase is the most specific enzyme for diagnosing acute
pancreatitis because it stays elevated longer than amylase. In pancreatitis, autodigestion of
the pancreas leads to the release of these enzymes into the bloodstream. Serum amylase
also rises but returns to normal within 24 to 72 hours, whereas lipase remains elevated for
up to two weeks.
, 4. A nurse is providing discharge instructions to a patient who underwent a Thyroidectomy.
Which symptom should the patient report immediately?
A. Tingling in the fingers and toes
B. Slight swelling at the incision site
C. Mild hoarseness when speaking
D. Fatigue and sleepiness
Correct Answer: A
Expert Explanation: Tingling in the fingers and toes is a sign of hypocalcemia, which can
occur if the parathyroid glands are accidentally damaged or removed during thyroid
surgery. Hypocalcemia can lead to tetany and life-threatening laryngospasms if not treated
promptly. The nurse should also assess for Trousseau’s and Chvostek’s signs to confirm
neuromuscular irritability.
5. In the Rule of Nines for an adult burn victim, what percentage of the total body surface
area (TBSA) is assigned to the entire right leg?
A. 18%
B. 9%
C. 4.5%
D. 1%
Correct Answer: A
