PNR 206/PNR206 Exam 4 V1 | Medical-
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A patient with Type 1 Diabetes Mellitus is found unconscious with a blood glucose level of
42 mg/dL. Which medication should the nurse expect to administer immediately?
A. Intravenous Glucagon or Dextrose 50%
B. Subcutaneous Insulin Lispro
C. Oral glucose tablets
D. Metformin
Correct Answer: A
Expert Explanation: Severe hypoglycemia in an unconscious patient requires immediate
elevation of blood glucose via parenteral routes. Intravenous Dextrose 50% or IM/SC
Glucagon are the standard treatments when the patient cannot swallow. Providing oral
glucose to an unconscious patient poses a high risk for aspiration.
2. A nurse is caring for a patient who is 12 hours post-thyroidectomy. The patient complains
of numbness in the lips and a positive Chvostek’s sign is noted. What is the priority
intervention?
A. Administer Calcium Gluconate as ordered
B. Assess the surgical site for bleeding
,C. Encourage the patient to cough and deep breathe
D. Place the patient in a prone position
Correct Answer: A
Expert Explanation: A positive Chvostek’s sign and numbness suggest hypocalcemia, often
caused by accidental removal or damage to the parathyroid glands during thyroid surgery.
Hypocalcemia is a medical emergency that can lead to laryngospasm and seizures if not
treated with IV calcium. The nurse must prioritize the administration of Calcium Gluconate
to stabilize the patient’s electrolyte levels.
3. A patient is admitted with a diagnosis of Cushing’s Syndrome. Which of the following
physical assessment findings should the nurse anticipate?
A. Weight loss and hypotension
B. Truncal obesity and a ‘Buffalo Hump’
C. Hyperpigmentation of the skin
D. Thin, brittle hair and cold intolerance
Correct Answer: B
Expert Explanation: Cushing’s Syndrome results from an excess of corticosteroids, leading
to specific fat redistribution. Characteristic features include truncal obesity, a fatty hump
between the shoulders (buffalo hump), and a rounded ‘moon face’. These symptoms are
direct results of chronic cortisol elevation affecting metabolism and tissue distribution.
, 4. Which lab value is the most important for the nurse to monitor in a patient diagnosed with
Diabetes Insipidus?
A. Hemoglobin A1c
B. Serum Sodium
C. White Blood Cell count
D. Serum Calcium
Correct Answer: B
Expert Explanation: Diabetes Insipidus involves a deficiency of ADH, leading to massive
diuresis of dilute urine. This excessive water loss causes hemoconcentration and severe
hypernatremia (elevated serum sodium). Monitoring sodium levels is critical to prevent
neurological complications such as seizures or coma.
5. A patient is prescribed Levothyroxine for the treatment of Hypothyroidism. Which
instruction should the nurse include in the teaching plan?
A. Take the medication with a high-calcium meal
B. Expect the medication to cause immediate weight gain
C. Take the medication on an empty stomach 30-60 minutes before breakfast
D. Stop the medication once energy levels return to normal
Correct Answer: C
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A patient with Type 1 Diabetes Mellitus is found unconscious with a blood glucose level of
42 mg/dL. Which medication should the nurse expect to administer immediately?
A. Intravenous Glucagon or Dextrose 50%
B. Subcutaneous Insulin Lispro
C. Oral glucose tablets
D. Metformin
Correct Answer: A
Expert Explanation: Severe hypoglycemia in an unconscious patient requires immediate
elevation of blood glucose via parenteral routes. Intravenous Dextrose 50% or IM/SC
Glucagon are the standard treatments when the patient cannot swallow. Providing oral
glucose to an unconscious patient poses a high risk for aspiration.
2. A nurse is caring for a patient who is 12 hours post-thyroidectomy. The patient complains
of numbness in the lips and a positive Chvostek’s sign is noted. What is the priority
intervention?
A. Administer Calcium Gluconate as ordered
B. Assess the surgical site for bleeding
,C. Encourage the patient to cough and deep breathe
D. Place the patient in a prone position
Correct Answer: A
Expert Explanation: A positive Chvostek’s sign and numbness suggest hypocalcemia, often
caused by accidental removal or damage to the parathyroid glands during thyroid surgery.
Hypocalcemia is a medical emergency that can lead to laryngospasm and seizures if not
treated with IV calcium. The nurse must prioritize the administration of Calcium Gluconate
to stabilize the patient’s electrolyte levels.
3. A patient is admitted with a diagnosis of Cushing’s Syndrome. Which of the following
physical assessment findings should the nurse anticipate?
A. Weight loss and hypotension
B. Truncal obesity and a ‘Buffalo Hump’
C. Hyperpigmentation of the skin
D. Thin, brittle hair and cold intolerance
Correct Answer: B
Expert Explanation: Cushing’s Syndrome results from an excess of corticosteroids, leading
to specific fat redistribution. Characteristic features include truncal obesity, a fatty hump
between the shoulders (buffalo hump), and a rounded ‘moon face’. These symptoms are
direct results of chronic cortisol elevation affecting metabolism and tissue distribution.
, 4. Which lab value is the most important for the nurse to monitor in a patient diagnosed with
Diabetes Insipidus?
A. Hemoglobin A1c
B. Serum Sodium
C. White Blood Cell count
D. Serum Calcium
Correct Answer: B
Expert Explanation: Diabetes Insipidus involves a deficiency of ADH, leading to massive
diuresis of dilute urine. This excessive water loss causes hemoconcentration and severe
hypernatremia (elevated serum sodium). Monitoring sodium levels is critical to prevent
neurological complications such as seizures or coma.
5. A patient is prescribed Levothyroxine for the treatment of Hypothyroidism. Which
instruction should the nurse include in the teaching plan?
A. Take the medication with a high-calcium meal
B. Expect the medication to cause immediate weight gain
C. Take the medication on an empty stomach 30-60 minutes before breakfast
D. Stop the medication once energy levels return to normal
Correct Answer: C
