NUR 209/NUR209 Exam 2 V2 | Medical-
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is assessing a patient with Graves’ disease. Which clinical manifestation should the
nurse expect to find?
A. Weight gain and bradycardia
B. Cold intolerance and lethargy
C. Exophthalmos and heat intolerance
D. Dry skin and constipation
Correct Answer: C
Expert Explanation: Graves’ disease is a common cause of hyperthyroidism, which results
in a hypermetabolic state. Clinical manifestations include exophthalmos, which is a
protrusion of the eyeballs, and heat intolerance due to increased metabolic heat
production. The nurse must also monitor for tachycardia and weight loss despite an
increased appetite.
2. Which laboratory value is most indicative of acute pancreatitis?
A. Decreased serum calcium
B. Decreased blood urea nitrogen (BUN)
C. Increased serum amylase and lipase
,D. Increased serum albumin
Correct Answer: C
Expert Explanation: Serum amylase and lipase are the primary biochemical markers used
to diagnose acute pancreatitis because they are released by the damaged pancreas. Lipase
is generally more specific to the pancreas and stays elevated longer than amylase.
Assessment of these levels is critical during the initial phase of the inflammatory process.
3. A patient is diagnosed with Addison’s disease. Which electrolyte abnormality should the
nurse prioritize in the assessment?
A. Hypocalcemia and hypomagnesemia
B. Hypokalemia and hypernatremia
C. Hypercalcemia and hypermagnesemia
D. Hyperkalemia and hyponatremia
Correct Answer: D
Expert Explanation: Addison’s disease involves a deficiency in adrenal corticosteroids,
specifically aldosterone and cortisol. A lack of aldosterone leads to sodium wasting and
potassium retention in the kidneys. Consequently, the nurse must monitor for life-
threatening hyperkalemia and signs of dehydration related to hyponatremia.
4. When caring for a patient with Cushing’s syndrome, the nurse should monitor for which
physical characteristic?
A. Bronze skin pigmentation
,B. Truncal obesity and moon face
C. Exophthalmos
D. Weight loss and hypotension
Correct Answer: B
Expert Explanation: Cushing’s syndrome is caused by an excess of glucocorticoids, which
leads to a characteristic redistribution of body fat. The nurse will observe truncal obesity, a
‘buffalo hump,’ and a ‘moon face’ appearance in these patients. These physical changes are
accompanied by thin extremities and fragile skin that bruises easily.
5. A patient with Type 1 Diabetes is found unconscious and clammy. What is the nurse’s
priority action?
A. Administer 15g of oral carbohydrates
B. Check the patient’s hemoglobin A1c level
C. Call the healthcare provider for an insulin order
D. Administer subcutaneous glucagon or IV D50
Correct Answer: D
Expert Explanation: In an unconscious patient with suspected hypoglycemia, the nurse
cannot safely administer oral treatments due to the risk of aspiration. Subcutaneous or
intramuscular glucagon, or intravenous 50% dextrose, is the standard emergency
, treatment to rapidly raise blood glucose. Following administration, the nurse must monitor
the patient’s level of consciousness and repeat glucose checks.
6. Which medication is considered the first-line treatment for a patient newly diagnosed with
Type 2 Diabetes?
A. Metformin
B. Glargine insulin
C. Glipizide
D. Lispro insulin
Correct Answer: A
Expert Explanation: Metformin is the preferred initial pharmacological agent for Type 2
Diabetes according to clinical guidelines. It works by reducing hepatic glucose production
and improving insulin sensitivity in the tissues. The nurse should educate the patient about
the common side effect of gastrointestinal upset and the need to hold the medication before
procedures involving contrast dye.
7. A nurse is caring for a patient with Cirrhosis who has developed hepatic encephalopathy.
What is the primary purpose of administering lactulose?
A. To treat constipation associated with liver failure
B. To decrease the production of bile salts
C. To improve the absorption of fat-soluble vitamins
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is assessing a patient with Graves’ disease. Which clinical manifestation should the
nurse expect to find?
A. Weight gain and bradycardia
B. Cold intolerance and lethargy
C. Exophthalmos and heat intolerance
D. Dry skin and constipation
Correct Answer: C
Expert Explanation: Graves’ disease is a common cause of hyperthyroidism, which results
in a hypermetabolic state. Clinical manifestations include exophthalmos, which is a
protrusion of the eyeballs, and heat intolerance due to increased metabolic heat
production. The nurse must also monitor for tachycardia and weight loss despite an
increased appetite.
2. Which laboratory value is most indicative of acute pancreatitis?
A. Decreased serum calcium
B. Decreased blood urea nitrogen (BUN)
C. Increased serum amylase and lipase
,D. Increased serum albumin
Correct Answer: C
Expert Explanation: Serum amylase and lipase are the primary biochemical markers used
to diagnose acute pancreatitis because they are released by the damaged pancreas. Lipase
is generally more specific to the pancreas and stays elevated longer than amylase.
Assessment of these levels is critical during the initial phase of the inflammatory process.
3. A patient is diagnosed with Addison’s disease. Which electrolyte abnormality should the
nurse prioritize in the assessment?
A. Hypocalcemia and hypomagnesemia
B. Hypokalemia and hypernatremia
C. Hypercalcemia and hypermagnesemia
D. Hyperkalemia and hyponatremia
Correct Answer: D
Expert Explanation: Addison’s disease involves a deficiency in adrenal corticosteroids,
specifically aldosterone and cortisol. A lack of aldosterone leads to sodium wasting and
potassium retention in the kidneys. Consequently, the nurse must monitor for life-
threatening hyperkalemia and signs of dehydration related to hyponatremia.
4. When caring for a patient with Cushing’s syndrome, the nurse should monitor for which
physical characteristic?
A. Bronze skin pigmentation
,B. Truncal obesity and moon face
C. Exophthalmos
D. Weight loss and hypotension
Correct Answer: B
Expert Explanation: Cushing’s syndrome is caused by an excess of glucocorticoids, which
leads to a characteristic redistribution of body fat. The nurse will observe truncal obesity, a
‘buffalo hump,’ and a ‘moon face’ appearance in these patients. These physical changes are
accompanied by thin extremities and fragile skin that bruises easily.
5. A patient with Type 1 Diabetes is found unconscious and clammy. What is the nurse’s
priority action?
A. Administer 15g of oral carbohydrates
B. Check the patient’s hemoglobin A1c level
C. Call the healthcare provider for an insulin order
D. Administer subcutaneous glucagon or IV D50
Correct Answer: D
Expert Explanation: In an unconscious patient with suspected hypoglycemia, the nurse
cannot safely administer oral treatments due to the risk of aspiration. Subcutaneous or
intramuscular glucagon, or intravenous 50% dextrose, is the standard emergency
, treatment to rapidly raise blood glucose. Following administration, the nurse must monitor
the patient’s level of consciousness and repeat glucose checks.
6. Which medication is considered the first-line treatment for a patient newly diagnosed with
Type 2 Diabetes?
A. Metformin
B. Glargine insulin
C. Glipizide
D. Lispro insulin
Correct Answer: A
Expert Explanation: Metformin is the preferred initial pharmacological agent for Type 2
Diabetes according to clinical guidelines. It works by reducing hepatic glucose production
and improving insulin sensitivity in the tissues. The nurse should educate the patient about
the common side effect of gastrointestinal upset and the need to hold the medication before
procedures involving contrast dye.
7. A nurse is caring for a patient with Cirrhosis who has developed hepatic encephalopathy.
What is the primary purpose of administering lactulose?
A. To treat constipation associated with liver failure
B. To decrease the production of bile salts
C. To improve the absorption of fat-soluble vitamins
