NUR 209/NUR209 Exam 3 V2 | Medical-
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A patient with Diabetes Insipidus (DI) is receiving desmopressin. Which finding indicates
the medication is effective?
A. Serum sodium level of 148 mEq/L
B. Increase in heart rate
C. Weight loss of 2 lbs in 24 hours
D. Urine specific gravity of 1.015
Correct Answer: D
Expert Explanation: Desmopressin is a synthetic form of antidiuretic hormone used to
concentrate urine in patients with DI. A specific gravity of 1.015 is within the normal range,
suggesting the kidneys are effectively conserving water. Without treatment, DI patients
typically exhibit a very low specific gravity below 1.005.
2. The nurse is caring for a patient with SIADH. Which physician order should the nurse
question?
A. Fluid restriction of 800 mL/day
B. Normal Saline (0.9% NaCl) at 150 mL/hr
C. Frequent oral hygiene
,D. Furosemide 20 mg IV daily
Correct Answer: B
Expert Explanation: In SIADH, the body retains too much water, leading to dilutional
hyponatremia and fluid volume excess. Administering 0.9% Normal Saline at a high rate
would further worsen the fluid overload and dilutional effect. Hypertonic saline (3%) is
sometimes used cautiously for severe hyponatremia, but isotonic fluids are generally
avoided.
3. A client is admitted in Diabetic Ketoacidosis (DKA). Which intervention is the priority?
A. Initiating IV fluid resuscitation
B. Starting an insulin drip
C. Administering IV bicarbonate
D. Checking the arterial blood gas
Correct Answer: A
Expert Explanation: The initial priority in DKA management is fluid resuscitation to
restore circulatory volume and perfusion. Dehydration is severe due to osmotic diuresis
caused by hyperglycemia. Once fluid status is stabilized, insulin therapy is initiated to
address the metabolic acidosis.
4. A patient with hypothyroidism is admitted with a temperature of 94.2°F and a heart rate of
42 bpm. Which condition does the nurse suspect?
A. Thyroid storm
, B. Myxedema coma
C. Addisonian crisis
D. Pheochromocytoma
Correct Answer: B
Expert Explanation: Myxedema coma is a life-threatening complication of untreated or
severe hypothyroidism. It is characterized by severe hypothermia, bradycardia, and mental
status changes. Immediate intervention with IV levothyroxine and supportive care is
required to prevent death.
5. Which clinical manifestation is expected in a patient diagnosed with Grave’s Disease?
A. Bradycardia
B. Cold intolerance
C. Exophthalmos
D. Weight gain
Correct Answer: C
Expert Explanation: Grave’s Disease is an autoimmune form of hyperthyroidism that often
presents with exophthalmos (bulging eyes). Patients also typically experience tachycardia,
heat intolerance, and weight loss despite increased appetite. These symptoms result from a
hypermetabolic state caused by excessive thyroid hormones.
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A patient with Diabetes Insipidus (DI) is receiving desmopressin. Which finding indicates
the medication is effective?
A. Serum sodium level of 148 mEq/L
B. Increase in heart rate
C. Weight loss of 2 lbs in 24 hours
D. Urine specific gravity of 1.015
Correct Answer: D
Expert Explanation: Desmopressin is a synthetic form of antidiuretic hormone used to
concentrate urine in patients with DI. A specific gravity of 1.015 is within the normal range,
suggesting the kidneys are effectively conserving water. Without treatment, DI patients
typically exhibit a very low specific gravity below 1.005.
2. The nurse is caring for a patient with SIADH. Which physician order should the nurse
question?
A. Fluid restriction of 800 mL/day
B. Normal Saline (0.9% NaCl) at 150 mL/hr
C. Frequent oral hygiene
,D. Furosemide 20 mg IV daily
Correct Answer: B
Expert Explanation: In SIADH, the body retains too much water, leading to dilutional
hyponatremia and fluid volume excess. Administering 0.9% Normal Saline at a high rate
would further worsen the fluid overload and dilutional effect. Hypertonic saline (3%) is
sometimes used cautiously for severe hyponatremia, but isotonic fluids are generally
avoided.
3. A client is admitted in Diabetic Ketoacidosis (DKA). Which intervention is the priority?
A. Initiating IV fluid resuscitation
B. Starting an insulin drip
C. Administering IV bicarbonate
D. Checking the arterial blood gas
Correct Answer: A
Expert Explanation: The initial priority in DKA management is fluid resuscitation to
restore circulatory volume and perfusion. Dehydration is severe due to osmotic diuresis
caused by hyperglycemia. Once fluid status is stabilized, insulin therapy is initiated to
address the metabolic acidosis.
4. A patient with hypothyroidism is admitted with a temperature of 94.2°F and a heart rate of
42 bpm. Which condition does the nurse suspect?
A. Thyroid storm
, B. Myxedema coma
C. Addisonian crisis
D. Pheochromocytoma
Correct Answer: B
Expert Explanation: Myxedema coma is a life-threatening complication of untreated or
severe hypothyroidism. It is characterized by severe hypothermia, bradycardia, and mental
status changes. Immediate intervention with IV levothyroxine and supportive care is
required to prevent death.
5. Which clinical manifestation is expected in a patient diagnosed with Grave’s Disease?
A. Bradycardia
B. Cold intolerance
C. Exophthalmos
D. Weight gain
Correct Answer: C
Expert Explanation: Grave’s Disease is an autoimmune form of hyperthyroidism that often
presents with exophthalmos (bulging eyes). Patients also typically experience tachycardia,
heat intolerance, and weight loss despite increased appetite. These symptoms result from a
hypermetabolic state caused by excessive thyroid hormones.
