PNR 201/PNR201 Exam 3 V3 | Medical-
Surgical Nursing Q&A with Rationale |
Fortis College
1. A nurse is teaching a patient with type 1 diabetes mellitus about self-administration of NPH
and regular insulin. Which statement by the patient indicates a need for further teaching?
A. I will draw up the regular insulin into the syringe first.
B. I will inject the air into the NPH vial before the regular vial.
C. I should shake the NPH vial vigorously to mix the suspension.
D. I need to rotate my injection sites within the same anatomical area.
Correct Answer: C
Expert Explanation: NPH insulin is a suspension and should be gently rolled between the
palms rather than shaken. Shaking can create bubbles that interfere with accurate dosing.
Proper technique involves injecting air into the NPH vial first, then air into the regular vial,
then drawing up the clear (regular) before the cloudy (NPH) insulin.
2. Which laboratory value should the nurse prioritize when assessing a patient suspected of
having acute pancreatitis?
A. Serum Potassium
B. Red Blood Cell count
C. Serum Creatinine
,D. Serum Amylase
Correct Answer: D
Expert Explanation: Serum amylase and lipase levels are the primary biochemical
markers used to diagnose acute pancreatitis. Amylase levels usually rise within 2 to 12
hours of the onset of symptoms and remain elevated for several days. Monitoring these
enzymes is crucial for confirming the diagnosis and assessing the severity of pancreatic
inflammation.
3. A patient with Graves’ disease is scheduled for a subtotal thyroidectomy. Which
medication does the nurse expect to administer preoperatively to reduce the vascularity of
the thyroid gland?
A. Levothyroxine
B. Furosemide
C. Lugol’s solution
D. Metformin
Correct Answer: C
Expert Explanation: Lugol’s solution, an iodine preparation, is administered
preoperatively to inhibit the release of thyroid hormones and decrease the size and
vascularity of the gland. This reduction in blood flow helps minimize the risk of
intraoperative hemorrhage. The medication is typically given for 10 to 14 days before the
surgical procedure.
, 4. The nurse is monitoring a patient post-thyroidectomy. The patient reports tingling in the
fingertips and around the mouth. Which action should the nurse take first?
A. Check the patient’s blood pressure.
B. Assess for Chvostek’s sign.
C. Administer an analgesic for pain.
D. Encourage the patient to cough and deep breathe.
Correct Answer: B
Expert Explanation: Tingling in the extremities and circumoral area are early signs of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged during a
thyroidectomy. Assessing for Chvostek’s sign (facial twitching) or Trousseau’s sign helps
confirm neuromuscular irritability. The nurse must notify the provider immediately as
untreated hypocalcemia can lead to tetany and respiratory distress.
5. A patient with Cushing’s syndrome is at risk for which of the following electrolyte
imbalances?
A. Hyperkalemia
B. Hypoglycemia
C. Hyponatremia
D. Hypokalemia
Correct Answer: D
Surgical Nursing Q&A with Rationale |
Fortis College
1. A nurse is teaching a patient with type 1 diabetes mellitus about self-administration of NPH
and regular insulin. Which statement by the patient indicates a need for further teaching?
A. I will draw up the regular insulin into the syringe first.
B. I will inject the air into the NPH vial before the regular vial.
C. I should shake the NPH vial vigorously to mix the suspension.
D. I need to rotate my injection sites within the same anatomical area.
Correct Answer: C
Expert Explanation: NPH insulin is a suspension and should be gently rolled between the
palms rather than shaken. Shaking can create bubbles that interfere with accurate dosing.
Proper technique involves injecting air into the NPH vial first, then air into the regular vial,
then drawing up the clear (regular) before the cloudy (NPH) insulin.
2. Which laboratory value should the nurse prioritize when assessing a patient suspected of
having acute pancreatitis?
A. Serum Potassium
B. Red Blood Cell count
C. Serum Creatinine
,D. Serum Amylase
Correct Answer: D
Expert Explanation: Serum amylase and lipase levels are the primary biochemical
markers used to diagnose acute pancreatitis. Amylase levels usually rise within 2 to 12
hours of the onset of symptoms and remain elevated for several days. Monitoring these
enzymes is crucial for confirming the diagnosis and assessing the severity of pancreatic
inflammation.
3. A patient with Graves’ disease is scheduled for a subtotal thyroidectomy. Which
medication does the nurse expect to administer preoperatively to reduce the vascularity of
the thyroid gland?
A. Levothyroxine
B. Furosemide
C. Lugol’s solution
D. Metformin
Correct Answer: C
Expert Explanation: Lugol’s solution, an iodine preparation, is administered
preoperatively to inhibit the release of thyroid hormones and decrease the size and
vascularity of the gland. This reduction in blood flow helps minimize the risk of
intraoperative hemorrhage. The medication is typically given for 10 to 14 days before the
surgical procedure.
, 4. The nurse is monitoring a patient post-thyroidectomy. The patient reports tingling in the
fingertips and around the mouth. Which action should the nurse take first?
A. Check the patient’s blood pressure.
B. Assess for Chvostek’s sign.
C. Administer an analgesic for pain.
D. Encourage the patient to cough and deep breathe.
Correct Answer: B
Expert Explanation: Tingling in the extremities and circumoral area are early signs of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged during a
thyroidectomy. Assessing for Chvostek’s sign (facial twitching) or Trousseau’s sign helps
confirm neuromuscular irritability. The nurse must notify the provider immediately as
untreated hypocalcemia can lead to tetany and respiratory distress.
5. A patient with Cushing’s syndrome is at risk for which of the following electrolyte
imbalances?
A. Hyperkalemia
B. Hypoglycemia
C. Hyponatremia
D. Hypokalemia
Correct Answer: D
