NU 185 Exam 3 - Medical-Surgical Nursing II Study Guide 2026 Galen
College
1. A nurse is caring for a patient with Cushing’s syndrome. Which clinical
manifestation should the nurse expect to observe?
A. Truncal obesity and moon face
B. Hyperpigmentation of the skin
C. Weight loss and hypotension
D. Increased muscle mass in extremities
Answer: A
Rationale: Cushing’s syndrome is characterized by an excess of cortisol, leading to truncal
obesity, moon face, a buffalo hump, and thin extremities due to muscle wasting.
2. Which laboratory value is most indicative of a patient experiencing Diabetic
Ketoacidosis (DKA)?
A. Blood glucose 150 mg/dL and pH 7.35
B. Blood glucose 400 mg/dL and pH 7.20
C. Blood glucose 800 mg/dL and pH 7.45
D. Blood glucose 110 mg/dL and bicarbonate 24 mEq/L
Answer: B
Rationale: DKA typically presents with blood glucose levels over 250 mg/dL, a decrease in
arterial pH (acidosis), and the presence of ketones in the urine and blood.
,3. A patient with Type 1 Diabetes is found unconscious and clammy. What is the
priority nursing action?
A. Check blood glucose level and prepare glucagon
B. Administer 10 units of regular insulin subcutaneous
C. Offer 4 ounces of orange juice
D. Provide a high-protein snack
Answer: A
Rationale: For an unconscious patient suspected of hypoglycemia, the nurse must quickly
assess glucose and administer glucagon or IV Dextrose (D50) because the patient cannot
safely swallow.
4. Which medication is considered the first-line treatment for Hyperthyroidism?
A. Levothyroxine
B. Hydrocortisone
C. Propylthiouracil (PTU)
D. Vasopressin
Answer: C
Rationale: Propylthiouracil (PTU) and Methimazole are antithyroid medications used to
inhibit the synthesis of thyroid hormones in hyperthyroidism.
5. A patient is recovering from a thyroidectomy. The nurse notes frequent
swallowing and throat clearing. What is the nurse’s primary concern?
A. Postoperative hemorrhage
B. Hypocalcemia
C. Infection of the surgical site
D. Thyroid storm
Answer: A
Rationale: Frequent swallowing and throat clearing are early signs of bleeding or
hemorrhage in the neck following a thyroidectomy, which can lead to airway obstruction.
, 6. Which assessment finding is a hallmark sign of Diabetes Insipidus (DI)?
A. High urine specific gravity
B. Elevated blood glucose levels
C. Fluid volume excess and hypertension
D. Excessive thirst and large volumes of dilute urine
Answer: D
Rationale: Diabetes Insipidus involves a deficiency of ADH, leading to massive polyuria
(dilute urine) and extreme polydipsia (thirst).
7. In SIADH, which electrolyte imbalance is the primary concern for the nurse?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: C
Rationale: SIADH involves excess ADH, causing water retention that dilutes serum sodium,
leading to dilutional hyponatremia.
8. A patient with Addison’s disease is prescribed lifelong corticosteroid
replacement. Which instruction is vital for the nurse to include?
A. Decrease dosage during periods of high stress
B. Stop the medication immediately if weight gain occurs
C. Increase the dose during periods of physical or emotional stress
D. Take the medication only when feeling weak
Answer: C
Rationale: Patients with Addison’s disease cannot produce extra cortisol during stress, so
they must increase their steroid dosage to prevent an Addisonian crisis.
College
1. A nurse is caring for a patient with Cushing’s syndrome. Which clinical
manifestation should the nurse expect to observe?
A. Truncal obesity and moon face
B. Hyperpigmentation of the skin
C. Weight loss and hypotension
D. Increased muscle mass in extremities
Answer: A
Rationale: Cushing’s syndrome is characterized by an excess of cortisol, leading to truncal
obesity, moon face, a buffalo hump, and thin extremities due to muscle wasting.
2. Which laboratory value is most indicative of a patient experiencing Diabetic
Ketoacidosis (DKA)?
A. Blood glucose 150 mg/dL and pH 7.35
B. Blood glucose 400 mg/dL and pH 7.20
C. Blood glucose 800 mg/dL and pH 7.45
D. Blood glucose 110 mg/dL and bicarbonate 24 mEq/L
Answer: B
Rationale: DKA typically presents with blood glucose levels over 250 mg/dL, a decrease in
arterial pH (acidosis), and the presence of ketones in the urine and blood.
,3. A patient with Type 1 Diabetes is found unconscious and clammy. What is the
priority nursing action?
A. Check blood glucose level and prepare glucagon
B. Administer 10 units of regular insulin subcutaneous
C. Offer 4 ounces of orange juice
D. Provide a high-protein snack
Answer: A
Rationale: For an unconscious patient suspected of hypoglycemia, the nurse must quickly
assess glucose and administer glucagon or IV Dextrose (D50) because the patient cannot
safely swallow.
4. Which medication is considered the first-line treatment for Hyperthyroidism?
A. Levothyroxine
B. Hydrocortisone
C. Propylthiouracil (PTU)
D. Vasopressin
Answer: C
Rationale: Propylthiouracil (PTU) and Methimazole are antithyroid medications used to
inhibit the synthesis of thyroid hormones in hyperthyroidism.
5. A patient is recovering from a thyroidectomy. The nurse notes frequent
swallowing and throat clearing. What is the nurse’s primary concern?
A. Postoperative hemorrhage
B. Hypocalcemia
C. Infection of the surgical site
D. Thyroid storm
Answer: A
Rationale: Frequent swallowing and throat clearing are early signs of bleeding or
hemorrhage in the neck following a thyroidectomy, which can lead to airway obstruction.
, 6. Which assessment finding is a hallmark sign of Diabetes Insipidus (DI)?
A. High urine specific gravity
B. Elevated blood glucose levels
C. Fluid volume excess and hypertension
D. Excessive thirst and large volumes of dilute urine
Answer: D
Rationale: Diabetes Insipidus involves a deficiency of ADH, leading to massive polyuria
(dilute urine) and extreme polydipsia (thirst).
7. In SIADH, which electrolyte imbalance is the primary concern for the nurse?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: C
Rationale: SIADH involves excess ADH, causing water retention that dilutes serum sodium,
leading to dilutional hyponatremia.
8. A patient with Addison’s disease is prescribed lifelong corticosteroid
replacement. Which instruction is vital for the nurse to include?
A. Decrease dosage during periods of high stress
B. Stop the medication immediately if weight gain occurs
C. Increase the dose during periods of physical or emotional stress
D. Take the medication only when feeling weak
Answer: C
Rationale: Patients with Addison’s disease cannot produce extra cortisol during stress, so
they must increase their steroid dosage to prevent an Addisonian crisis.
