GRAND CANYON UNIVERSITY COLLEGE OF NURSING
NSG-320 ADULT HEALTH NURSING I COMPREHENSIVE EXAM 3
PREPARATION 200 ORIGINAL QUESTIONS WITH ANSWERS AND
RATIONALES 2026/2027 ACADEMIC YEAR
TABLE OF CONTENTS
SECTION I: ENDOCRINE SYSTEM DISORDERS .......................... Q1 - Q50
1.1 Diabetes Mellitus (Type 1 & 2) .......................... Q1 - Q15
1.2 DKA & HHS ................................................ Q16 - Q22
1.3 Thyroid Disorders ........................................ Q23 - Q30
1.4 Adrenal Disorders (Addison's & Cushing's) ................ Q31 - Q38
1.5 Pheochromocytoma & Adrenal Crisis ........................ Q39 - Q42
1.6 Diabetes Insipidus & SIADH ............................... Q43 - Q50
SECTION II: NEUROLOGICAL SYSTEM DISORDERS ....................... Q51 - Q100
2.1 Ischemic & Hemorrhagic Stroke ............................ Q51 - Q62
2.2 Traumatic Brain Injury & Increased ICP ................... Q63 - Q72
2.3 Seizures & Epilepsy ...................................... Q73 - Q80
2.4 Multiple Sclerosis ....................................... Q81 - Q86
2.5 Meningitis & Encephalitis ................................ Q87 - Q92
2.6 Parkinson's Disease ...................................... Q93 - Q100
SECTION III: MUSCULOSKELETAL SYSTEM DISORDERS .................... Q101 - Q150
3.1 Fractures & Fracture Management .......................... Q101 - Q115
3.2 Osteoarthritis & Rheumatoid Arthritis .................... Q116 - Q125
3.3 Osteoporosis & Metabolic Bone Disease .................... Q126 - Q132
3.4 Joint Replacement (Hip/Knee) ............................. Q133 - Q140
3.5 Compartment Syndrome & Musculoskeletal Trauma ............ Q141 - Q150
SECTION IV: SENSORY (EYE & EAR) DISORDERS ....................... Q151 - Q200
4.1 Glaucoma ................................................. Q151 - Q158
4.2 Cataracts ................................................ Q159 - Q164
4.3 Macular Degeneration ..................................... Q165 - Q170
4.4 Hearing Loss & Meniere's Disease ......................... Q171 - Q180
4.5 Eye Trauma & Infections .................................. Q181 - Q188
4.6 Otitis Media, Otitis Externa, & Ear Disorders ............ Q189 - Q200
SECTION I: ENDOCRINE SYSTEM DISORDERS AND MANAGEMENT
1.1 Diabetes Mellitus (Type 1 & 2)
Q1. A client with type 1 diabetes mellitus is admitted with a blood glucose
level of 620 mg/dL, serum potassium of 5.8 mEq/L, and arterial pH of 7.18.
Which finding would the nurse expect to assess?
1
, A. Kussmaul respirations
B. Slow, shallow breathing
C. Hyperactive bowel sounds
D. Flushed, moist skin
Answer: A. Kussmaul respirations
Rationale: Kussmaul respirations (deep, rapid breathing) are a compensatory
mechanism for metabolic acidosis in DKA. The body attempts to blow off
excess CO2. Shallow breathing is seen in respiratory depression, not DKA.
Bowel sounds are typically decreased, and skin is dry due to dehydration.
Q2. The nurse is teaching a client with type 2 diabetes about self-monitoring
of blood glucose. Which statement indicates the need for further teaching?
A. "I should wash my hands with warm water before checking."
B. "I will rotate my finger-stick sites to prevent soreness."
C. "I can check my blood sugar only once a week since I take oral meds."
D. "I should keep a log of my results to share with my provider."
Answer: C. "I can check my blood sugar only once a week..."
Rationale: Clients with type 2 diabetes, even on oral medications, may
need daily monitoring. Once weekly is insufficient. Hand washing, site
rotation, and logging are appropriate.
Q3. A client with type 2 diabetes is prescribed metformin. Which instruction
should the nurse include?
A. "Take this medication on an empty stomach for best absorption."
B. "Report any muscle pain or weakness to your provider immediately."
C. "This medication replaces the need for dietary changes."
D. "You may experience weight gain as a common side effect."
2
, Answer: B. "Report any muscle pain or weakness immediately."
Rationale: Metformin can cause lactic acidosis. Symptoms include muscle
pain, weakness, and malaise. It should be taken with meals to reduce GI
upset. It does not replace diet/exercise and is weight-neutral.
Q4. The nurse is caring for a client with diabetes who is experiencing
hypoglycemia. The client is awake and alert. Which intervention should the
nurse implement first?
A. Administer 50% dextrose IV push
B. Give 15 g of fast-acting carbohydrate (e.g., 4 oz orange juice)
C. Give 1 mg glucagon subcutaneously
D. Offer a complex carbohydrate like a peanut butter sandwich
Answer: B. Give 15 g of fast-acting carbohydrate.
Rationale: For an awake/alert client, the rule of 15 is applied: give 15g
of fast-acting carbohydrate, recheck in 15 minutes. IV dextrose and glucagon
are for severe hypoglycemia or unconscious clients. Complex carbs are given
after recovery to stabilize glucose.
Q5. A client is prescribed insulin glargine (Lantus) once daily. The nurse
should instruct the client that this insulin:
A. Has a peak effect in 2-4 hours
B. Should not be mixed with other insulins in the same syringe
C. Must be given 30 minutes before meals
D. Is a rapid-acting insulin used for bolus coverage
Answer: B. Should not be mixed with other insulins in the same syringe.
Rationale: Insulin glargine is a long-acting, peakless insulin that should
not be mixed with any other insulin to maintain its pH stability. It has no
pronounced peak and is given once daily, not before meals.
3
, Q6. Which laboratory finding is most indicative of diabetic nephropathy in a
client with type 1 diabetes?
A. Elevated serum creatinine
B. Microalbuminuria
C. Decreased glomerular filtration rate (GFR)
D. Elevated BUN
Answer: B. Microalbuminuria
Rationale: Microalbuminuria (30-300 mg/24 hr) is the earliest sign of
diabetic nephropathy. Elevated creatinine, decreased GFR, and elevated BUN
occur later in the disease process.
Q7. A client with diabetes reports numbness and tingling in both feet. The
nurse recognizes this as a sign of:
A. Peripheral vascular disease
B. Diabetic neuropathy
C. Muscular dystrophy
D. Venous insufficiency
Answer: B. Diabetic neuropathy
Rationale: Distal symmetric polyneuropathy is common in diabetes, causing
numbness, tingling, and burning pain in a "stocking-glove" distribution.
This is due to prolonged hyperglycemia damaging peripheral nerves.
Q8. The nurse is providing dietary teaching to a client with type 2 diabetes.
Which carbohydrate choice is most appropriate for consistent carbohydrate
management?
A. 1 cup of white rice
B. 1 medium apple
C. 1 slice of whole-wheat bread
4
NSG-320 ADULT HEALTH NURSING I COMPREHENSIVE EXAM 3
PREPARATION 200 ORIGINAL QUESTIONS WITH ANSWERS AND
RATIONALES 2026/2027 ACADEMIC YEAR
TABLE OF CONTENTS
SECTION I: ENDOCRINE SYSTEM DISORDERS .......................... Q1 - Q50
1.1 Diabetes Mellitus (Type 1 & 2) .......................... Q1 - Q15
1.2 DKA & HHS ................................................ Q16 - Q22
1.3 Thyroid Disorders ........................................ Q23 - Q30
1.4 Adrenal Disorders (Addison's & Cushing's) ................ Q31 - Q38
1.5 Pheochromocytoma & Adrenal Crisis ........................ Q39 - Q42
1.6 Diabetes Insipidus & SIADH ............................... Q43 - Q50
SECTION II: NEUROLOGICAL SYSTEM DISORDERS ....................... Q51 - Q100
2.1 Ischemic & Hemorrhagic Stroke ............................ Q51 - Q62
2.2 Traumatic Brain Injury & Increased ICP ................... Q63 - Q72
2.3 Seizures & Epilepsy ...................................... Q73 - Q80
2.4 Multiple Sclerosis ....................................... Q81 - Q86
2.5 Meningitis & Encephalitis ................................ Q87 - Q92
2.6 Parkinson's Disease ...................................... Q93 - Q100
SECTION III: MUSCULOSKELETAL SYSTEM DISORDERS .................... Q101 - Q150
3.1 Fractures & Fracture Management .......................... Q101 - Q115
3.2 Osteoarthritis & Rheumatoid Arthritis .................... Q116 - Q125
3.3 Osteoporosis & Metabolic Bone Disease .................... Q126 - Q132
3.4 Joint Replacement (Hip/Knee) ............................. Q133 - Q140
3.5 Compartment Syndrome & Musculoskeletal Trauma ............ Q141 - Q150
SECTION IV: SENSORY (EYE & EAR) DISORDERS ....................... Q151 - Q200
4.1 Glaucoma ................................................. Q151 - Q158
4.2 Cataracts ................................................ Q159 - Q164
4.3 Macular Degeneration ..................................... Q165 - Q170
4.4 Hearing Loss & Meniere's Disease ......................... Q171 - Q180
4.5 Eye Trauma & Infections .................................. Q181 - Q188
4.6 Otitis Media, Otitis Externa, & Ear Disorders ............ Q189 - Q200
SECTION I: ENDOCRINE SYSTEM DISORDERS AND MANAGEMENT
1.1 Diabetes Mellitus (Type 1 & 2)
Q1. A client with type 1 diabetes mellitus is admitted with a blood glucose
level of 620 mg/dL, serum potassium of 5.8 mEq/L, and arterial pH of 7.18.
Which finding would the nurse expect to assess?
1
, A. Kussmaul respirations
B. Slow, shallow breathing
C. Hyperactive bowel sounds
D. Flushed, moist skin
Answer: A. Kussmaul respirations
Rationale: Kussmaul respirations (deep, rapid breathing) are a compensatory
mechanism for metabolic acidosis in DKA. The body attempts to blow off
excess CO2. Shallow breathing is seen in respiratory depression, not DKA.
Bowel sounds are typically decreased, and skin is dry due to dehydration.
Q2. The nurse is teaching a client with type 2 diabetes about self-monitoring
of blood glucose. Which statement indicates the need for further teaching?
A. "I should wash my hands with warm water before checking."
B. "I will rotate my finger-stick sites to prevent soreness."
C. "I can check my blood sugar only once a week since I take oral meds."
D. "I should keep a log of my results to share with my provider."
Answer: C. "I can check my blood sugar only once a week..."
Rationale: Clients with type 2 diabetes, even on oral medications, may
need daily monitoring. Once weekly is insufficient. Hand washing, site
rotation, and logging are appropriate.
Q3. A client with type 2 diabetes is prescribed metformin. Which instruction
should the nurse include?
A. "Take this medication on an empty stomach for best absorption."
B. "Report any muscle pain or weakness to your provider immediately."
C. "This medication replaces the need for dietary changes."
D. "You may experience weight gain as a common side effect."
2
, Answer: B. "Report any muscle pain or weakness immediately."
Rationale: Metformin can cause lactic acidosis. Symptoms include muscle
pain, weakness, and malaise. It should be taken with meals to reduce GI
upset. It does not replace diet/exercise and is weight-neutral.
Q4. The nurse is caring for a client with diabetes who is experiencing
hypoglycemia. The client is awake and alert. Which intervention should the
nurse implement first?
A. Administer 50% dextrose IV push
B. Give 15 g of fast-acting carbohydrate (e.g., 4 oz orange juice)
C. Give 1 mg glucagon subcutaneously
D. Offer a complex carbohydrate like a peanut butter sandwich
Answer: B. Give 15 g of fast-acting carbohydrate.
Rationale: For an awake/alert client, the rule of 15 is applied: give 15g
of fast-acting carbohydrate, recheck in 15 minutes. IV dextrose and glucagon
are for severe hypoglycemia or unconscious clients. Complex carbs are given
after recovery to stabilize glucose.
Q5. A client is prescribed insulin glargine (Lantus) once daily. The nurse
should instruct the client that this insulin:
A. Has a peak effect in 2-4 hours
B. Should not be mixed with other insulins in the same syringe
C. Must be given 30 minutes before meals
D. Is a rapid-acting insulin used for bolus coverage
Answer: B. Should not be mixed with other insulins in the same syringe.
Rationale: Insulin glargine is a long-acting, peakless insulin that should
not be mixed with any other insulin to maintain its pH stability. It has no
pronounced peak and is given once daily, not before meals.
3
, Q6. Which laboratory finding is most indicative of diabetic nephropathy in a
client with type 1 diabetes?
A. Elevated serum creatinine
B. Microalbuminuria
C. Decreased glomerular filtration rate (GFR)
D. Elevated BUN
Answer: B. Microalbuminuria
Rationale: Microalbuminuria (30-300 mg/24 hr) is the earliest sign of
diabetic nephropathy. Elevated creatinine, decreased GFR, and elevated BUN
occur later in the disease process.
Q7. A client with diabetes reports numbness and tingling in both feet. The
nurse recognizes this as a sign of:
A. Peripheral vascular disease
B. Diabetic neuropathy
C. Muscular dystrophy
D. Venous insufficiency
Answer: B. Diabetic neuropathy
Rationale: Distal symmetric polyneuropathy is common in diabetes, causing
numbness, tingling, and burning pain in a "stocking-glove" distribution.
This is due to prolonged hyperglycemia damaging peripheral nerves.
Q8. The nurse is providing dietary teaching to a client with type 2 diabetes.
Which carbohydrate choice is most appropriate for consistent carbohydrate
management?
A. 1 cup of white rice
B. 1 medium apple
C. 1 slice of whole-wheat bread
4
