NSG 320 Exam 3 V1 | NSG 320 Adult
Health Nursing I | Actual Q&A with
Rationale (NSG320 Exam 3) | Grand
Canyon University
1. A nurse is caring for a client with type 1 diabetes mellitus who is admitted with a blood
glucose of 560 mg/dL and positive ketones in the urine. Which intervention is the priority for
this client?
A. Administering a bolus of intravenous regular insulin
B. Initiating fluid resuscitation with 0.9% normal saline
C. Starting a potassium chloride infusion
D. Administering sodium bicarbonate for acidosis
Correct Answer: B
Explanation: The priority intervention in Diabetic Ketoacidosis (DKA) is fluid resuscitation
to restore extracellular fluid volume and improve perfusion to the kidneys. Fluid
replacement should be initiated before insulin to prevent a rapid drop in serum osmolarity
which could lead to cerebral edema. Once the patient is stabilized with fluids, insulin is
then titrated to address the hyperglycemia and ketosis.
2. The nurse is assessing a client with hyperthyroidism (Graves’ disease). Which clinical
manifestations should the nurse expect to find? Select all that apply.
A. Tachycardia and palpitations
,B. Cold intolerance
C. Exophthalmos
D. Weight gain
E. Fine tremors of the hands
F. Diarrhea and increased bowel sounds
Correct Answer: A, C, E, F
Explanation: Hyperthyroidism results in a hypermetabolic state characterized by
increased sympathetic nervous system activity. Exophthalmos is a hallmark sign specific to
Graves’ disease due to edema in the extraocular muscles. Tremors and diarrhea are
common findings because of the systemic overstimulation of physiological processes.
3. A client with chronic kidney disease (CKD) is being educated on a renal diet. The nurse
knows that the client understands the teaching when they identify which foods as being high
in potassium? Select all that apply.
A. Apples
B. Bananas
C. Spinach
D. Potatoes
E. White bread
F. Tomatoes
,Correct Answer: B, C, D, F
Explanation: Patients with CKD often need to limit potassium to prevent life-threatening
cardiac arrhythmias as the kidneys lose the ability to excrete it. Bananas, spinach, potatoes,
and tomatoes are all high-potassium foods that should be restricted. Apples and white
bread are considered low-potassium options and are generally safer for this population.
4. A client is diagnosed with Cushing syndrome. Which physical assessment finding is the
nurse most likely to observe?
A. Hyperpigmentation of the skin
B. Hypotension and bradycardia
C. Weight loss and muscle wasting of the abdomen
D. Truncal obesity and a buffalo hump
Correct Answer: D
Explanation: Cushing syndrome is caused by an excess of corticosteroids, particularly
cortisol, which leads to a redistribution of fat. This results in the characteristic truncal
obesity, moon face, and a buffalo hump on the upper back. Conversely, hyperpigmentation
is a sign of Addison’s disease, not Cushing’s.
5. A nurse is providing discharge instructions to a client with Addison’s disease. Which
instruction is most important regarding medication management?
A. Increase the dose during periods of high stress or illness
B. Stop taking the medication if you experience nausea
, C. Take the medication only when feeling weak
D. Avoid salt intake while on the medication
Correct Answer: A
Explanation: Clients with Addison’s disease require lifelong hormone replacement
therapy, usually with hydrocortisone. During times of stress, infection, or surgery, the
body’s demand for cortisol increases, so the client must be taught to increase their dosage
to prevent an Addisonian crisis. Stopping the medication abruptly can be fatal and must be
avoided.
6. A client is admitted with suspected Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory result would the nurse expect to see?
A. Serum sodium of 120 mEq/L
B. Serum osmolarity of 310 mOsm/kg
C. Dilute urine with low specific gravity
D. Increased hematocrit level
Correct Answer: A
Explanation: SIADH involves the excessive release of ADH, causing the body to retain
water and dilute the blood. This results in dilutional hyponatremia and a low serum
osmolarity. Urine in these patients is highly concentrated, which is the opposite of what is
seen in Diabetes Insipidus.
Health Nursing I | Actual Q&A with
Rationale (NSG320 Exam 3) | Grand
Canyon University
1. A nurse is caring for a client with type 1 diabetes mellitus who is admitted with a blood
glucose of 560 mg/dL and positive ketones in the urine. Which intervention is the priority for
this client?
A. Administering a bolus of intravenous regular insulin
B. Initiating fluid resuscitation with 0.9% normal saline
C. Starting a potassium chloride infusion
D. Administering sodium bicarbonate for acidosis
Correct Answer: B
Explanation: The priority intervention in Diabetic Ketoacidosis (DKA) is fluid resuscitation
to restore extracellular fluid volume and improve perfusion to the kidneys. Fluid
replacement should be initiated before insulin to prevent a rapid drop in serum osmolarity
which could lead to cerebral edema. Once the patient is stabilized with fluids, insulin is
then titrated to address the hyperglycemia and ketosis.
2. The nurse is assessing a client with hyperthyroidism (Graves’ disease). Which clinical
manifestations should the nurse expect to find? Select all that apply.
A. Tachycardia and palpitations
,B. Cold intolerance
C. Exophthalmos
D. Weight gain
E. Fine tremors of the hands
F. Diarrhea and increased bowel sounds
Correct Answer: A, C, E, F
Explanation: Hyperthyroidism results in a hypermetabolic state characterized by
increased sympathetic nervous system activity. Exophthalmos is a hallmark sign specific to
Graves’ disease due to edema in the extraocular muscles. Tremors and diarrhea are
common findings because of the systemic overstimulation of physiological processes.
3. A client with chronic kidney disease (CKD) is being educated on a renal diet. The nurse
knows that the client understands the teaching when they identify which foods as being high
in potassium? Select all that apply.
A. Apples
B. Bananas
C. Spinach
D. Potatoes
E. White bread
F. Tomatoes
,Correct Answer: B, C, D, F
Explanation: Patients with CKD often need to limit potassium to prevent life-threatening
cardiac arrhythmias as the kidneys lose the ability to excrete it. Bananas, spinach, potatoes,
and tomatoes are all high-potassium foods that should be restricted. Apples and white
bread are considered low-potassium options and are generally safer for this population.
4. A client is diagnosed with Cushing syndrome. Which physical assessment finding is the
nurse most likely to observe?
A. Hyperpigmentation of the skin
B. Hypotension and bradycardia
C. Weight loss and muscle wasting of the abdomen
D. Truncal obesity and a buffalo hump
Correct Answer: D
Explanation: Cushing syndrome is caused by an excess of corticosteroids, particularly
cortisol, which leads to a redistribution of fat. This results in the characteristic truncal
obesity, moon face, and a buffalo hump on the upper back. Conversely, hyperpigmentation
is a sign of Addison’s disease, not Cushing’s.
5. A nurse is providing discharge instructions to a client with Addison’s disease. Which
instruction is most important regarding medication management?
A. Increase the dose during periods of high stress or illness
B. Stop taking the medication if you experience nausea
, C. Take the medication only when feeling weak
D. Avoid salt intake while on the medication
Correct Answer: A
Explanation: Clients with Addison’s disease require lifelong hormone replacement
therapy, usually with hydrocortisone. During times of stress, infection, or surgery, the
body’s demand for cortisol increases, so the client must be taught to increase their dosage
to prevent an Addisonian crisis. Stopping the medication abruptly can be fatal and must be
avoided.
6. A client is admitted with suspected Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory result would the nurse expect to see?
A. Serum sodium of 120 mEq/L
B. Serum osmolarity of 310 mOsm/kg
C. Dilute urine with low specific gravity
D. Increased hematocrit level
Correct Answer: A
Explanation: SIADH involves the excessive release of ADH, causing the body to retain
water and dilute the blood. This results in dilutional hyponatremia and a low serum
osmolarity. Urine in these patients is highly concentrated, which is the opposite of what is
seen in Diabetes Insipidus.
