,NSG4100/NSG 4100 Exam 2 | Nursing Practice – Adult
Health III | Galen College | Q & A | 2026/2027 Edition
(PDF)
1. A client is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Which
assessment finding is most consistent with this condition?
A) Polyuria and polydipsia
B) Hypotension and tachycardia
C) Hyponatremia and fluid retention
D) Hyperglycemia and ketonuria
Correct Answer: Hyponatremia and fluid retention
Rationale: SIADH is characterized by excessive ADH secretion, leading to water retention, dilutional
hyponatremia, and concentrated urine. Clients present with weight gain, fluid overload, and
neurological symptoms like confusion and seizures due to low serum sodium.
2. A client with a traumatic brain injury develops excessive thirst and produces large amounts of dilute
urine. Which condition should the nurse suspect?
A) Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
B) Diabetes Insipidus (DI)
C) Congenital Adrenal Hyperplasia
D) Hyperaldosteronism
Correct Answer: Diabetes Insipidus (DI)
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, often secondary to head trauma,
brain tumor, or surgery. The hallmark manifestations include excessive thirst (polydipsia), large volumes
of dilute urine, and nocturia.
,3. A client with Diabetes Insipidus (DI) is prescribed desmopressin (DDAVP). The nurse should monitor
for which therapeutic response?
A) Increased urine output and decreased thirst
B) Decreased urine output and decreased thirst
C) Increased urine output and increased thirst
D) Decreased urine output and increased thirst
Correct Answer: Decreased urine output and decreased thirst
Rationale: Desmopressin is a synthetic analog of ADH used to replace the deficient hormone in DI. A
therapeutic response is indicated by decreased urine output, increased urine concentration, and relief
from excessive thirst (polydipsia).
4. A client with SIADH has a serum sodium level of 118 mEq/L. Which nursing intervention is the
priority?
A) Administer a bolus of 0.9% normal saline
B) Restrict oral fluids to 800 mL per day
C) Encourage the client to drink more water
D) Administer desmopressin as prescribed
Correct Answer: Restrict oral fluids to 800 mL per day
Rationale: The primary treatment for SIADH is free water restriction to prevent further dilutional
hyponatremia. Hypertonic saline (3% NaCl) may be used for severe hyponatremia, and vasopressin
antagonists may be prescribed.
5. What is the most common cause of Cushing's syndrome?
A) Adrenal tumor
B) Pituitary adenoma
C) Prolonged use of exogenous corticosteroids
D) Ectopic ACTH production
, Correct Answer: Prolonged use of exogenous corticosteroids
Rationale: The most common cause of Cushing's syndrome is the prolonged use of exogenous
corticosteroids (iatrogenic Cushing's syndrome). This is followed by pituitary adenomas (Cushing's
disease) and adrenal tumors.
6. A client with Cushing's syndrome is being evaluated. Which clinical manifestation is most
characteristic of this condition?
A) Hypotension and hyperpigmentation
B) Moon face, buffalo hump, and central obesity
C) Weight loss and diarrhea
D) Bradycardia and hypothermia
Correct Answer: Moon face, buffalo hump, and central obesity
Rationale: Cushing's syndrome results from excess cortisol, leading to characteristic features including
moon face, buffalo hump, central obesity, purple striae, hypertension, and hyperglycemia. Hypotension
and hyperpigmentation are seen in Addison's disease.
7. A client with Addison's disease is at risk for an adrenal crisis. Which assessment finding is most
concerning?
A) Hyperpigmentation of the skin
B) Hypotension and hyponatremia
C) Weight gain and edema
D) Tachycardia and hyperglycemia
Correct Answer: Hypotension and hyponatremia
Rationale: Addison's disease is characterized by adrenal insufficiency, leading to deficient cortisol and
aldosterone production. This results in hypotension, hyponatremia, hyperkalemia, and hypoglycemia.
Adrenal crisis is a life-threatening emergency with severe hypotension and shock.
Health III | Galen College | Q & A | 2026/2027 Edition
(PDF)
1. A client is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Which
assessment finding is most consistent with this condition?
A) Polyuria and polydipsia
B) Hypotension and tachycardia
C) Hyponatremia and fluid retention
D) Hyperglycemia and ketonuria
Correct Answer: Hyponatremia and fluid retention
Rationale: SIADH is characterized by excessive ADH secretion, leading to water retention, dilutional
hyponatremia, and concentrated urine. Clients present with weight gain, fluid overload, and
neurological symptoms like confusion and seizures due to low serum sodium.
2. A client with a traumatic brain injury develops excessive thirst and produces large amounts of dilute
urine. Which condition should the nurse suspect?
A) Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
B) Diabetes Insipidus (DI)
C) Congenital Adrenal Hyperplasia
D) Hyperaldosteronism
Correct Answer: Diabetes Insipidus (DI)
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, often secondary to head trauma,
brain tumor, or surgery. The hallmark manifestations include excessive thirst (polydipsia), large volumes
of dilute urine, and nocturia.
,3. A client with Diabetes Insipidus (DI) is prescribed desmopressin (DDAVP). The nurse should monitor
for which therapeutic response?
A) Increased urine output and decreased thirst
B) Decreased urine output and decreased thirst
C) Increased urine output and increased thirst
D) Decreased urine output and increased thirst
Correct Answer: Decreased urine output and decreased thirst
Rationale: Desmopressin is a synthetic analog of ADH used to replace the deficient hormone in DI. A
therapeutic response is indicated by decreased urine output, increased urine concentration, and relief
from excessive thirst (polydipsia).
4. A client with SIADH has a serum sodium level of 118 mEq/L. Which nursing intervention is the
priority?
A) Administer a bolus of 0.9% normal saline
B) Restrict oral fluids to 800 mL per day
C) Encourage the client to drink more water
D) Administer desmopressin as prescribed
Correct Answer: Restrict oral fluids to 800 mL per day
Rationale: The primary treatment for SIADH is free water restriction to prevent further dilutional
hyponatremia. Hypertonic saline (3% NaCl) may be used for severe hyponatremia, and vasopressin
antagonists may be prescribed.
5. What is the most common cause of Cushing's syndrome?
A) Adrenal tumor
B) Pituitary adenoma
C) Prolonged use of exogenous corticosteroids
D) Ectopic ACTH production
, Correct Answer: Prolonged use of exogenous corticosteroids
Rationale: The most common cause of Cushing's syndrome is the prolonged use of exogenous
corticosteroids (iatrogenic Cushing's syndrome). This is followed by pituitary adenomas (Cushing's
disease) and adrenal tumors.
6. A client with Cushing's syndrome is being evaluated. Which clinical manifestation is most
characteristic of this condition?
A) Hypotension and hyperpigmentation
B) Moon face, buffalo hump, and central obesity
C) Weight loss and diarrhea
D) Bradycardia and hypothermia
Correct Answer: Moon face, buffalo hump, and central obesity
Rationale: Cushing's syndrome results from excess cortisol, leading to characteristic features including
moon face, buffalo hump, central obesity, purple striae, hypertension, and hyperglycemia. Hypotension
and hyperpigmentation are seen in Addison's disease.
7. A client with Addison's disease is at risk for an adrenal crisis. Which assessment finding is most
concerning?
A) Hyperpigmentation of the skin
B) Hypotension and hyponatremia
C) Weight gain and edema
D) Tachycardia and hyperglycemia
Correct Answer: Hypotension and hyponatremia
Rationale: Addison's disease is characterized by adrenal insufficiency, leading to deficient cortisol and
aldosterone production. This results in hypotension, hyponatremia, hyperkalemia, and hypoglycemia.
Adrenal crisis is a life-threatening emergency with severe hypotension and shock.
