Grand Canyon University NSG 320 Exam 1 (pdf) | 2026/2027 | Adult
Health I Q&A | Nursing
1. Which of the following best describes the underlying pathophysiology of
type 1 diabetes mellitus?
A) Insulin resistance with compensatory hyperinsulinemia
B) Autoimmune destruction of pancreatic beta cells leading to absolute
insulin deficiency
C) Impaired glucose tolerance with elevated fasting glucose
D) Deficiency of glucagon secretion from alpha cells
Correct Answer: Autoimmune destruction of pancreatic beta cells leading to
absolute insulin deficiency
Rationale: Type 1 diabetes is characterized by autoimmune destruction of
pancreatic beta cells, resulting in absolute insulin deficiency. This requires
lifelong exogenous insulin therapy. Type 2 diabetes involves insulin
resistance and relative insulin deficiency. Glucagon deficiency is not the
primary defect.
---
2. A nurse is assessing a patient with suspected hyperthyroidism. Which
clinical manifestation would the nurse expect to find?
A) Weight gain and cold intolerance
B) Bradycardia and constipation
C) Tachycardia and heat intolerance
D) Lethargy and dry skin
Correct Answer: Tachycardia and heat intolerance
,Rationale: Hyperthyroidism results from excessive thyroid hormone, causing
increased metabolic rate. Classic manifestations include tachycardia, heat
intolerance, weight loss, diaphoresis, and nervousness. Weight gain,
bradycardia, constipation, lethargy, and dry skin are associated with
hypothyroidism.
---
3. A patient with hypothyroidism is prescribed levothyroxine. Which
instruction should the nurse include in patient teaching?
A) Take the medication with food to prevent gastric upset
B) Take the medication on an empty stomach in the morning
C) Take the medication at bedtime for better absorption
D) Take the medication with antacids to reduce side effects
Correct Answer: Take the medication on an empty stomach in the morning
Rationale: Levothyroxine should be taken on an empty stomach, typically 30-
60 minutes before breakfast, to maximize absorption. Food, calcium, iron,
and antacids can significantly reduce absorption. Consistent timing is
essential for maintaining stable thyroid hormone levels.
---
4. A patient with type 2 diabetes is prescribed metformin. What is the
primary mechanism of action of this medication?
A) Stimulates insulin secretion from pancreatic beta cells
B) Decreases hepatic glucose production and increases insulin sensitivity
C) Slows intestinal absorption of carbohydrates
D) Increases glucose excretion through the kidneys
,Correct Answer: Decreases hepatic glucose production and increases insulin
sensitivity
Rationale: Metformin is a biguanide that works primarily by decreasing
hepatic glucose production (gluconeogenesis) and improving peripheral
insulin sensitivity. It does not stimulate insulin secretion. SGLT2 inhibitors
increase renal glucose excretion, and alpha-glucosidase inhibitors slow
carbohydrate absorption.
---
5. A nurse is caring for a patient in diabetic ketoacidosis (DKA). Which
assessment finding is most consistent with this condition?
A) Kussmaul respirations and fruity breath odor
B) Slow, shallow respirations and bradypnea
C) Absent breath sounds and wheezing
D) Cheyne-Stokes respirations and cyanosis
Correct Answer: Kussmaul respirations and fruity breath odor
Rationale: DKA causes metabolic acidosis with respiratory compensation
(Kussmaul: deep, rapid breathing). Acetone breath (fruity odor) results from
ketone production. Other findings include hyperglycemia, dehydration, and
electrolyte imbalances.
---
6. Which diagnostic finding is expected in a patient with hyperthyroidism?
A) Elevated TSH and low T4
, B) Low TSH and elevated T4
C) Elevated TSH and elevated T4
D) Low TSH and low T4
Correct Answer: Low TSH and elevated T4
Rationale: In hyperthyroidism, the negative feedback loop is disrupted.
Excess thyroid hormone (T4) suppresses TSH secretion from the pituitary,
resulting in low TSH with elevated free T4. Primary hypothyroidism presents
with elevated TSH and low T4.
---
7. A patient is admitted with myxedema coma. Which of the following is a
priority nursing intervention?
A) Administer oral levothyroxine immediately
B) Maintain a warm environment and monitor for hypothermia
C) Restrict fluids to prevent fluid overload
D) Administer beta blockers to reduce heart rate
Correct Answer: Maintain a warm environment and monitor for hypothermia
Rationale: Myxedema coma is a life-threatening complication of severe
hypothyroidism. Patients are profoundly hypothermic and require passive
rewarming. IV levothyroxine is administered, not oral. Fluid restriction is not
appropriate; patients may need careful fluid replacement.
---
Health I Q&A | Nursing
1. Which of the following best describes the underlying pathophysiology of
type 1 diabetes mellitus?
A) Insulin resistance with compensatory hyperinsulinemia
B) Autoimmune destruction of pancreatic beta cells leading to absolute
insulin deficiency
C) Impaired glucose tolerance with elevated fasting glucose
D) Deficiency of glucagon secretion from alpha cells
Correct Answer: Autoimmune destruction of pancreatic beta cells leading to
absolute insulin deficiency
Rationale: Type 1 diabetes is characterized by autoimmune destruction of
pancreatic beta cells, resulting in absolute insulin deficiency. This requires
lifelong exogenous insulin therapy. Type 2 diabetes involves insulin
resistance and relative insulin deficiency. Glucagon deficiency is not the
primary defect.
---
2. A nurse is assessing a patient with suspected hyperthyroidism. Which
clinical manifestation would the nurse expect to find?
A) Weight gain and cold intolerance
B) Bradycardia and constipation
C) Tachycardia and heat intolerance
D) Lethargy and dry skin
Correct Answer: Tachycardia and heat intolerance
,Rationale: Hyperthyroidism results from excessive thyroid hormone, causing
increased metabolic rate. Classic manifestations include tachycardia, heat
intolerance, weight loss, diaphoresis, and nervousness. Weight gain,
bradycardia, constipation, lethargy, and dry skin are associated with
hypothyroidism.
---
3. A patient with hypothyroidism is prescribed levothyroxine. Which
instruction should the nurse include in patient teaching?
A) Take the medication with food to prevent gastric upset
B) Take the medication on an empty stomach in the morning
C) Take the medication at bedtime for better absorption
D) Take the medication with antacids to reduce side effects
Correct Answer: Take the medication on an empty stomach in the morning
Rationale: Levothyroxine should be taken on an empty stomach, typically 30-
60 minutes before breakfast, to maximize absorption. Food, calcium, iron,
and antacids can significantly reduce absorption. Consistent timing is
essential for maintaining stable thyroid hormone levels.
---
4. A patient with type 2 diabetes is prescribed metformin. What is the
primary mechanism of action of this medication?
A) Stimulates insulin secretion from pancreatic beta cells
B) Decreases hepatic glucose production and increases insulin sensitivity
C) Slows intestinal absorption of carbohydrates
D) Increases glucose excretion through the kidneys
,Correct Answer: Decreases hepatic glucose production and increases insulin
sensitivity
Rationale: Metformin is a biguanide that works primarily by decreasing
hepatic glucose production (gluconeogenesis) and improving peripheral
insulin sensitivity. It does not stimulate insulin secretion. SGLT2 inhibitors
increase renal glucose excretion, and alpha-glucosidase inhibitors slow
carbohydrate absorption.
---
5. A nurse is caring for a patient in diabetic ketoacidosis (DKA). Which
assessment finding is most consistent with this condition?
A) Kussmaul respirations and fruity breath odor
B) Slow, shallow respirations and bradypnea
C) Absent breath sounds and wheezing
D) Cheyne-Stokes respirations and cyanosis
Correct Answer: Kussmaul respirations and fruity breath odor
Rationale: DKA causes metabolic acidosis with respiratory compensation
(Kussmaul: deep, rapid breathing). Acetone breath (fruity odor) results from
ketone production. Other findings include hyperglycemia, dehydration, and
electrolyte imbalances.
---
6. Which diagnostic finding is expected in a patient with hyperthyroidism?
A) Elevated TSH and low T4
, B) Low TSH and elevated T4
C) Elevated TSH and elevated T4
D) Low TSH and low T4
Correct Answer: Low TSH and elevated T4
Rationale: In hyperthyroidism, the negative feedback loop is disrupted.
Excess thyroid hormone (T4) suppresses TSH secretion from the pituitary,
resulting in low TSH with elevated free T4. Primary hypothyroidism presents
with elevated TSH and low T4.
---
7. A patient is admitted with myxedema coma. Which of the following is a
priority nursing intervention?
A) Administer oral levothyroxine immediately
B) Maintain a warm environment and monitor for hypothermia
C) Restrict fluids to prevent fluid overload
D) Administer beta blockers to reduce heart rate
Correct Answer: Maintain a warm environment and monitor for hypothermia
Rationale: Myxedema coma is a life-threatening complication of severe
hypothyroidism. Patients are profoundly hypothermic and require passive
rewarming. IV levothyroxine is administered, not oral. Fluid restriction is not
appropriate; patients may need careful fluid replacement.
---
