Final Exam - NUR2392 / NUR 2392
Multidimensional Care II / MDC 2
Rasmussen University | 2026-2027 Curriculum
100 Questions | Comprehensive with Rationales
Section 1: Endocrine Disorders
Questions 1-20
1. A nurse is assessing a client with suspected diabetes insipidus. Which of the following findings would the
nurse expect?
A. Urine specific gravity of 1.030 and decreased urine output
B. Urine specific gravity less than 1.005 and polyuria [CORRECT]
C. Urine specific gravity of 1.015 and oliguria
D. Urine specific gravity of 1.020 and polydipsia
Correct Answer: B
Rationale: In diabetes insipidus, ADH deficiency prevents water reabsorption in the collecting ducts, resulting in large volumes of
dilute urine with a specific gravity below 1.005. Polyuria and polydipsia are hallmark findings. Option A describes concentrated
urine in dehydration. Option C suggests normal urine. Option D has normal specific gravity inconsistent with DI.
2. A client with diabetes insipidus is prescribed desmopressin (DDAVP). The nurse understands that this
medication works by which mechanism?
A. Blocking aldosterone receptors in the kidneys
B. Increasing calcium reabsorption in the distal tubules
C. Mimicking antidiuretic hormone to promote water reabsorption [CORRECT]
D. Inhibiting insulin release from the pancreatic beta cells
Correct Answer: C
Rationale: Desmopressin (DDAVP) is a synthetic ADH analog that acts on V2 receptors in the collecting ducts to increase water
permeability, promoting water reabsorption and reducing urine output. Option A describes spironolactone. Option B relates to
PTH. Option D describes diazoxide.
3. A nurse is caring for a client diagnosed with SIADH. Which clinical manifestation is most consistent?
A. Hyponatremia with euvolemia [CORRECT]
B. Hypernatremia with dehydration
C. Hyperkalemia with fluid volume deficit
D. Hypocalcemia with tetany
Correct Answer: A
,Rationale: SIADH is characterized by excessive ADH secretion causing water retention and dilutional hyponatremia with
euvolemia. Option B describes DI. Option C is Addison disease. Option D is hyperventilation or parathyroidectomy.
4. What is the priority nursing intervention for a client diagnosed with SIADH?
A. Administer hypertonic saline immediately
B. Restrict fluid intake as prescribed [CORRECT]
C. Encourage increased oral fluid intake
D. Administer potassium-sparing diuretics
Correct Answer: B
Rationale: Fluid restriction is the first-line intervention for SIADH because the underlying problem is excess water retention.
Hypertonic saline (A) is reserved for severe symptomatic hyponatremia. Option C would worsen it. Option D is not primary
treatment.
5. A client with Graves' disease presents with exophthalmos, a diffuse goiter, and tachycardia. The nurse
understands that Graves' disease is classified as which type of disorder?
A. A metabolic disorder caused by iodine deficiency
B. An autoimmune disorder causing hyperthyroidism [CORRECT]
C. A genetic disorder causing hypothyroidism
D. A pituitary disorder causing secondary hypothyroidism
Correct Answer: B
Rationale: Graves' disease is an autoimmune disorder in which TSI bind to TSH receptors, causing hyperthyroidism. The triad
includes diffuse goiter, exophthalmos, and pretibial myxedema. Option A is endemic goiter. Option C is wrong because Graves
causes hyperthyroidism. Option D is wrong because it is primary, not pituitary.
6. A nurse is developing a plan of care for a client with Graves' disease. Which intervention promotes
comfort and safety?
A. Provide a warm environment and encourage activity
B. Maintain a cool environment and reduce environmental stimuli [CORRECT]
C. Restrict calcium intake and monitor for bradycardia
D. Encourage high-carbohydrate meals and limit protein
Correct Answer: B
Rationale: Graves' clients have heat intolerance and stimulus sensitivity. A cool, calm, quiet environment reduces sympathetic
stimulation and thyroid storm risk. Option A worsens heat intolerance. Option C is incorrect for hyperthyroidism. Option D is not
recommended.
7. A client with Graves' disease is prescribed methimazole. The nurse should monitor for which adverse
effect?
A. Hypoglycemia
B. Agranulocytosis [CORRECT]
C. Hyperkalemia
, D. Bradycardia
Correct Answer: B
Rationale: Methimazole carries the risk of agranulocytosis, a potentially life-threatening WBC decrease. The client should report
sore throat, fever, and mouth sores immediately. Option A is not associated. Option C is from ACE inhibitors. Option D is from
beta-blockers.
8. A nurse is assessing a client taking levothyroxine for hypothyroidism. Which laboratory value indicates
effective dosing?
A. Elevated TSH level
B. Decreased TSH level within normal range [CORRECT]
C. Elevated T3 level above normal
D. Decreased free T4 level
Correct Answer: B
Rationale: The goal of levothyroxine therapy is TSH within normal range (0.4-4.0 mIU/L). Adequate replacement restores
negative feedback, reducing TSH. Option A indicates inadequate dosing. Option C suggests over-replacement. Option D indicates
subtherapeutic dosing.
9. A client presents with moon face, buffalo hump, truncal obesity, and purple striae. The nurse recognizes
these as characteristic of which condition?
A. Addison disease
B. Cushing syndrome [CORRECT]
C. Hypothyroidism
D. Diabetes insipidus
Correct Answer: B
Rationale: Cushing syndrome results from prolonged cortisol excess causing fat redistribution (moon face, buffalo hump, truncal
obesity) and purple striae from protein catabolism weakening connective tissue. Option A has hyperpigmentation and weight loss.
Option C has fatigue and cold intolerance. Option D has polyuria.
10. A nurse is caring for a client with Cushing syndrome. Which finding should the nurse expect?
A. Hypoglycemia and hypotension
B. Hyperglycemia and hypertension [CORRECT]
C. Hypokalemia and hyponatremia
D. Bradycardia and weight loss
Correct Answer: B
Rationale: Cushing causes hyperglycemia (cortisol-induced gluconeogenesis and insulin resistance) and hypertension (sodium
retention and catecholamine sensitivity). Option A describes Addison disease. Option C is not the primary finding. Option D is
inconsistent with cortisol excess.
11. A client with Addison disease is at risk for which electrolyte imbalance?
Multidimensional Care II / MDC 2
Rasmussen University | 2026-2027 Curriculum
100 Questions | Comprehensive with Rationales
Section 1: Endocrine Disorders
Questions 1-20
1. A nurse is assessing a client with suspected diabetes insipidus. Which of the following findings would the
nurse expect?
A. Urine specific gravity of 1.030 and decreased urine output
B. Urine specific gravity less than 1.005 and polyuria [CORRECT]
C. Urine specific gravity of 1.015 and oliguria
D. Urine specific gravity of 1.020 and polydipsia
Correct Answer: B
Rationale: In diabetes insipidus, ADH deficiency prevents water reabsorption in the collecting ducts, resulting in large volumes of
dilute urine with a specific gravity below 1.005. Polyuria and polydipsia are hallmark findings. Option A describes concentrated
urine in dehydration. Option C suggests normal urine. Option D has normal specific gravity inconsistent with DI.
2. A client with diabetes insipidus is prescribed desmopressin (DDAVP). The nurse understands that this
medication works by which mechanism?
A. Blocking aldosterone receptors in the kidneys
B. Increasing calcium reabsorption in the distal tubules
C. Mimicking antidiuretic hormone to promote water reabsorption [CORRECT]
D. Inhibiting insulin release from the pancreatic beta cells
Correct Answer: C
Rationale: Desmopressin (DDAVP) is a synthetic ADH analog that acts on V2 receptors in the collecting ducts to increase water
permeability, promoting water reabsorption and reducing urine output. Option A describes spironolactone. Option B relates to
PTH. Option D describes diazoxide.
3. A nurse is caring for a client diagnosed with SIADH. Which clinical manifestation is most consistent?
A. Hyponatremia with euvolemia [CORRECT]
B. Hypernatremia with dehydration
C. Hyperkalemia with fluid volume deficit
D. Hypocalcemia with tetany
Correct Answer: A
,Rationale: SIADH is characterized by excessive ADH secretion causing water retention and dilutional hyponatremia with
euvolemia. Option B describes DI. Option C is Addison disease. Option D is hyperventilation or parathyroidectomy.
4. What is the priority nursing intervention for a client diagnosed with SIADH?
A. Administer hypertonic saline immediately
B. Restrict fluid intake as prescribed [CORRECT]
C. Encourage increased oral fluid intake
D. Administer potassium-sparing diuretics
Correct Answer: B
Rationale: Fluid restriction is the first-line intervention for SIADH because the underlying problem is excess water retention.
Hypertonic saline (A) is reserved for severe symptomatic hyponatremia. Option C would worsen it. Option D is not primary
treatment.
5. A client with Graves' disease presents with exophthalmos, a diffuse goiter, and tachycardia. The nurse
understands that Graves' disease is classified as which type of disorder?
A. A metabolic disorder caused by iodine deficiency
B. An autoimmune disorder causing hyperthyroidism [CORRECT]
C. A genetic disorder causing hypothyroidism
D. A pituitary disorder causing secondary hypothyroidism
Correct Answer: B
Rationale: Graves' disease is an autoimmune disorder in which TSI bind to TSH receptors, causing hyperthyroidism. The triad
includes diffuse goiter, exophthalmos, and pretibial myxedema. Option A is endemic goiter. Option C is wrong because Graves
causes hyperthyroidism. Option D is wrong because it is primary, not pituitary.
6. A nurse is developing a plan of care for a client with Graves' disease. Which intervention promotes
comfort and safety?
A. Provide a warm environment and encourage activity
B. Maintain a cool environment and reduce environmental stimuli [CORRECT]
C. Restrict calcium intake and monitor for bradycardia
D. Encourage high-carbohydrate meals and limit protein
Correct Answer: B
Rationale: Graves' clients have heat intolerance and stimulus sensitivity. A cool, calm, quiet environment reduces sympathetic
stimulation and thyroid storm risk. Option A worsens heat intolerance. Option C is incorrect for hyperthyroidism. Option D is not
recommended.
7. A client with Graves' disease is prescribed methimazole. The nurse should monitor for which adverse
effect?
A. Hypoglycemia
B. Agranulocytosis [CORRECT]
C. Hyperkalemia
, D. Bradycardia
Correct Answer: B
Rationale: Methimazole carries the risk of agranulocytosis, a potentially life-threatening WBC decrease. The client should report
sore throat, fever, and mouth sores immediately. Option A is not associated. Option C is from ACE inhibitors. Option D is from
beta-blockers.
8. A nurse is assessing a client taking levothyroxine for hypothyroidism. Which laboratory value indicates
effective dosing?
A. Elevated TSH level
B. Decreased TSH level within normal range [CORRECT]
C. Elevated T3 level above normal
D. Decreased free T4 level
Correct Answer: B
Rationale: The goal of levothyroxine therapy is TSH within normal range (0.4-4.0 mIU/L). Adequate replacement restores
negative feedback, reducing TSH. Option A indicates inadequate dosing. Option C suggests over-replacement. Option D indicates
subtherapeutic dosing.
9. A client presents with moon face, buffalo hump, truncal obesity, and purple striae. The nurse recognizes
these as characteristic of which condition?
A. Addison disease
B. Cushing syndrome [CORRECT]
C. Hypothyroidism
D. Diabetes insipidus
Correct Answer: B
Rationale: Cushing syndrome results from prolonged cortisol excess causing fat redistribution (moon face, buffalo hump, truncal
obesity) and purple striae from protein catabolism weakening connective tissue. Option A has hyperpigmentation and weight loss.
Option C has fatigue and cold intolerance. Option D has polyuria.
10. A nurse is caring for a client with Cushing syndrome. Which finding should the nurse expect?
A. Hypoglycemia and hypotension
B. Hyperglycemia and hypertension [CORRECT]
C. Hypokalemia and hyponatremia
D. Bradycardia and weight loss
Correct Answer: B
Rationale: Cushing causes hyperglycemia (cortisol-induced gluconeogenesis and insulin resistance) and hypertension (sodium
retention and catecholamine sensitivity). Option A describes Addison disease. Option C is not the primary finding. Option D is
inconsistent with cortisol excess.
11. A client with Addison disease is at risk for which electrolyte imbalance?
