NUR 301 EXAM 4 2026/2027 – COMPREHENSIVE STUDY GUIDE, PRACTICE
QUESTIONS & EXAM REVIEW
what happens in hyperaldosteronism? - correct answer ✔✔-serum Na and H2o increases
-part of the RAAS system
-caused by: adrenal gland releases too much ACTH (Conn disease)
what electrolyte imbalance happens in hyperaldosteronism? - correct answer ✔✔hypertension and
hypernatremia
-increased retention of salt and water
what is SIADH? - correct answer ✔✔syndrome of inappropriate antidiuretic hormone
what causes SIADH? - correct answer ✔✔ADH increases without normal stimulus
-Ectopically produced by cancer cells (most common=Oat cell CA)
-stress of surgery increases ADH for 5-7 days
-infected lung tissue
-emotional stress and antipsychotic drugs
-anesthesia and morphine
Pathophisiology of SIADH - correct answer ✔✔-cont release leads to H2O retention, results in decreased
serum sodium levels, water retention leads to concentrated urine
Clinical manifestations of SIADH - correct answer ✔✔Na 130= thirst, anorexia, fatigue dulled senses
Na 120= GI symptoms
Na 115= confused, seizures
SIADH evaluations - correct answer ✔✔-serum Na decrease, increased urine osmolarity (urine
concentrate)
-h20 restriction improves to decrease ADH
-hyponatremia
Treatment- fluid restriction
What is diabetes insipidus? - correct answer ✔✔insufficiency of ADH, opposite of SIADH
neurogenic diabetes insipidus - correct answer ✔✔-hypothalamic/posterior pituitary tumor dec ADH
-thrombosis of glands
-aneurism, infection, IR, head injury
nephrogenic diabetes insipidus - correct answer ✔✔-dont see as much d/t renal dialysis
-renal failure, nephrotoxic drugs, kidney infections
pathophis of diabetes insipidus - correct answer ✔✔-decrease ADH= increase Na
-loss of fluid d/t increased sodium levels
-diluted urine
, clinical manifestations of diabetes insipidus - correct answer ✔✔-polyuria (10-12 L/day)
-thirst esp. for cold drinks
-large bladder and nocturia
-hydronephrosis (water on kidney, urine bath=post renal)
evaluation of diabetes insipidus - correct answer ✔✔-serum Na inc
-urine osmolality low with dec specific gravity
treatment: hourly urine checks, DDAVP- desmopressin (synthetic ADH), oral and iv fluids
pathophysiology of hyperthyroidism/graves - correct answer ✔✔antibody attacks receptor and blocks
TSH to keep releasing T3 and T4
-IgG inc thyroid growth
-inc vascularity
-hypersecretion of thyroid
clinical manifestations of hyperthyroidism - correct answer ✔✔-goiter (enlarged gland, bruit), dec libido,
wt loss, excess sweating, heat intolerance, exophthalmos (eyes bug out), HTN, nervous, insomnia, all
metabolism (BP/temp) affected
evaluation of graves - correct answer ✔✔increase t3 and t4
-dec TSH d/t auto-antibody
-iodine studies
treatment of graves - correct answer ✔✔-surgery (thyroidectomy)
-radioactive iodine
-anti-thyroid medicine
why does a thyroidectomy set off hypoparathyroidism? - correct answer ✔✔-removal of the thyroid
damages the parathyroid and causes low PTH levels because it would not be stimulated
-this would decrease serum calcium and increase serum phosphate
would have s/s of hypocalcemia: dry skin, hair loss, cataracts, teeth hypoplasia, nail ridges, bowed legs,
muscle spasms, hyper reflexes, laryngo/bronchospasm l/t asphyxiation
hypothyroidism labs - correct answer ✔✔High TSH
Low T4
Low or normal T3
clinical manifestations of hypothyroidism - correct answer ✔✔-periorbital oedema
-husky voice
-goitre
-bradycardia
-carpal tunnel
-menorrhagia
-constipation
general: low metabolic rate, weight gain, cold sensitivity, lethargy, mental impairment, depression
QUESTIONS & EXAM REVIEW
what happens in hyperaldosteronism? - correct answer ✔✔-serum Na and H2o increases
-part of the RAAS system
-caused by: adrenal gland releases too much ACTH (Conn disease)
what electrolyte imbalance happens in hyperaldosteronism? - correct answer ✔✔hypertension and
hypernatremia
-increased retention of salt and water
what is SIADH? - correct answer ✔✔syndrome of inappropriate antidiuretic hormone
what causes SIADH? - correct answer ✔✔ADH increases without normal stimulus
-Ectopically produced by cancer cells (most common=Oat cell CA)
-stress of surgery increases ADH for 5-7 days
-infected lung tissue
-emotional stress and antipsychotic drugs
-anesthesia and morphine
Pathophisiology of SIADH - correct answer ✔✔-cont release leads to H2O retention, results in decreased
serum sodium levels, water retention leads to concentrated urine
Clinical manifestations of SIADH - correct answer ✔✔Na 130= thirst, anorexia, fatigue dulled senses
Na 120= GI symptoms
Na 115= confused, seizures
SIADH evaluations - correct answer ✔✔-serum Na decrease, increased urine osmolarity (urine
concentrate)
-h20 restriction improves to decrease ADH
-hyponatremia
Treatment- fluid restriction
What is diabetes insipidus? - correct answer ✔✔insufficiency of ADH, opposite of SIADH
neurogenic diabetes insipidus - correct answer ✔✔-hypothalamic/posterior pituitary tumor dec ADH
-thrombosis of glands
-aneurism, infection, IR, head injury
nephrogenic diabetes insipidus - correct answer ✔✔-dont see as much d/t renal dialysis
-renal failure, nephrotoxic drugs, kidney infections
pathophis of diabetes insipidus - correct answer ✔✔-decrease ADH= increase Na
-loss of fluid d/t increased sodium levels
-diluted urine
, clinical manifestations of diabetes insipidus - correct answer ✔✔-polyuria (10-12 L/day)
-thirst esp. for cold drinks
-large bladder and nocturia
-hydronephrosis (water on kidney, urine bath=post renal)
evaluation of diabetes insipidus - correct answer ✔✔-serum Na inc
-urine osmolality low with dec specific gravity
treatment: hourly urine checks, DDAVP- desmopressin (synthetic ADH), oral and iv fluids
pathophysiology of hyperthyroidism/graves - correct answer ✔✔antibody attacks receptor and blocks
TSH to keep releasing T3 and T4
-IgG inc thyroid growth
-inc vascularity
-hypersecretion of thyroid
clinical manifestations of hyperthyroidism - correct answer ✔✔-goiter (enlarged gland, bruit), dec libido,
wt loss, excess sweating, heat intolerance, exophthalmos (eyes bug out), HTN, nervous, insomnia, all
metabolism (BP/temp) affected
evaluation of graves - correct answer ✔✔increase t3 and t4
-dec TSH d/t auto-antibody
-iodine studies
treatment of graves - correct answer ✔✔-surgery (thyroidectomy)
-radioactive iodine
-anti-thyroid medicine
why does a thyroidectomy set off hypoparathyroidism? - correct answer ✔✔-removal of the thyroid
damages the parathyroid and causes low PTH levels because it would not be stimulated
-this would decrease serum calcium and increase serum phosphate
would have s/s of hypocalcemia: dry skin, hair loss, cataracts, teeth hypoplasia, nail ridges, bowed legs,
muscle spasms, hyper reflexes, laryngo/bronchospasm l/t asphyxiation
hypothyroidism labs - correct answer ✔✔High TSH
Low T4
Low or normal T3
clinical manifestations of hypothyroidism - correct answer ✔✔-periorbital oedema
-husky voice
-goitre
-bradycardia
-carpal tunnel
-menorrhagia
-constipation
general: low metabolic rate, weight gain, cold sensitivity, lethargy, mental impairment, depression
