NSG 3250: Exam 4 Practice Assessment
updated 2026 with correct questions
with verified answers and rationale
Section 1: Endocrine System (Diabetes, Thyroid, Adrenal)
A patient presents with a serum glucose of 750 mg/dL, negative ketones in the urine, and severe
dehydration. Which condition does the nurse suspect?
A. Diabetic Ketoacidosis (DKA)
B. Hyperglycemic Hyperosmolar State (HHS)
C. Diabetes Insipidus
D. Somogyi Effect
Rationale: HHS is characterized by extreme hyperglycemia and hyperosmolarity without significant
ketosis, typically occurring in Type 2 diabetics.
Which insulin can be administered intravenously?
A. Regular Insulin
B. Insulin Lispro
C. Insulin Glargine
D. NPH Insulin
Rationale: Regular insulin is the only insulin approved for IV use in acute settings like DKA.
A patient with hyperthyroidism is post-op day 1 following a subtotal thyroidectomy. Which finding
requires immediate intervention?
A. Sore throat when swallowing
B. Laryngeal stridor and crowing sounds
C. Incisional pain rated 4/10
D. Heart rate of 90 bpm
Rationale: Stridor indicates airway obstruction, possibly due to edema or tetany (hypocalcemia).
,Which electrolyte imbalance should the nurse monitor for following a parathyroidectomy?
A. Hypernatremia
B. Hypokalemia
C. Hypocalcemia
D. Hypermagnesemia
Rationale: The parathyroid glands regulate calcium; their removal or accidental damage leads to low
calcium.
A patient has a moon face, buffalo hump, and purple striae on the abdomen. Which lab result is
consistent with this?
A. Increased serum cortisol
B. Decreased serum sodium
C. Increased serum potassium
D. Decreased blood glucose
Rationale: These are classic signs of Cushing’s Syndrome, caused by excessive cortisol.
A patient with Addison’s disease is being discharged. Which instruction is most important?
A. "Limit your salt intake."
B. "Increase your exercise intensity."
C. "Do not abruptly stop taking your steroid medication."
D. "Restrict fluid intake to 1 liter a day."
Rationale: Abrupt cessation of steroids in Addison's can trigger a life-threatening Addisonian Crisis.
Which medication is used to treat Diabetes Insipidus (DI)?
A. Insulin
B. Desmopressin (DDAVP)
C. Furosemide
D. Metformin
Rationale: DI is a deficiency of ADH; Desmopressin is a synthetic replacement for ADH.
, A patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone) would likely exhibit:
A. Polydipsia and Polyuria
B. Dilutional hyponatremia and fluid retention
C. Hypernatremia and dehydration
D. Weight loss and hypotension
Rationale: SIADH causes excess water reabsorption, diluting the sodium in the blood.
What is the priority nursing intervention for a patient in a Myxedema Coma?
A. Maintain a patent airway and provide ventilatory support
B. Administer large doses of rapid-acting insulin
C. Apply cooling blankets
D. Encourage oral fluid intake
Rationale: Myxedema coma is severe hypothyroidism leading to respiratory failure and
cardiovascular collapse.
A patient is taking Levothyroxine for hypothyroidism. Which statement indicates the medication is
effective?
A. "I am sleeping 12 hours a day now."
B. "I have more energy and my heart rate has increased to 72."
C. "I have gained 5 pounds this week."
D. "I feel cold all the time."
Rationale: Levothyroxine increases metabolic rate, improving energy and vital signs.
What is a hallmark sign of Pheochromocytoma?
A. Bradycardia
B. Severe hypertension and pounding headache
C. Hypoglycemia
D. Weight gain
Rationale: Pheochromocytoma is a tumor of the adrenal medulla that secretes catecholamines,
causing "spells" of high BP.
A patient with Type 1 Diabetes is trembling, diaphoretic, and confused. What is the first action?
updated 2026 with correct questions
with verified answers and rationale
Section 1: Endocrine System (Diabetes, Thyroid, Adrenal)
A patient presents with a serum glucose of 750 mg/dL, negative ketones in the urine, and severe
dehydration. Which condition does the nurse suspect?
A. Diabetic Ketoacidosis (DKA)
B. Hyperglycemic Hyperosmolar State (HHS)
C. Diabetes Insipidus
D. Somogyi Effect
Rationale: HHS is characterized by extreme hyperglycemia and hyperosmolarity without significant
ketosis, typically occurring in Type 2 diabetics.
Which insulin can be administered intravenously?
A. Regular Insulin
B. Insulin Lispro
C. Insulin Glargine
D. NPH Insulin
Rationale: Regular insulin is the only insulin approved for IV use in acute settings like DKA.
A patient with hyperthyroidism is post-op day 1 following a subtotal thyroidectomy. Which finding
requires immediate intervention?
A. Sore throat when swallowing
B. Laryngeal stridor and crowing sounds
C. Incisional pain rated 4/10
D. Heart rate of 90 bpm
Rationale: Stridor indicates airway obstruction, possibly due to edema or tetany (hypocalcemia).
,Which electrolyte imbalance should the nurse monitor for following a parathyroidectomy?
A. Hypernatremia
B. Hypokalemia
C. Hypocalcemia
D. Hypermagnesemia
Rationale: The parathyroid glands regulate calcium; their removal or accidental damage leads to low
calcium.
A patient has a moon face, buffalo hump, and purple striae on the abdomen. Which lab result is
consistent with this?
A. Increased serum cortisol
B. Decreased serum sodium
C. Increased serum potassium
D. Decreased blood glucose
Rationale: These are classic signs of Cushing’s Syndrome, caused by excessive cortisol.
A patient with Addison’s disease is being discharged. Which instruction is most important?
A. "Limit your salt intake."
B. "Increase your exercise intensity."
C. "Do not abruptly stop taking your steroid medication."
D. "Restrict fluid intake to 1 liter a day."
Rationale: Abrupt cessation of steroids in Addison's can trigger a life-threatening Addisonian Crisis.
Which medication is used to treat Diabetes Insipidus (DI)?
A. Insulin
B. Desmopressin (DDAVP)
C. Furosemide
D. Metformin
Rationale: DI is a deficiency of ADH; Desmopressin is a synthetic replacement for ADH.
, A patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone) would likely exhibit:
A. Polydipsia and Polyuria
B. Dilutional hyponatremia and fluid retention
C. Hypernatremia and dehydration
D. Weight loss and hypotension
Rationale: SIADH causes excess water reabsorption, diluting the sodium in the blood.
What is the priority nursing intervention for a patient in a Myxedema Coma?
A. Maintain a patent airway and provide ventilatory support
B. Administer large doses of rapid-acting insulin
C. Apply cooling blankets
D. Encourage oral fluid intake
Rationale: Myxedema coma is severe hypothyroidism leading to respiratory failure and
cardiovascular collapse.
A patient is taking Levothyroxine for hypothyroidism. Which statement indicates the medication is
effective?
A. "I am sleeping 12 hours a day now."
B. "I have more energy and my heart rate has increased to 72."
C. "I have gained 5 pounds this week."
D. "I feel cold all the time."
Rationale: Levothyroxine increases metabolic rate, improving energy and vital signs.
What is a hallmark sign of Pheochromocytoma?
A. Bradycardia
B. Severe hypertension and pounding headache
C. Hypoglycemia
D. Weight gain
Rationale: Pheochromocytoma is a tumor of the adrenal medulla that secretes catecholamines,
causing "spells" of high BP.
A patient with Type 1 Diabetes is trembling, diaphoretic, and confused. What is the first action?
