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NURS 618 EXAM 3 2026/2027 COMPLETE CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
NURS
Prepare for NURS 618 Exam 3 with this focused study resource designed to reinforce
key course concepts and essential nursing material. Use it to review important topics,
strengthen your understanding, and identify areas that may require additional study.
This resource provides a structured supplement to your coursework and can help
improve your exam readiness. It is ideal for students seeking a convenient way to
organize their preparation and approach Exam 3 with greater confidence.
MULTIPLE CHOICE.
Module 1: Endocrine System Disorders (Questions 1–30)
1. The nurse administers levothyroxine to a client with hypothyroidism.
Which data indicate(s) that the drug is effective?
1. Increase in T3 and T4
2. Decrease in heart rate
3. Increase in TSH
4. Decrease in urine output
5. Decrease in periorbital edema
A. 1, 2, 3, 4, 5
B. 1, 2, 3
C. 2, 3, 4
D. 1, 2, 5
Answer: D
Rationale: Levothyroxine is a synthetic form of thyroxine (T4) used to treat
hypothyroidism. Effective therapy would result in increased T3 and T4
levels (1), decreased heart rate as metabolic rate normalizes (2), and
decreased periorbital edema (5) as myxedema resolves. TSH would
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decrease, not increase, due to negative feedback. Urine output is not
directly affected by levothyroxine therapy.
2. A client with hyperparathyroidism presents to the hospital with flank
pain. Which should be included in the client's plan of care?
A. Strain all urine to see if kidney stones will pass in the urine
B. Assess vital signs and call the respiratory therapist to draw blood for arterial
blood gases
C. Check blood for T3, T4, and TSH
D. Draw blood to check for serum sodium and potassium
Answer: A
Rationale: Hyperparathyroidism leads to hypercalcemia, which can cause
kidney stones (renal calculi). Flank pain is a classic symptom of kidney
stones. Straining all urine is essential to detect stone passage and
analyze the stone composition. ABGs, thyroid function tests, and serum
sodium/potassium are not the priority assessments for this presentation.
3. The nurse prepares to administer 3 units of insulin subcutaneously to a
client with a blood glucose level of 250 mg/dL. Which procedure is
correct?
A. Using one syringe, add the regular insulin into the syringe and then add the
NPH insulin.
B. Using one syringe, first insert air into the regular vial and then insert air into
the NPH vial
C. Avoid combining the two insulins because incompatibility could cause an
adverse reaction
D. Administer regular insulin subcutaneously and then give the NPH IV to
prevent a separate stick
Answer: A
Rationale: When mixing regular (short-acting) and NPH (intermediate-
acting) insulin in one syringe, the regular (clear) insulin must be drawn up
first to prevent contamination of the regular vial with the cloudy NPH
insulin. Air should be injected into the NPH vial first, then the regular vial,
but the regular insulin is drawn up first. NPH insulin is never given IV.
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4. An elderly client with long-term type 2 diabetes mellitus is seen in the
clinic for a routine health assessment. To determine if the client is
experiencing any long-term complications of diabetes, which
assessments should the nurse obtain?
1. Sensation in feet and legs
2. Serum creatinine and blood urea nitrogen
3. Visual acuity
4. Signs of respiratory tract infection
A. 1, 2, 3
B. 1, 3, 4
C. 2, 3, 4
D. 1, 2, 4
Answer: A
Rationale: Long-term complications of diabetes include peripheral
neuropathy (assess sensation in feet and legs), nephropathy (assess
serum creatinine and BUN), and retinopathy (assess visual acuity).
Respiratory tract infection is an acute concern, not a long-term
complication of diabetes.
5. The nurse is caring for a client after thyroidectomy. The nurse notes that
calcium gluconate is prescribed for the client. The nurse determines that
this medication has been prescribed for which purpose?
A. To treat tetany
B. To treat thyroid storm
C. To stimulate release of parathyroid hormone
D. To prevent cardiac irritability
Answer: A
Rationale: After thyroidectomy, accidental removal or damage to the
parathyroid glands can cause hypocalcemia, leading to tetany (muscle
spasms, tingling, positive Chvostek's and Trousseau's signs). Calcium
gluconate is administered to treat hypocalcemia and prevent tetany. It
does not treat thyroid storm or stimulate PTH release.
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6. A patient with SIADH (syndrome of inappropriate antidiuretic hormone)
would be expected to exhibit which laboratory findings?
A. Hypernatremia and decreased urine osmolality
B. Hyponatremia and increased urine osmolality
C. Hyperkalemia and decreased urine osmolality
D. Hyponatremia and decreased urine osmolality
Answer: B
Rationale: SIADH is characterized by excessive ADH secretion, leading to
water retention and dilutional hyponatremia. The urine is concentrated
(increased urine osmolality) because ADH promotes water reabsorption.
Hypernatremia, hyperkalemia, and decreased urine osmolality are not
characteristic of SIADH.
7. A patient with diabetes insipidus is at risk for which complication?
A. Hypernatremia and dehydration
B. Hyponatremia and fluid overload
C. Hyperkalemia and metabolic acidosis
D. Hypocalcemia and tetany
Answer: A
Rationale: Diabetes insipidus results from deficient ADH, causing
excessive water loss through urination (polyuria). This leads to
hypernatremia (elevated serum sodium due to water loss) and
dehydration. Hyponatremia, fluid overload, hyperkalemia, and
hypocalcemia are not typical complications.
8. A patient with Cushing's syndrome would be expected to exhibit which
clinical manifestations?
A. Weight loss, hypotension, and hyperkalemia
B. Weight gain, hypertension, and hyperglycemia
C. Hyperpigmentation, hypotension, and hyponatremia
D. Weight loss, hypertension, and hypoglycemia
Answer: B
Rationale: Cushing's syndrome results from excessive cortisol. Cortisol
promotes sodium and water retention (hypertension), gluconeogenesis
(hyperglycemia), and fat deposition (weight gain, especially central
NURS 618 EXAM 3 2026/2027 COMPLETE CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
NURS
Prepare for NURS 618 Exam 3 with this focused study resource designed to reinforce
key course concepts and essential nursing material. Use it to review important topics,
strengthen your understanding, and identify areas that may require additional study.
This resource provides a structured supplement to your coursework and can help
improve your exam readiness. It is ideal for students seeking a convenient way to
organize their preparation and approach Exam 3 with greater confidence.
MULTIPLE CHOICE.
Module 1: Endocrine System Disorders (Questions 1–30)
1. The nurse administers levothyroxine to a client with hypothyroidism.
Which data indicate(s) that the drug is effective?
1. Increase in T3 and T4
2. Decrease in heart rate
3. Increase in TSH
4. Decrease in urine output
5. Decrease in periorbital edema
A. 1, 2, 3, 4, 5
B. 1, 2, 3
C. 2, 3, 4
D. 1, 2, 5
Answer: D
Rationale: Levothyroxine is a synthetic form of thyroxine (T4) used to treat
hypothyroidism. Effective therapy would result in increased T3 and T4
levels (1), decreased heart rate as metabolic rate normalizes (2), and
decreased periorbital edema (5) as myxedema resolves. TSH would
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decrease, not increase, due to negative feedback. Urine output is not
directly affected by levothyroxine therapy.
2. A client with hyperparathyroidism presents to the hospital with flank
pain. Which should be included in the client's plan of care?
A. Strain all urine to see if kidney stones will pass in the urine
B. Assess vital signs and call the respiratory therapist to draw blood for arterial
blood gases
C. Check blood for T3, T4, and TSH
D. Draw blood to check for serum sodium and potassium
Answer: A
Rationale: Hyperparathyroidism leads to hypercalcemia, which can cause
kidney stones (renal calculi). Flank pain is a classic symptom of kidney
stones. Straining all urine is essential to detect stone passage and
analyze the stone composition. ABGs, thyroid function tests, and serum
sodium/potassium are not the priority assessments for this presentation.
3. The nurse prepares to administer 3 units of insulin subcutaneously to a
client with a blood glucose level of 250 mg/dL. Which procedure is
correct?
A. Using one syringe, add the regular insulin into the syringe and then add the
NPH insulin.
B. Using one syringe, first insert air into the regular vial and then insert air into
the NPH vial
C. Avoid combining the two insulins because incompatibility could cause an
adverse reaction
D. Administer regular insulin subcutaneously and then give the NPH IV to
prevent a separate stick
Answer: A
Rationale: When mixing regular (short-acting) and NPH (intermediate-
acting) insulin in one syringe, the regular (clear) insulin must be drawn up
first to prevent contamination of the regular vial with the cloudy NPH
insulin. Air should be injected into the NPH vial first, then the regular vial,
but the regular insulin is drawn up first. NPH insulin is never given IV.
, Page 3 of 44
4. An elderly client with long-term type 2 diabetes mellitus is seen in the
clinic for a routine health assessment. To determine if the client is
experiencing any long-term complications of diabetes, which
assessments should the nurse obtain?
1. Sensation in feet and legs
2. Serum creatinine and blood urea nitrogen
3. Visual acuity
4. Signs of respiratory tract infection
A. 1, 2, 3
B. 1, 3, 4
C. 2, 3, 4
D. 1, 2, 4
Answer: A
Rationale: Long-term complications of diabetes include peripheral
neuropathy (assess sensation in feet and legs), nephropathy (assess
serum creatinine and BUN), and retinopathy (assess visual acuity).
Respiratory tract infection is an acute concern, not a long-term
complication of diabetes.
5. The nurse is caring for a client after thyroidectomy. The nurse notes that
calcium gluconate is prescribed for the client. The nurse determines that
this medication has been prescribed for which purpose?
A. To treat tetany
B. To treat thyroid storm
C. To stimulate release of parathyroid hormone
D. To prevent cardiac irritability
Answer: A
Rationale: After thyroidectomy, accidental removal or damage to the
parathyroid glands can cause hypocalcemia, leading to tetany (muscle
spasms, tingling, positive Chvostek's and Trousseau's signs). Calcium
gluconate is administered to treat hypocalcemia and prevent tetany. It
does not treat thyroid storm or stimulate PTH release.
, Page 4 of 44
6. A patient with SIADH (syndrome of inappropriate antidiuretic hormone)
would be expected to exhibit which laboratory findings?
A. Hypernatremia and decreased urine osmolality
B. Hyponatremia and increased urine osmolality
C. Hyperkalemia and decreased urine osmolality
D. Hyponatremia and decreased urine osmolality
Answer: B
Rationale: SIADH is characterized by excessive ADH secretion, leading to
water retention and dilutional hyponatremia. The urine is concentrated
(increased urine osmolality) because ADH promotes water reabsorption.
Hypernatremia, hyperkalemia, and decreased urine osmolality are not
characteristic of SIADH.
7. A patient with diabetes insipidus is at risk for which complication?
A. Hypernatremia and dehydration
B. Hyponatremia and fluid overload
C. Hyperkalemia and metabolic acidosis
D. Hypocalcemia and tetany
Answer: A
Rationale: Diabetes insipidus results from deficient ADH, causing
excessive water loss through urination (polyuria). This leads to
hypernatremia (elevated serum sodium due to water loss) and
dehydration. Hyponatremia, fluid overload, hyperkalemia, and
hypocalcemia are not typical complications.
8. A patient with Cushing's syndrome would be expected to exhibit which
clinical manifestations?
A. Weight loss, hypotension, and hyperkalemia
B. Weight gain, hypertension, and hyperglycemia
C. Hyperpigmentation, hypotension, and hyponatremia
D. Weight loss, hypertension, and hypoglycemia
Answer: B
Rationale: Cushing's syndrome results from excessive cortisol. Cortisol
promotes sodium and water retention (hypertension), gluconeogenesis
(hyperglycemia), and fat deposition (weight gain, especially central
