NSG 3130 Exam 2 2026/2027 | Nursing Practice Questions, Answers &
Rationales | Comprehensive Exam Prep
Question 1
A nurse is caring for a client who is prescribed a continuous intravenous
infusion of regular insulin for severe diabetic ketoacidosis (DKA). Which
intravenous solution is added to the infusion regimen once serum
glucose reaches 250--300 mg/dLto prevent rapid hypoglycemia and
cerebral edema?
• A. 0.9%Sodium Chloride (Normal Saline)
• B. 5%Dextrose in 0.45%Sodium Chloride (D5 ½NS)
• C. Lactated Ringer's solution
• D. 3%Sodium Chloride (Hypertonic Saline)
Correct Answer: B. 5%Dextrose in 0.45%Sodium Chloride (D5 ½NS)
Detailed Rationale: When serum glucose drops to
250--300 mg/dLduring treatment for DKA, dextrose is added to the IV
fluids (such as D5 ½NS) while insulin therapy is maintained. This
prevents rapid hypoglycemia and minimizes the risk of cerebral edema
caused by a sudden drop in serum osmolarity.
Question 2
A nurse is assessing a client with Cushing's syndrome resulting from
chronic corticosteroid therapy. Which clinical manifestation should the
nurse anticipate finding?
• A. Weight loss, hypotension, and hyperpigmentation
• B. Truncal obesity, buffalo hump, moon face, and purple striae
, • C. Cold intolerance, bradycardia, and dry coarse skin
• D. Tachycardia, weight gain from dehydration, and exophthalmos
Correct Answer: B. Truncal obesity, buffalo hump, moon face, and
purple striae
Detailed Rationale: Cushing's syndrome is caused by excess circulating
glucocorticoids (cortisol). Classic manifestations include truncal obesity,
a "buffalo hump" on the upper back, a round "moon face," muscle
wasting of the extremities, thin fragile skin, purple abdominal striae,
and hypertension.
Question 3
A client is admitted to the emergency department with acute adrenal
crisis (Addisonian crisis). Which prescribed medication should the nurse
anticipate administering immediately?
• A. Intravenous hydrocortisone sodium succinate and normal saline
boluses
• B. Oral levothyroxine sodium
• C. Subcutaneous regular insulin and potassium chloride
• D. Intravenous furosemide
Correct Answer: A. Intravenous hydrocortisone sodium succinate and
normal saline boluses
Detailed Rationale: Addisonian crisis is a life-threatening emergency
caused by profound adrenocortical insufficiency. Immediate
management requires large-volume fluid resuscitation with normal
,saline to correct hypotension and IV hydrocortisone replacement to
reverse glucocorticoid deficiency.
Question 4
A nurse is providing discharge education to a client diagnosed with
hypothyroidism who has been newly prescribed levothyroxine. Which
instruction is essential?
• A. "Take this medication at bedtime right after eating a heavy
meal."
• B. "Take the medication in the morning on an empty stomach with
a full glass of water, at least 30 to 60 minutes before breakfast."
• C. "Stop taking the medication immediately if your heart rate
exceeds 70 beats per minute."
• D. "You can expect full relief of symptoms within 24 hours of your
first dose."
Correct Answer: B. "Take the medication in the morning on an empty
stomach with a full glass of water, at least 30 to 60 minutes before
breakfast."
Detailed Rationale: Levothyroxine absorption is significantly impaired
by food, calcium, iron, and antacids. To ensure consistent therapeutic
blood levels, it must be taken daily in the morning on an empty
stomach with water, 30 to 60 minutes before food intake.
Question 5
A client returns to the nursing unit following a subtotal thyroidectomy.
Which equipment must be kept immediately available at the bedside at
all times?
, • A. Emergency tracheostomy tray, oxygen setup, and suction
equipment
• B. Cardiac defibrillator and transcutaneous pacemaker
• C. Padded tongue blades and padded side rails
• D. Continuous bladder irrigation setup
Correct Answer: A. Emergency tracheostomy tray, oxygen setup, and
suction equipment
Detailed Rationale: Following thyroid surgery, acute laryngeal edema,
vocal cord paralysis, or hemorrhage can compress the trachea, leading
to life-threatening airway obstruction. An emergency tracheostomy tray,
suction equipment, and oxygen must be immediately accessible at the
bedside.
Question 6
A nurse is monitoring a client post-thyroidectomy who exhibits
twitching of facial muscles when the facial nerve is tapped anterior to
the ear, along with carpal spasms when a blood pressure cuff is inflated.
What electrolyte imbalance has occurred?
• A. Hypercalcemia
• B. Hypocalcemia
• C. Hypernatremia
• D. Hypokalemia
Correct Answer: B. Hypocalcemia
Detailed Rationale: Inadvertent trauma, bruising, or surgical removal of
the parathyroid glands during thyroidectomy leads to
Rationales | Comprehensive Exam Prep
Question 1
A nurse is caring for a client who is prescribed a continuous intravenous
infusion of regular insulin for severe diabetic ketoacidosis (DKA). Which
intravenous solution is added to the infusion regimen once serum
glucose reaches 250--300 mg/dLto prevent rapid hypoglycemia and
cerebral edema?
• A. 0.9%Sodium Chloride (Normal Saline)
• B. 5%Dextrose in 0.45%Sodium Chloride (D5 ½NS)
• C. Lactated Ringer's solution
• D. 3%Sodium Chloride (Hypertonic Saline)
Correct Answer: B. 5%Dextrose in 0.45%Sodium Chloride (D5 ½NS)
Detailed Rationale: When serum glucose drops to
250--300 mg/dLduring treatment for DKA, dextrose is added to the IV
fluids (such as D5 ½NS) while insulin therapy is maintained. This
prevents rapid hypoglycemia and minimizes the risk of cerebral edema
caused by a sudden drop in serum osmolarity.
Question 2
A nurse is assessing a client with Cushing's syndrome resulting from
chronic corticosteroid therapy. Which clinical manifestation should the
nurse anticipate finding?
• A. Weight loss, hypotension, and hyperpigmentation
• B. Truncal obesity, buffalo hump, moon face, and purple striae
, • C. Cold intolerance, bradycardia, and dry coarse skin
• D. Tachycardia, weight gain from dehydration, and exophthalmos
Correct Answer: B. Truncal obesity, buffalo hump, moon face, and
purple striae
Detailed Rationale: Cushing's syndrome is caused by excess circulating
glucocorticoids (cortisol). Classic manifestations include truncal obesity,
a "buffalo hump" on the upper back, a round "moon face," muscle
wasting of the extremities, thin fragile skin, purple abdominal striae,
and hypertension.
Question 3
A client is admitted to the emergency department with acute adrenal
crisis (Addisonian crisis). Which prescribed medication should the nurse
anticipate administering immediately?
• A. Intravenous hydrocortisone sodium succinate and normal saline
boluses
• B. Oral levothyroxine sodium
• C. Subcutaneous regular insulin and potassium chloride
• D. Intravenous furosemide
Correct Answer: A. Intravenous hydrocortisone sodium succinate and
normal saline boluses
Detailed Rationale: Addisonian crisis is a life-threatening emergency
caused by profound adrenocortical insufficiency. Immediate
management requires large-volume fluid resuscitation with normal
,saline to correct hypotension and IV hydrocortisone replacement to
reverse glucocorticoid deficiency.
Question 4
A nurse is providing discharge education to a client diagnosed with
hypothyroidism who has been newly prescribed levothyroxine. Which
instruction is essential?
• A. "Take this medication at bedtime right after eating a heavy
meal."
• B. "Take the medication in the morning on an empty stomach with
a full glass of water, at least 30 to 60 minutes before breakfast."
• C. "Stop taking the medication immediately if your heart rate
exceeds 70 beats per minute."
• D. "You can expect full relief of symptoms within 24 hours of your
first dose."
Correct Answer: B. "Take the medication in the morning on an empty
stomach with a full glass of water, at least 30 to 60 minutes before
breakfast."
Detailed Rationale: Levothyroxine absorption is significantly impaired
by food, calcium, iron, and antacids. To ensure consistent therapeutic
blood levels, it must be taken daily in the morning on an empty
stomach with water, 30 to 60 minutes before food intake.
Question 5
A client returns to the nursing unit following a subtotal thyroidectomy.
Which equipment must be kept immediately available at the bedside at
all times?
, • A. Emergency tracheostomy tray, oxygen setup, and suction
equipment
• B. Cardiac defibrillator and transcutaneous pacemaker
• C. Padded tongue blades and padded side rails
• D. Continuous bladder irrigation setup
Correct Answer: A. Emergency tracheostomy tray, oxygen setup, and
suction equipment
Detailed Rationale: Following thyroid surgery, acute laryngeal edema,
vocal cord paralysis, or hemorrhage can compress the trachea, leading
to life-threatening airway obstruction. An emergency tracheostomy tray,
suction equipment, and oxygen must be immediately accessible at the
bedside.
Question 6
A nurse is monitoring a client post-thyroidectomy who exhibits
twitching of facial muscles when the facial nerve is tapped anterior to
the ear, along with carpal spasms when a blood pressure cuff is inflated.
What electrolyte imbalance has occurred?
• A. Hypercalcemia
• B. Hypocalcemia
• C. Hypernatremia
• D. Hypokalemia
Correct Answer: B. Hypocalcemia
Detailed Rationale: Inadvertent trauma, bruising, or surgical removal of
the parathyroid glands during thyroidectomy leads to
