NU 216 Adult Health Nursing II Test 3 Herzing University
Actual Exam 2026/2027 – Complete 60 Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION A: ENDOCRINE DISORDERS & MANAGEMENT (Questions
1–12)
Q1: Which hemoglobin A1c value meets the American Diabetes Association diagnostic
criterion for diabetes mellitus?
A. 5.4%
B. 5.9%
C. 6.1%
D. 6.5% [CORRECT]
Correct Answer: D
Rationale: An A1c of 6.5% or higher confirms the diagnosis of diabetes mellitus; values
of 5.7–6.4% indicate prediabetes, and values below 5.7% are normal, so options A–C
fall short of the diagnostic threshold.
Q2: A patient admitted with diabetic ketoacidosis has a blood glucose of 520 mg/dL, pH
7.19, and serum potassium of 3.0 mEq/L. The provider has prescribed an IV regular
insulin infusion. Which action should the nurse take first?
A. Start the IV regular insulin infusion as prescribed
B. Hold the insulin and notify the provider of the potassium level [CORRECT]
C. Push the prescribed potassium chloride rapidly by IV
D. Administer the insulin and recheck the potassium in 6 hours
Correct Answer: B
Rationale: Insulin drives potassium intracellularly and can precipitate fatal hypokalemia
when potassium is below 3.3 mEq/L, so insulin is held until potassium is corrected
(options A and D ignore this danger). Rapid IV potassium push (C) is contraindicated
because it can cause fatal cardiac dysrhythmias.
Q3: A 78-year-old patient is admitted with hyperosmolar hyperglycemic state (HHS):
blood glucose 980 mg/dL, serum osmolality 340 mOsm/kg, negative ketones, BP 88/54
mm Hg, and dry mucous membranes. Which intervention is the priority?
,A. Begin an IV bolus of 0.9% sodium chloride [CORRECT]
B. Administer subcutaneous NPH insulin
C. Infuse 5% dextrose in water
D. Insert an indwelling urinary catheter to monitor output
Correct Answer: A
Rationale: Profound dehydration drives morbidity in HHS, so isotonic fluid resuscitation
is the first priority before low-dose insulin therapy is initiated; D5W is reserved until
glucose approaches 250–300 mg/dL, and catheterization does not address the
circulatory volume deficit.
Q4: The nurse is teaching a patient with newly diagnosed hypothyroidism about
levothyroxine. Which statement indicates correct understanding?
A. "I will take it with my calcium supplement at breakfast."
B. "I will take it with a full meal in the evening."
C. "I will take it on an empty stomach 30 to 60 minutes before breakfast." [CORRECT]
D. "I will stop taking it once my energy returns."
Correct Answer: C
Rationale: Levothyroxine is best absorbed on an empty stomach, while calcium, iron,
and food markedly reduce absorption (options A and B). Therapy is lifelong, so stopping
when symptoms improve (D) causes recurrence of hypothyroidism.
Q5: A patient develops a positive Trousseau sign and perioral tingling 6 hours after a
thyroidectomy. The nurse anticipates a prescription for which medication?
A. IV levothyroxine
B. IV calcium gluconate [CORRECT]
C. IV potassium chloride
D. IV magnesium sulfate
Correct Answer: B
Rationale: A positive Trousseau sign with perioral tingling indicates hypocalcemia from
inadvertent parathyroid trauma or removal, an emergency treated with IV calcium
gluconate; levothyroxine replaces thyroid hormone and will not correct the calcium level.
Q6: A patient with Addison's disease takes oral hydrocortisone daily. The patient calls
the clinic reporting influenza with persistent vomiting and inability to keep medications
down. Which instruction from the nurse is most appropriate?
A. "Skip your hydrocortisone until the vomiting stops."
B. "Resume your usual dose when you feel better in a few days."
C. "Take an extra dose of fludrocortisone and rest at home."
D. "Contact the provider immediately; you may need injectable steroids." [CORRECT]
Correct Answer: D
, Rationale: Vomiting prevents absorption of oral glucocorticoids and places the patient
at high risk for Addisonian crisis, requiring immediate evaluation and possible
parenteral hydrocortisone; skipping or delaying doses (options A and B) invites
life-threatening cardiovascular collapse.
Q7: A newly admitted patient with Cushing's syndrome has a moon face, truncal obesity,
blood glucose 214 mg/dL, and BP 168/96 mm Hg. Which nursing intervention is the
priority?
A. Monitor blood glucose closely and implement fall precautions [CORRECT]
B. Provide a high-protein, low-potassium diet
C. Encourage vigorous aerobic exercise daily
D. Institute a fluid restriction of 500 mL/day
Correct Answer: A
Rationale: Hyperglycemia from gluconeogenesis requires close glucose monitoring, and
muscle wasting, skin fragility, and osteoporosis make fall prevention critical in Cushing's
syndrome; vigorous exercise (C) increases fracture risk, and the other options do not
address the highest-risk complications.
Q8: A patient 2 days post-craniotomy has urine output of 350 mL/hr for 3 consecutive
hours, urine specific gravity 1.002, serum sodium 152 mEq/L, and reports intense thirst.
The nurse interprets these findings as which condition with which expected
prescription?
A. SIADH; hypertonic saline infusion
B. Fluid volume overload; furosemide administration
C. Diabetes insipidus; desmopressin administration [CORRECT]
D. Cerebral salt wasting; fluid restriction
Correct Answer: C
Rationale: Polyuria with very dilute urine (specific gravity 1.002), hypernatremia, and
intense thirst after neurosurgery is classic for diabetes insipidus caused by decreased
ADH and is treated with desmopressin; SIADH and cerebral salt wasting cause
hyponatremia, and furosemide would worsen the volume deficit.
Q9: When mixing regular insulin and NPH insulin in one syringe, which technique should
the nurse use?
A. Draw up the NPH insulin first, then the regular insulin
B. Draw up the regular insulin first, then the NPH insulin [CORRECT]
C. Inject air into the regular vial, then draw the NPH immediately
D. Draw both insulins in separate syringes and administer two injections
Correct Answer: B
Actual Exam 2026/2027 – Complete 60 Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION A: ENDOCRINE DISORDERS & MANAGEMENT (Questions
1–12)
Q1: Which hemoglobin A1c value meets the American Diabetes Association diagnostic
criterion for diabetes mellitus?
A. 5.4%
B. 5.9%
C. 6.1%
D. 6.5% [CORRECT]
Correct Answer: D
Rationale: An A1c of 6.5% or higher confirms the diagnosis of diabetes mellitus; values
of 5.7–6.4% indicate prediabetes, and values below 5.7% are normal, so options A–C
fall short of the diagnostic threshold.
Q2: A patient admitted with diabetic ketoacidosis has a blood glucose of 520 mg/dL, pH
7.19, and serum potassium of 3.0 mEq/L. The provider has prescribed an IV regular
insulin infusion. Which action should the nurse take first?
A. Start the IV regular insulin infusion as prescribed
B. Hold the insulin and notify the provider of the potassium level [CORRECT]
C. Push the prescribed potassium chloride rapidly by IV
D. Administer the insulin and recheck the potassium in 6 hours
Correct Answer: B
Rationale: Insulin drives potassium intracellularly and can precipitate fatal hypokalemia
when potassium is below 3.3 mEq/L, so insulin is held until potassium is corrected
(options A and D ignore this danger). Rapid IV potassium push (C) is contraindicated
because it can cause fatal cardiac dysrhythmias.
Q3: A 78-year-old patient is admitted with hyperosmolar hyperglycemic state (HHS):
blood glucose 980 mg/dL, serum osmolality 340 mOsm/kg, negative ketones, BP 88/54
mm Hg, and dry mucous membranes. Which intervention is the priority?
,A. Begin an IV bolus of 0.9% sodium chloride [CORRECT]
B. Administer subcutaneous NPH insulin
C. Infuse 5% dextrose in water
D. Insert an indwelling urinary catheter to monitor output
Correct Answer: A
Rationale: Profound dehydration drives morbidity in HHS, so isotonic fluid resuscitation
is the first priority before low-dose insulin therapy is initiated; D5W is reserved until
glucose approaches 250–300 mg/dL, and catheterization does not address the
circulatory volume deficit.
Q4: The nurse is teaching a patient with newly diagnosed hypothyroidism about
levothyroxine. Which statement indicates correct understanding?
A. "I will take it with my calcium supplement at breakfast."
B. "I will take it with a full meal in the evening."
C. "I will take it on an empty stomach 30 to 60 minutes before breakfast." [CORRECT]
D. "I will stop taking it once my energy returns."
Correct Answer: C
Rationale: Levothyroxine is best absorbed on an empty stomach, while calcium, iron,
and food markedly reduce absorption (options A and B). Therapy is lifelong, so stopping
when symptoms improve (D) causes recurrence of hypothyroidism.
Q5: A patient develops a positive Trousseau sign and perioral tingling 6 hours after a
thyroidectomy. The nurse anticipates a prescription for which medication?
A. IV levothyroxine
B. IV calcium gluconate [CORRECT]
C. IV potassium chloride
D. IV magnesium sulfate
Correct Answer: B
Rationale: A positive Trousseau sign with perioral tingling indicates hypocalcemia from
inadvertent parathyroid trauma or removal, an emergency treated with IV calcium
gluconate; levothyroxine replaces thyroid hormone and will not correct the calcium level.
Q6: A patient with Addison's disease takes oral hydrocortisone daily. The patient calls
the clinic reporting influenza with persistent vomiting and inability to keep medications
down. Which instruction from the nurse is most appropriate?
A. "Skip your hydrocortisone until the vomiting stops."
B. "Resume your usual dose when you feel better in a few days."
C. "Take an extra dose of fludrocortisone and rest at home."
D. "Contact the provider immediately; you may need injectable steroids." [CORRECT]
Correct Answer: D
, Rationale: Vomiting prevents absorption of oral glucocorticoids and places the patient
at high risk for Addisonian crisis, requiring immediate evaluation and possible
parenteral hydrocortisone; skipping or delaying doses (options A and B) invites
life-threatening cardiovascular collapse.
Q7: A newly admitted patient with Cushing's syndrome has a moon face, truncal obesity,
blood glucose 214 mg/dL, and BP 168/96 mm Hg. Which nursing intervention is the
priority?
A. Monitor blood glucose closely and implement fall precautions [CORRECT]
B. Provide a high-protein, low-potassium diet
C. Encourage vigorous aerobic exercise daily
D. Institute a fluid restriction of 500 mL/day
Correct Answer: A
Rationale: Hyperglycemia from gluconeogenesis requires close glucose monitoring, and
muscle wasting, skin fragility, and osteoporosis make fall prevention critical in Cushing's
syndrome; vigorous exercise (C) increases fracture risk, and the other options do not
address the highest-risk complications.
Q8: A patient 2 days post-craniotomy has urine output of 350 mL/hr for 3 consecutive
hours, urine specific gravity 1.002, serum sodium 152 mEq/L, and reports intense thirst.
The nurse interprets these findings as which condition with which expected
prescription?
A. SIADH; hypertonic saline infusion
B. Fluid volume overload; furosemide administration
C. Diabetes insipidus; desmopressin administration [CORRECT]
D. Cerebral salt wasting; fluid restriction
Correct Answer: C
Rationale: Polyuria with very dilute urine (specific gravity 1.002), hypernatremia, and
intense thirst after neurosurgery is classic for diabetes insipidus caused by decreased
ADH and is treated with desmopressin; SIADH and cerebral salt wasting cause
hyponatremia, and furosemide would worsen the volume deficit.
Q9: When mixing regular insulin and NPH insulin in one syringe, which technique should
the nurse use?
A. Draw up the NPH insulin first, then the regular insulin
B. Draw up the regular insulin first, then the NPH insulin [CORRECT]
C. Inject air into the regular vial, then draw the NPH immediately
D. Draw both insulins in separate syringes and administer two injections
Correct Answer: B
