Renal and Urinary Systems Disorders unit
Adult Medical-Surgical Nursing curriculum
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Highly Detailed Multi-System
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Which assessment parameter is of highest priority when caring for a patient
undergoing a water deprivation test?
a. Serum glucose
b. Patient weight
c. Arterial blood gases
d. Patient temperature
b. Patient weight
A patient is at risk for severe dehydration during a water deprivation test. The test
should be discontinued and the patient rehydrated if the patient's weight drops more
than 2 kg at any time. The other assessment parameters do not assess fluid
balance.
A patient has sought care because of a loss of 25 lb over the past 6 months,
during which the patient claims to have made no significant dietary changes.
What potential problem should the nurse assess the patient for?
a. Thyroid disorders
b. Diabetes insipidus
c. Pituitary dysfunction
d. Parathyroid dysfunction
a. Thyroid disorders
Hyperthyroidism is associated with weight loss. Alterations in pituitary function, such
as diabetes insipidus, and parathyroid dysfunction are not commonly associated with
this phenomenon.
The surgeon was unable to save a patient's parathyroid gland during a radical
thyroidectomy. The nurse should consequently pay particular attention to
which laboratory value?
a. Calcium levels
b. Potassium levels
c. Blood glucose levels
d. Sodium and chloride levels
, Page 3 of 200
a. Calcium levels
The parathyroid gland plays a key role in maintaining calcium levels. Potassium,
sodium, glucose, and chloride are not directly influenced by the loss of the
parathyroid gland.
A patient's recent medical history is indicative of diabetes insipidus. The nurse
would perform patient teaching related to which diagnostic test?
a. Thyroid scan
b. Fasting glucose test
c. Oral glucose tolerance
d. Water deprivation test
d. Water deprivation test
A water deprivation test is used to diagnose the polyuria that accompanies diabetes
insipidus. Glucose tests and thyroid tests are not directly related to the diagnosis of
diabetes insipidus.
When the nurse assesses the patient that has pancreatitis, what function may
be altered related to the endocrine function of the pancreas?
a. Blood glucose regulation
b. Increased response to stress
c. Fluid and electrolyte regulation
d. Regulates metabolic rate of cells
a. Blood glucose regulation
The endocrine functions of the pancreas are regulated by α cells that produce and
secrete glucagon, β cells that produce and secrete insulin and amylin, delta cells that
produce and secrete somatostatin, and F cells that secrete pancreatic polypeptide.
Glucagon, insulin, and amylin, and somatostatin all affect blood glucose. Pancreatic
polypeptide regulates appetite. Increased response to stress occurs from
epinephrine secreted by the adrenal medulla. Fluid and electrolyte regulation occurs
in response to several hormones (mineralocorticoids, antidiuretic hormone,
parathyroid hormone, calcitonin) from several organs (adrenal cortex, posterior
, Page 4 of 200
pituitary, parathyroid, thyroid). The metabolic rate of cells is regulated by
triiodothyronine (T3) from the thyroid
The hypothalamus secretes releasing hormones and inhibiting hormones.
What is the target tissue of these releasing hormones and inhibiting
hormones?
a. Pineal
b. Adrenal cortex
c. Posterior pituitary
d. Anterior pituitary
d. Anterior pituitary
The anterior pituitary is the target tissue of the releasing hormones (corticotropin
releasing hormone, thyrotropin releasing hormone, growth hormone releasing factor,
gonadotropin releasing hormone, prolactin releasing factor) and the inhibiting
hormones (somatostatin, prolactin inhibiting factor). These hormones release or
inhibit other hormones that affect the thyroid, adrenal cortex, pancreas, reproductive
organs, and all body cells. The pineal gland is not directly affected by the releasing
and inhibiting hormones from the hypothalamus. The posterior pituitary releases
antidiuretic hormone (ADH) in response to plasma osmolality changes that is not
directly affected by the hypothalamus hormones.
The patient has been feeling tired lately and has gained weight; reports
thickened, dry skin and increased cold sensitivity even though it is now
summer. Which endocrine diagnostic test should be done first?
a. Free thyroxine (FT4)
b. Serum growth hormone (GH)
c. Follicle stimulating hormone (FSH)
d. Magnetic resonance imaging (MRI) of the head
a. Free thyroxine (FT4)
The manifestations the patient is experiencing could be related to hypothyroidism.
Free thyroxine (FT4) is considered a better indicator of thyroid function than total T4
and could be done to evaluate the patient for hypothyroidism. Growth hormone