AACN EXAM NEWEST 2026/2027 UPDATE | PROGRESSIVE CARE
CERTIFIED NURSE COMPLETE PRACTICE TEST WITH VERIFIED
ANSWERS | GRADED A+ PDF
Cushing's Syndrome/Disease - ANSWER cortisol excess typically caused by pituitary adenoma 60-70%
of cases.
Central obesity w/ extremity wasting.
dorsocervical fat pad.
rounded facies.
spontaneous bruising.
purple striae
hyperpigmentation
poor wound healing/ skin infections.
Dexamethasone suppression test.
1mg dexamethasone at 2300 hours and measure serum cortisol at 0800.
Remove sources of excess and manage consequences ( HTN, hypokalemia, hyperglycemia.)
Addison's disease - ANSWER Primary
Caused by damage to the adrenal cortex (autoimmune, TB, metastatic disease, deposition diseases,
and drug induced) leading to a decrease in cortisol production.
Secondary
Caused by pituitary failure to release ACTH (in any hypopituitary disorder) causing a decrease in
cortisol production.
Sudden withdrawal of systemic corticosteroids leading to a decrease in cortisol production from
induced corticosteroid suppression.
diabetes insipidus (DI) - ANSWER Insufficient ADH or decreased sensitivity to ADH
Nephron cannot conserve water.
, Commonly caused by damage to the pituitary gland or hypothalamus (surgery, tumor, meningitis,
head injury).
Can be nephrogenic where the kidney in unable to respond to ADH.
Serum: Hypernatremia and hyperosmolarity.
Urine: Hyponatremia and hypoosmolality.
Replaced ADH and supportive fluid replacement.
Syndrome of Inapropriate Antidiuretic Hormone (SIADH) - ANSWER Excess ADH production.
Nephron conserves excess water.
Caused by head injury and lung cancers.
Serum: Hyponatremia and hypoosmolality.
Urine: Hypernatremia and hyperosmolarity.
Fluid overload.
Treat with:
Free water restriction
Loop diuretic and NS
IN extremes 3% saline
Transudate pleural effusion - ANSWER CHF
Constrictive pericarditis
Cirrhosis
CERTIFIED NURSE COMPLETE PRACTICE TEST WITH VERIFIED
ANSWERS | GRADED A+ PDF
Cushing's Syndrome/Disease - ANSWER cortisol excess typically caused by pituitary adenoma 60-70%
of cases.
Central obesity w/ extremity wasting.
dorsocervical fat pad.
rounded facies.
spontaneous bruising.
purple striae
hyperpigmentation
poor wound healing/ skin infections.
Dexamethasone suppression test.
1mg dexamethasone at 2300 hours and measure serum cortisol at 0800.
Remove sources of excess and manage consequences ( HTN, hypokalemia, hyperglycemia.)
Addison's disease - ANSWER Primary
Caused by damage to the adrenal cortex (autoimmune, TB, metastatic disease, deposition diseases,
and drug induced) leading to a decrease in cortisol production.
Secondary
Caused by pituitary failure to release ACTH (in any hypopituitary disorder) causing a decrease in
cortisol production.
Sudden withdrawal of systemic corticosteroids leading to a decrease in cortisol production from
induced corticosteroid suppression.
diabetes insipidus (DI) - ANSWER Insufficient ADH or decreased sensitivity to ADH
Nephron cannot conserve water.
, Commonly caused by damage to the pituitary gland or hypothalamus (surgery, tumor, meningitis,
head injury).
Can be nephrogenic where the kidney in unable to respond to ADH.
Serum: Hypernatremia and hyperosmolarity.
Urine: Hyponatremia and hypoosmolality.
Replaced ADH and supportive fluid replacement.
Syndrome of Inapropriate Antidiuretic Hormone (SIADH) - ANSWER Excess ADH production.
Nephron conserves excess water.
Caused by head injury and lung cancers.
Serum: Hyponatremia and hypoosmolality.
Urine: Hypernatremia and hyperosmolarity.
Fluid overload.
Treat with:
Free water restriction
Loop diuretic and NS
IN extremes 3% saline
Transudate pleural effusion - ANSWER CHF
Constrictive pericarditis
Cirrhosis
