NU 185 Exam 1: Medical-Surgical Nursing II Practice Test 2026 Galen
College
1. A nurse is caring for a patient with Type 1 Diabetes Mellitus who is
experiencing Kussmaul respirations. What is the primary reason for this
respiratory pattern?
A. To compensate for metabolic alkalosis
B. To reduce the level of circulating ketones in the bloodstream
C. To increase oxygen saturation due to hypoxemia
D. To expel excess carbon dioxide to compensate for metabolic acidosis
Answer: D
Rationale: Kussmaul respirations are deep, rapid breaths that occur as the body attempts
to blow off carbon dioxide (an acid) to compensate for the metabolic acidosis found in
Diabetic Ketoacidosis (DKA).
2. Which laboratory result is most indicative of a diagnosis of Hyperthyroidism?
A. Elevated TSH and Elevated T4
B. Decreased TSH and Elevated T4
C. Decreased TSH and Decreased T3
D. Elevated TSH and Decreased T4
Answer: B
Rationale: In primary hyperthyroidism, the thyroid gland overproduces T3 and T4, which
then signals the pituitary gland to stop releasing Thyroid Stimulating Hormone (TSH),
resulting in low TSH levels.
,3. A patient is admitted with suspected Cushing’s Syndrome. Which clinical
manifestation should the nurse expect to observe?
A. Weight loss and hypotension
B. Trunkal obesity and moon face
C. Hyperpigmentation of the skin
D. Polyuria and polydipsia
Answer: B
Rationale: Cushing’s Syndrome is characterized by excess cortisol, leading to fat
redistribution (trunkal obesity, moon face, buffalo hump), hypertension, and
hyperglycemia.
4. The nurse is providing discharge education to a patient newly diagnosed with
Addison’s Disease. Which instruction is the most critical?
A. Limit sodium intake to prevent edema
B. Carry an emergency kit with injectable hydrocortisone
C. Discontinue steroids if you experience weight gain
D. Avoid high-potassium foods like bananas
Answer: B
Rationale: Patients with Addison’s disease must carry an emergency kit because any
stressor (illness, injury) can trigger an adrenal crisis, requiring an immediate dose of
steroids.
5. A patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone) is
being treated. Which nursing intervention is a priority?
A. Implement fluid restrictions and monitor serum sodium
B. Administer desmopressin as ordered
C. Monitor for signs of hypernatremia
D. Encourage fluid intake up to 3 liters per day
Answer: A
, Rationale: SIADH involves excessive water retention leading to dilutional hyponatremia.
Fluid restriction is the primary treatment to prevent further dilution and cerebral edema.
6. Which assessment finding in a patient with Diabetes Insipidus (DI) indicates
that the condition is not well-controlled?
A. Urine specific gravity of 1.025
B. Weight gain of 2 lbs in 24 hours
C. Serum sodium of 138 mEq/L
D. Urine output of 500 mL per hour
Answer: D
Rationale: DI is characterized by a deficiency of ADH, leading to massive polyuria (large
amounts of dilute urine). High urine output indicates the condition is poorly controlled.
7. The nurse notes a positive Chvostek’s sign in a patient following a
thyroidectomy. This is indicative of which electrolyte imbalance?
A. Hypermagnesemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: D
Rationale: A positive Chvostek’s sign (facial twitching when the facial nerve is tapped)
indicates hypocalcemia, often caused by accidental damage to the parathyroid glands
during thyroid surgery.
College
1. A nurse is caring for a patient with Type 1 Diabetes Mellitus who is
experiencing Kussmaul respirations. What is the primary reason for this
respiratory pattern?
A. To compensate for metabolic alkalosis
B. To reduce the level of circulating ketones in the bloodstream
C. To increase oxygen saturation due to hypoxemia
D. To expel excess carbon dioxide to compensate for metabolic acidosis
Answer: D
Rationale: Kussmaul respirations are deep, rapid breaths that occur as the body attempts
to blow off carbon dioxide (an acid) to compensate for the metabolic acidosis found in
Diabetic Ketoacidosis (DKA).
2. Which laboratory result is most indicative of a diagnosis of Hyperthyroidism?
A. Elevated TSH and Elevated T4
B. Decreased TSH and Elevated T4
C. Decreased TSH and Decreased T3
D. Elevated TSH and Decreased T4
Answer: B
Rationale: In primary hyperthyroidism, the thyroid gland overproduces T3 and T4, which
then signals the pituitary gland to stop releasing Thyroid Stimulating Hormone (TSH),
resulting in low TSH levels.
,3. A patient is admitted with suspected Cushing’s Syndrome. Which clinical
manifestation should the nurse expect to observe?
A. Weight loss and hypotension
B. Trunkal obesity and moon face
C. Hyperpigmentation of the skin
D. Polyuria and polydipsia
Answer: B
Rationale: Cushing’s Syndrome is characterized by excess cortisol, leading to fat
redistribution (trunkal obesity, moon face, buffalo hump), hypertension, and
hyperglycemia.
4. The nurse is providing discharge education to a patient newly diagnosed with
Addison’s Disease. Which instruction is the most critical?
A. Limit sodium intake to prevent edema
B. Carry an emergency kit with injectable hydrocortisone
C. Discontinue steroids if you experience weight gain
D. Avoid high-potassium foods like bananas
Answer: B
Rationale: Patients with Addison’s disease must carry an emergency kit because any
stressor (illness, injury) can trigger an adrenal crisis, requiring an immediate dose of
steroids.
5. A patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone) is
being treated. Which nursing intervention is a priority?
A. Implement fluid restrictions and monitor serum sodium
B. Administer desmopressin as ordered
C. Monitor for signs of hypernatremia
D. Encourage fluid intake up to 3 liters per day
Answer: A
, Rationale: SIADH involves excessive water retention leading to dilutional hyponatremia.
Fluid restriction is the primary treatment to prevent further dilution and cerebral edema.
6. Which assessment finding in a patient with Diabetes Insipidus (DI) indicates
that the condition is not well-controlled?
A. Urine specific gravity of 1.025
B. Weight gain of 2 lbs in 24 hours
C. Serum sodium of 138 mEq/L
D. Urine output of 500 mL per hour
Answer: D
Rationale: DI is characterized by a deficiency of ADH, leading to massive polyuria (large
amounts of dilute urine). High urine output indicates the condition is poorly controlled.
7. The nurse notes a positive Chvostek’s sign in a patient following a
thyroidectomy. This is indicative of which electrolyte imbalance?
A. Hypermagnesemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: D
Rationale: A positive Chvostek’s sign (facial twitching when the facial nerve is tapped)
indicates hypocalcemia, often caused by accidental damage to the parathyroid glands
during thyroid surgery.
