NUR 445 LATEST 2026 EXAM QUESTIONS AND ANSWERS
GRADED A+
✔✔What are six interventions for DKA? (Hint: "Hungry Hippos Munch Many Cheesy
Nachos") - ✔✔- Hydration (0.9% NS)
- Hourly glucose check (give IV insulin dip 10%)
- Monitor for ketones. (I&Os)
- Monitor more when patient is sick
- Notify provider if serum glucose is >250 & N/V >24 hrs
- Check K+
✔✔What should we educate patient on how to manage sick days at home to prevent
DKA? - ✔✔- Assess blood glucose more often
- Check for ketones.
- Fluid replacement.
✔✔How will you know if the problem is DKA or HHS? - ✔✔Check pH: DKA will have
acidosis.
✔✔Which insulin do you give at night? - ✔✔Long-acting insulin (insulin glargine/
Lantus)
✔✔What is the onset, peak, and duration of insulin glargine? - ✔✔- Onset: 1 hr
- Peak: none
- Duration 10-24 hours
Remember: No mixing
✔✔How do you mix regular insulin with NPH insulin? (Hint: 6 steps) - ✔✔1) Regular
(short acting ex: Humulin R)
2) NPH (intermediate acting ex: Humulin N)
3) Inject air into cloudy (NPH)
4) Inject air into clear (regular)
5) Draw from clear
6) Draw from cloudy
✔✔Describe the patho and causes of hypothyroidism. - ✔✔Low T3 and T4 thyroid
hormones
- Low iodine, antithyroid treatments
- Pituitary tumor
- Autoimmune: Hashimoto's (low and slow)
✔✔What are two causes myxedema coma? - ✔✔- Hypothyroidism
- Medication adjustment is not right.
,✔✔What are nine clinical manifestations of myxedema coma? (Hint:
H.C.L.F.G.C.W.H.H) - ✔✔- Hypoxia
- Carbon dioxide retention
- Lethargy
- Fatigue
- Goiter
- Cold intolerance
- Weight gain
- Hypoglycemia
- Hyponatremia
✔✔What medication is used for hypothyroidism? - ✔✔Levothyroxine
✔✔What are four interventions you would do for a patient with myxedema coma? (Hint:
SIMI) - ✔✔- Slow warming
- Monitor T3 T4 levels
- IV levothyroxine
- Intubation equipment ready (due to hypoxia and carbon dioxide retention)
✔✔How do you know if its hypothyroidism and hyperthyroidism? - ✔✔- Look at the TSH
- Increased T3 & T4 / Decreased TSH (hyper)
- Decreased T3 & T4 / increased TSH (hypo)
✔✔If the thyroid regulates metabolism what would a decreased metabolic rate indicate?
- ✔✔Hypothyroidism
✔✔What is the patho. and causes of hyperthyroidism? - ✔✔High T3 and T4 thyroid
hormones
- Too much iodine
- Too much thyroid medication (ex. Levothyroxine)
- Autoimmune: Gave = GAINS "HIGH"
✔✔What causes hyperthyroidism which can lead to a thyroid storm? - ✔✔- Sudden
illness of surgery
- Untreated hyperthyroidism
✔✔What are four cues that would indicate hyperthyroidism? (Hint: E.S.T.F) - ✔✔-
Exophthalmos (bulging eyes)
- Sever agitation
- Tachy
- Fever
✔✔What medication would be given to patient with thyroid storm (hyperthyroidism)? -
✔✔Methimazole
, ✔✔What three other interventions would you do for hyperthyroidism patients? (Hint:
F.F.B) - ✔✔- Fluid replacement
- Fever reduction
- Beta blockers like atenolol for HR
✔✔What are common labs for hyperthyroidism? - ✔✔- Increased T3 & T4
- Decreased TSH
✔✔What is diabetes insipidus? - ✔✔Body can't balance fluids levels normally.
✔✔What causes DI? - ✔✔Damage to the brain- Tumors, trauma, surgery
✔✔What is one complication of removing the tumor for the pituitary? - ✔✔Postop CSF
leak
✔✔How will you know if it's a CSF leak - ✔✔Tissue will have yellow halos
✔✔What are eight signs and symptoms of DI? (Hint: S.L.H.H.H.P.P.P) - ✔✔- Severe
dehydration
- Low urine specific gravity
- High serum osmo.
- High Na+ (Hypernatremia )
- Hypotension
- Polydipsia
- Polyuria
- Polyphagia
✔✔What are two interventions for DI? - ✔✔- Give desmopressin (DDAVP)
- Daily weights
✔✔Education regarding desmopressin to DI patients? (Hint: I.D.I.M.T) - ✔✔- Intranasal
(NOT subq)
- Daily weights
- If patient gains 1-3 lbs in day call doc
- Monitor I&Os
- Teach s/s of overload
✔✔What is SIADH? - ✔✔Inappropriate antidiuretic hormone secretion (high ADH) from
pituitary
✔✔What are four possible causes of SIADH? (Hint: "HIT Me") - ✔✔- Head trauma
- Tumors
- Infection
- Medications
GRADED A+
✔✔What are six interventions for DKA? (Hint: "Hungry Hippos Munch Many Cheesy
Nachos") - ✔✔- Hydration (0.9% NS)
- Hourly glucose check (give IV insulin dip 10%)
- Monitor for ketones. (I&Os)
- Monitor more when patient is sick
- Notify provider if serum glucose is >250 & N/V >24 hrs
- Check K+
✔✔What should we educate patient on how to manage sick days at home to prevent
DKA? - ✔✔- Assess blood glucose more often
- Check for ketones.
- Fluid replacement.
✔✔How will you know if the problem is DKA or HHS? - ✔✔Check pH: DKA will have
acidosis.
✔✔Which insulin do you give at night? - ✔✔Long-acting insulin (insulin glargine/
Lantus)
✔✔What is the onset, peak, and duration of insulin glargine? - ✔✔- Onset: 1 hr
- Peak: none
- Duration 10-24 hours
Remember: No mixing
✔✔How do you mix regular insulin with NPH insulin? (Hint: 6 steps) - ✔✔1) Regular
(short acting ex: Humulin R)
2) NPH (intermediate acting ex: Humulin N)
3) Inject air into cloudy (NPH)
4) Inject air into clear (regular)
5) Draw from clear
6) Draw from cloudy
✔✔Describe the patho and causes of hypothyroidism. - ✔✔Low T3 and T4 thyroid
hormones
- Low iodine, antithyroid treatments
- Pituitary tumor
- Autoimmune: Hashimoto's (low and slow)
✔✔What are two causes myxedema coma? - ✔✔- Hypothyroidism
- Medication adjustment is not right.
,✔✔What are nine clinical manifestations of myxedema coma? (Hint:
H.C.L.F.G.C.W.H.H) - ✔✔- Hypoxia
- Carbon dioxide retention
- Lethargy
- Fatigue
- Goiter
- Cold intolerance
- Weight gain
- Hypoglycemia
- Hyponatremia
✔✔What medication is used for hypothyroidism? - ✔✔Levothyroxine
✔✔What are four interventions you would do for a patient with myxedema coma? (Hint:
SIMI) - ✔✔- Slow warming
- Monitor T3 T4 levels
- IV levothyroxine
- Intubation equipment ready (due to hypoxia and carbon dioxide retention)
✔✔How do you know if its hypothyroidism and hyperthyroidism? - ✔✔- Look at the TSH
- Increased T3 & T4 / Decreased TSH (hyper)
- Decreased T3 & T4 / increased TSH (hypo)
✔✔If the thyroid regulates metabolism what would a decreased metabolic rate indicate?
- ✔✔Hypothyroidism
✔✔What is the patho. and causes of hyperthyroidism? - ✔✔High T3 and T4 thyroid
hormones
- Too much iodine
- Too much thyroid medication (ex. Levothyroxine)
- Autoimmune: Gave = GAINS "HIGH"
✔✔What causes hyperthyroidism which can lead to a thyroid storm? - ✔✔- Sudden
illness of surgery
- Untreated hyperthyroidism
✔✔What are four cues that would indicate hyperthyroidism? (Hint: E.S.T.F) - ✔✔-
Exophthalmos (bulging eyes)
- Sever agitation
- Tachy
- Fever
✔✔What medication would be given to patient with thyroid storm (hyperthyroidism)? -
✔✔Methimazole
, ✔✔What three other interventions would you do for hyperthyroidism patients? (Hint:
F.F.B) - ✔✔- Fluid replacement
- Fever reduction
- Beta blockers like atenolol for HR
✔✔What are common labs for hyperthyroidism? - ✔✔- Increased T3 & T4
- Decreased TSH
✔✔What is diabetes insipidus? - ✔✔Body can't balance fluids levels normally.
✔✔What causes DI? - ✔✔Damage to the brain- Tumors, trauma, surgery
✔✔What is one complication of removing the tumor for the pituitary? - ✔✔Postop CSF
leak
✔✔How will you know if it's a CSF leak - ✔✔Tissue will have yellow halos
✔✔What are eight signs and symptoms of DI? (Hint: S.L.H.H.H.P.P.P) - ✔✔- Severe
dehydration
- Low urine specific gravity
- High serum osmo.
- High Na+ (Hypernatremia )
- Hypotension
- Polydipsia
- Polyuria
- Polyphagia
✔✔What are two interventions for DI? - ✔✔- Give desmopressin (DDAVP)
- Daily weights
✔✔Education regarding desmopressin to DI patients? (Hint: I.D.I.M.T) - ✔✔- Intranasal
(NOT subq)
- Daily weights
- If patient gains 1-3 lbs in day call doc
- Monitor I&Os
- Teach s/s of overload
✔✔What is SIADH? - ✔✔Inappropriate antidiuretic hormone secretion (high ADH) from
pituitary
✔✔What are four possible causes of SIADH? (Hint: "HIT Me") - ✔✔- Head trauma
- Tumors
- Infection
- Medications
