NSG 223 Exam 3: Addison's Disease, Cushing Syndrome, Diabetes Insipidus,
SIADH, Fractures, GBS, Myasthenia Gravis | Q&A | Grade A | 100% Correct
(Verified Answers) – Nursing Program
Subject: Medical-Surgical Nursing II – Endocrine Disorders (Addison's Disease: Addisonian Crisis,
Assessment Findings, Hydrocortisone Timing, Live Vaccine Contraindication; Cushing Syndrome:
Hirsutism, Diet; Diabetes Insipidus: Desmopressin, Fluid Deprivation Test; SIADH: Fluid Balance);
Orthopedic Trauma (Fractures: Assessment Findings, Healing Time, Compartment Syndrome,
Neurovascular Checks (6 P's), Splinting, Amputation); Neuromuscular Disorders (Guillain-Barré
Syndrome: ICU Management, Respiratory Failure, Ataxia; Myasthenia Gravis: Tensilon Test, Neostigmine,
Cholinergic Crisis, Myasthenic Crisis, Thymectomy; Fibromyalgia); Growth Hormone Disorders
(Gigantism); Medications (Baclofen, Octreotide, Ketoconazole, Morphine, PCA, Neostigmine, Lovenox,
Heparin, Hydrocodone)
Source: NSG 223 Exam 3 Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. A client presents to the ED in Addisonian Crisis. Which IV fluid should the nurse anticipate to administer
STAT?
Correct Answer: 5% dextrose in NS (normal saline).
1. Addisonian crisis involves hypoglycemia, hyponatremia, and hypotension.
2. Dextrose treats hypoglycemia; normal saline corrects hypovolemia and hyponatremia.
2. Which assessment findings would the nurse expect in a client with Addison's disease? (SATA)
Correct Answer: Muscle weakness, Dark pigmentation, N/V, Fatigue, HYPERKALEMIA,
HYPONATREMIA, HYPOGLYCEMIA, HYPOTENSION (<120/80).
1. Adrenal insufficiency causes deficiency of cortisol and aldosterone.
2. Hyperpigmentation is due to increased ACTH.
3. A patient with Addison's disease, what medication do you expect for spasticity?
Correct Answer: Baclofen.
1. Baclofen is a muscle relaxant used for spasticity.
2. Acts on GABA-B receptors in the spinal cord.
4. Which statement by a patient with Addison's shows understanding?
Correct Answer: "When it's hot out, I will eat more salty food and drink fluids." (increase
sodium/water levels due to hypovolemia/hyponatremia).
1. Addison's patients need increased sodium and fluids, especially in hot weather.
2. This prevents dehydration and electrolyte imbalance.
5. Addison disease, corticosteroid therapy is for long-term use. What happens if the patient abruptly withdraws
from taking the medication?
Correct Answer: Abrupt withdrawal from life-term high-dose steroid can lead to secondary causes
(adrenal insufficiency/Addisonian crisis).
1. Abrupt withdrawal of corticosteroids can precipitate adrenal crisis.
2. Must taper steroids slowly to allow adrenal recovery.
, 6. What is contraindicated for patients with Addison Disease?
Correct Answer: Live vaccines – no MMR or flu vaccine (live attenuated).
1. Immunosuppressed patients (on chronic steroids) should not receive live vaccines.
2. Inactivated vaccines are safe.
7. Nurse is teaching the patient about the best time to take hydrocortisone. Which is the time?
Correct Answer: At 9am with breakfast (same time with meal and snack).
1. Hydrocortisone should be taken in the morning to mimic natural cortisol rhythm.
2. Taking with food reduces GI irritation.
8. Nurse is performing an assessment for a patient with possible Cushing syndrome. Which assessment finding
would be expected?
Correct Answer: Hirsutism (excessive hair growth).
1. Other findings: moon face, buffalo hump, purple striae, weight gain, hypertension.
2. Cushing syndrome results from excess cortisol.
9. What diet would you recommend for a patient that has Cushing?
Correct Answer: Greek Salad (increase potassium levels), yogurt, and milk (vitamin D + calcium for
osteoporosis).
1. Cushing syndrome causes hypokalemia, osteoporosis, and protein wasting.
2. Increase potassium, calcium, and protein; restrict sodium and fluids.
10. Cushing Syndrome, what patient education would the nurse provide for nutrition/fluids?
Correct Answer: Increase potassium, increase calcium, increase protein, restrict fluid and sodium
intake.
1. Sodium and fluid retention cause hypertension and edema.
2. Protein helps prevent muscle wasting.
11. Nurse is preparing to administer Desmopressin for a client with Diabetes Insipidus. Which info contraindicates
medication administration?
Correct Answer: Creatinine clearance 40 mL/min (related to CKD... creatinine clearance <50 is
contraindicated).
1. Desmopressin (DDAVP) is an ADH analog.
2. Impaired renal function may affect drug excretion and effectiveness.
12. What are the clinical manifestations of Diabetes Insipidus (DI)?
Correct Answer: Urine output >250 mL/hr; polyuria; polydipsia; signs of dehydration (skin turgor, dry
skin and mucous membranes), weakness.
1. DI results from ADH deficiency or resistance.
2. Large volumes of dilute urine (low specific gravity).
13. Nurse is caring for a client completing a fluid deprivation test. Which result should the nurse expect to confirm
DI?
Correct Answer: Unchanged urine osmolality (failure to concentrate urine).
1. In DI, urine osmolality remains low (<300 mOsm/kg) despite fluid deprivation.
2. Normal response is increased urine osmolality.
SIADH, Fractures, GBS, Myasthenia Gravis | Q&A | Grade A | 100% Correct
(Verified Answers) – Nursing Program
Subject: Medical-Surgical Nursing II – Endocrine Disorders (Addison's Disease: Addisonian Crisis,
Assessment Findings, Hydrocortisone Timing, Live Vaccine Contraindication; Cushing Syndrome:
Hirsutism, Diet; Diabetes Insipidus: Desmopressin, Fluid Deprivation Test; SIADH: Fluid Balance);
Orthopedic Trauma (Fractures: Assessment Findings, Healing Time, Compartment Syndrome,
Neurovascular Checks (6 P's), Splinting, Amputation); Neuromuscular Disorders (Guillain-Barré
Syndrome: ICU Management, Respiratory Failure, Ataxia; Myasthenia Gravis: Tensilon Test, Neostigmine,
Cholinergic Crisis, Myasthenic Crisis, Thymectomy; Fibromyalgia); Growth Hormone Disorders
(Gigantism); Medications (Baclofen, Octreotide, Ketoconazole, Morphine, PCA, Neostigmine, Lovenox,
Heparin, Hydrocodone)
Source: NSG 223 Exam 3 Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. A client presents to the ED in Addisonian Crisis. Which IV fluid should the nurse anticipate to administer
STAT?
Correct Answer: 5% dextrose in NS (normal saline).
1. Addisonian crisis involves hypoglycemia, hyponatremia, and hypotension.
2. Dextrose treats hypoglycemia; normal saline corrects hypovolemia and hyponatremia.
2. Which assessment findings would the nurse expect in a client with Addison's disease? (SATA)
Correct Answer: Muscle weakness, Dark pigmentation, N/V, Fatigue, HYPERKALEMIA,
HYPONATREMIA, HYPOGLYCEMIA, HYPOTENSION (<120/80).
1. Adrenal insufficiency causes deficiency of cortisol and aldosterone.
2. Hyperpigmentation is due to increased ACTH.
3. A patient with Addison's disease, what medication do you expect for spasticity?
Correct Answer: Baclofen.
1. Baclofen is a muscle relaxant used for spasticity.
2. Acts on GABA-B receptors in the spinal cord.
4. Which statement by a patient with Addison's shows understanding?
Correct Answer: "When it's hot out, I will eat more salty food and drink fluids." (increase
sodium/water levels due to hypovolemia/hyponatremia).
1. Addison's patients need increased sodium and fluids, especially in hot weather.
2. This prevents dehydration and electrolyte imbalance.
5. Addison disease, corticosteroid therapy is for long-term use. What happens if the patient abruptly withdraws
from taking the medication?
Correct Answer: Abrupt withdrawal from life-term high-dose steroid can lead to secondary causes
(adrenal insufficiency/Addisonian crisis).
1. Abrupt withdrawal of corticosteroids can precipitate adrenal crisis.
2. Must taper steroids slowly to allow adrenal recovery.
, 6. What is contraindicated for patients with Addison Disease?
Correct Answer: Live vaccines – no MMR or flu vaccine (live attenuated).
1. Immunosuppressed patients (on chronic steroids) should not receive live vaccines.
2. Inactivated vaccines are safe.
7. Nurse is teaching the patient about the best time to take hydrocortisone. Which is the time?
Correct Answer: At 9am with breakfast (same time with meal and snack).
1. Hydrocortisone should be taken in the morning to mimic natural cortisol rhythm.
2. Taking with food reduces GI irritation.
8. Nurse is performing an assessment for a patient with possible Cushing syndrome. Which assessment finding
would be expected?
Correct Answer: Hirsutism (excessive hair growth).
1. Other findings: moon face, buffalo hump, purple striae, weight gain, hypertension.
2. Cushing syndrome results from excess cortisol.
9. What diet would you recommend for a patient that has Cushing?
Correct Answer: Greek Salad (increase potassium levels), yogurt, and milk (vitamin D + calcium for
osteoporosis).
1. Cushing syndrome causes hypokalemia, osteoporosis, and protein wasting.
2. Increase potassium, calcium, and protein; restrict sodium and fluids.
10. Cushing Syndrome, what patient education would the nurse provide for nutrition/fluids?
Correct Answer: Increase potassium, increase calcium, increase protein, restrict fluid and sodium
intake.
1. Sodium and fluid retention cause hypertension and edema.
2. Protein helps prevent muscle wasting.
11. Nurse is preparing to administer Desmopressin for a client with Diabetes Insipidus. Which info contraindicates
medication administration?
Correct Answer: Creatinine clearance 40 mL/min (related to CKD... creatinine clearance <50 is
contraindicated).
1. Desmopressin (DDAVP) is an ADH analog.
2. Impaired renal function may affect drug excretion and effectiveness.
12. What are the clinical manifestations of Diabetes Insipidus (DI)?
Correct Answer: Urine output >250 mL/hr; polyuria; polydipsia; signs of dehydration (skin turgor, dry
skin and mucous membranes), weakness.
1. DI results from ADH deficiency or resistance.
2. Large volumes of dilute urine (low specific gravity).
13. Nurse is caring for a client completing a fluid deprivation test. Which result should the nurse expect to confirm
DI?
Correct Answer: Unchanged urine osmolality (failure to concentrate urine).
1. In DI, urine osmolality remains low (<300 mOsm/kg) despite fluid deprivation.
2. Normal response is increased urine osmolality.
