NURS 120 | Diabetes & Endocrine Disorders Comprehensive Final
Exam 2026 |WCU
1. A client with Type 1 Diabetes Mellitus is admitted with Diabetic Ketoacidosis
(DKA). Which of the following physician orders should the nurse prioritize first?
A. Infuse 1 liter of 0.9% Normal Saline over 1 hour
B. Administer 10 units of Regular insulin IV bolus
C. Obtain an arterial blood gas (ABG) and electrolyte panel
D. Administer Potassium Chloride 20 mEq/L in the IV fluids
Answer: A
Rationale: The priority in DKA management is fluid resuscitation to restore perfusion and
volume; insulin is secondary to volume replacement to prevent vascular collapse.
2. The nurse is caring for a patient with Syndrome of Inappropriate Antidiuretic
Hormone (SIADH). Which laboratory finding is most consistent with this
diagnosis?
A. Hematocrit of 55%
B. Serum osmolality of 310 mOsm/kg
C. Urine specific gravity of 1.002
D. Serum sodium of 128 mEq/L
Answer: D
Rationale: SIADH involves excessive ADH release, leading to water retention and dilutional
hyponatremia (sodium < 135 mEq/L) and low serum osmolality.
,3. Following a thyroidectomy, a patient develops numbness and tingling around
the mouth and fingertips. Which medication should the nurse have readily
available?
A. Calcium Gluconate
B. Potassium Chloride
C. Levothyroxine
D. Propylthiouracil (PTU)
Answer: A
Rationale: Hypocalcemia can occur if the parathyroid glands are accidentally damaged or
removed during thyroid surgery; Calcium Gluconate is the emergency treatment for tetany.
4. A client is diagnosed with Pheochromocytoma. Which nursing action is
contraindicated when preparing the client for surgery?
A. Palpating the abdomen to check for masses
B. Monitoring blood pressure every 15 minutes
C. Providing a high-calorie, low-caffeine diet
D. Administering alpha-adrenergic blockers as ordered
Answer: A
Rationale: Palpation of the abdomen can trigger a sudden release of catecholamines from
the tumor, leading to a hypertensive crisis.
5. Which clinical manifestation should the nurse expect to see in a patient with
Addison’s Disease?
A. Hyperpigmentation of the skin and hypotension
B. Moon face and truncal obesity
C. Hirsutism and striae
D. Weight gain and hypertension
Answer: A
, Rationale: Addison’s Disease involves adrenal insufficiency, leading to bronze-like skin
pigmentation (due to high ACTH) and hypotension (due to low aldosterone).
6. A patient is prescribed Levothyroxine for hypothyroidism. Which instruction
is essential for the nurse to provide?
A. Take the medication with a high-calcium snack
B. Expect symptoms to resolve within 24 hours
C. Take the medication on an empty stomach in the morning
D. Discontinue the medication once heart rate increases
Answer: C
Rationale: Levothyroxine must be taken on an empty stomach, usually 30-60 minutes
before breakfast, to ensure optimal absorption.
7. A nurse monitors a patient for the ‘Somogyi Effect.’ Which of the following
descriptions best defines this phenomenon?
A. Hyperglycemia upon awakening caused by growth hormone release
B. Insulin resistance caused by chronic obesity
C. A rise in blood sugar due to excessive carbohydrate intake at bedtime
D. Hypoglycemia during the night followed by rebound hyperglycemia
Answer: D
Rationale: The Somogyi effect is characterized by nighttime hypoglycemia followed by a
surge in counter-regulatory hormones causing morning hyperglycemia.
8. A client with Hyperglycemic Hyperosmolar State (HHS) has a blood glucose of
850 mg/dL. Which finding distinguishes HHS from DKA?
A. Presence of Kussmaul respirations
B. Absence of significant ketosis
C. Significant metabolic acidosis
D. Fruity breath odor
Answer: B
Exam 2026 |WCU
1. A client with Type 1 Diabetes Mellitus is admitted with Diabetic Ketoacidosis
(DKA). Which of the following physician orders should the nurse prioritize first?
A. Infuse 1 liter of 0.9% Normal Saline over 1 hour
B. Administer 10 units of Regular insulin IV bolus
C. Obtain an arterial blood gas (ABG) and electrolyte panel
D. Administer Potassium Chloride 20 mEq/L in the IV fluids
Answer: A
Rationale: The priority in DKA management is fluid resuscitation to restore perfusion and
volume; insulin is secondary to volume replacement to prevent vascular collapse.
2. The nurse is caring for a patient with Syndrome of Inappropriate Antidiuretic
Hormone (SIADH). Which laboratory finding is most consistent with this
diagnosis?
A. Hematocrit of 55%
B. Serum osmolality of 310 mOsm/kg
C. Urine specific gravity of 1.002
D. Serum sodium of 128 mEq/L
Answer: D
Rationale: SIADH involves excessive ADH release, leading to water retention and dilutional
hyponatremia (sodium < 135 mEq/L) and low serum osmolality.
,3. Following a thyroidectomy, a patient develops numbness and tingling around
the mouth and fingertips. Which medication should the nurse have readily
available?
A. Calcium Gluconate
B. Potassium Chloride
C. Levothyroxine
D. Propylthiouracil (PTU)
Answer: A
Rationale: Hypocalcemia can occur if the parathyroid glands are accidentally damaged or
removed during thyroid surgery; Calcium Gluconate is the emergency treatment for tetany.
4. A client is diagnosed with Pheochromocytoma. Which nursing action is
contraindicated when preparing the client for surgery?
A. Palpating the abdomen to check for masses
B. Monitoring blood pressure every 15 minutes
C. Providing a high-calorie, low-caffeine diet
D. Administering alpha-adrenergic blockers as ordered
Answer: A
Rationale: Palpation of the abdomen can trigger a sudden release of catecholamines from
the tumor, leading to a hypertensive crisis.
5. Which clinical manifestation should the nurse expect to see in a patient with
Addison’s Disease?
A. Hyperpigmentation of the skin and hypotension
B. Moon face and truncal obesity
C. Hirsutism and striae
D. Weight gain and hypertension
Answer: A
, Rationale: Addison’s Disease involves adrenal insufficiency, leading to bronze-like skin
pigmentation (due to high ACTH) and hypotension (due to low aldosterone).
6. A patient is prescribed Levothyroxine for hypothyroidism. Which instruction
is essential for the nurse to provide?
A. Take the medication with a high-calcium snack
B. Expect symptoms to resolve within 24 hours
C. Take the medication on an empty stomach in the morning
D. Discontinue the medication once heart rate increases
Answer: C
Rationale: Levothyroxine must be taken on an empty stomach, usually 30-60 minutes
before breakfast, to ensure optimal absorption.
7. A nurse monitors a patient for the ‘Somogyi Effect.’ Which of the following
descriptions best defines this phenomenon?
A. Hyperglycemia upon awakening caused by growth hormone release
B. Insulin resistance caused by chronic obesity
C. A rise in blood sugar due to excessive carbohydrate intake at bedtime
D. Hypoglycemia during the night followed by rebound hyperglycemia
Answer: D
Rationale: The Somogyi effect is characterized by nighttime hypoglycemia followed by a
surge in counter-regulatory hormones causing morning hyperglycemia.
8. A client with Hyperglycemic Hyperosmolar State (HHS) has a blood glucose of
850 mg/dL. Which finding distinguishes HHS from DKA?
A. Presence of Kussmaul respirations
B. Absence of significant ketosis
C. Significant metabolic acidosis
D. Fruity breath odor
Answer: B
