NSG 4100 Exam 2 Practice Questions and Answers with
Rationales GRADED A+
SECTION 1: ENDOCRINE DISORDERS – PITUITARY & ADRENAL
(Questions 1-25)
Question 1
Excessive ADH secretion from the pituitary gland results in concentrated urine, fluid retention,
and dilutional hyponatremia. This describes which disorder?
A) Diabetes Insipidus
B) Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
C) Addison's Disease
D) Cushing's Syndrome
Correct Answer: B
Rationale: SIADH is characterized by excessive ADH secretion, leading to water retention, concentrated
urine, and dilutional hyponatremia. Diabetes Insipidus (A) is caused by a deficiency of ADH, not excess.
Addison's Disease (C) involves adrenal insufficiency, and Cushing's Syndrome (D) involves excess
cortisol.
Question 2
Which disorder is the most common disorder of the posterior lobe of the pituitary gland and is
characterized by a deficiency of ADH?
A) SIADH
B) Diabetes Insipidus
C) Addison's Disease
D) Cushing's Syndrome
Correct Answer: B
,Rationale: Diabetes Insipidus (DI) is the most common disorder of the posterior pituitary and is
characterized by a deficiency of antidiuretic hormone (ADH). This leads to excessive thirst and large
volumes of dilute urine.
Question 3
Which of the following are clinical manifestations of Diabetes Insipidus? (Select all that apply)
A) Excessive thirst (polydipsia)
B) Large amounts of dilute urine
C) Nocturia
D) Fluid retention
E) Weight gain
Correct Answer: A, B, C
Rationale: Clinical manifestations of DI include excessive thirst (polydipsia), large amounts of dilute
urine, and nocturia. Fluid retention and weight gain are characteristic of SIADH, not DI.
Question 4
A patient with Diabetes Insipidus is prescribed desmopressin (DDAVP). The nurse understands
that this medication works by:
A) Increasing urine output
B) Replacing ADH to reduce urine output
C) Blocking aldosterone receptors
D) Stimulating the adrenal cortex
Correct Answer: B
Rationale: Desmopressin (DDAVP) is a synthetic form of ADH used to replace the deficient hormone in
Diabetes Insipidus, thereby reducing urine output. It does not increase urine output (A), block aldosterone
(C), or stimulate the adrenal cortex (D).
Question 5
A client with a diagnosis of Addisonian crisis is being admitted to the ICU. Which findings will the
interprofessional care team focus on? (Select all that apply)
,A) Hyperkalemia
B) Hyponatremia
C) Hyperglycemia
D) Hypotension
E) Hypoglycemia
Correct Answer: A, B, D, E
Rationale: Addisonian crisis (acute adrenal insufficiency) is characterized by hyperkalemia,
hyponatremia, hypotension, and hypoglycemia. Hyperglycemia (C) is not associated with adrenal
insufficiency; it is seen in Cushing's syndrome and diabetes.
Question 6
A patient with Cushing's syndrome is likely to exhibit which physical findings?
A) Weight loss and muscle wasting
B) Moon facies and buffalo hump
C) Hyperpigmentation and hypotension
D) Exophthalmos and goiter
Correct Answer: B
Rationale: Cushing's syndrome results from excess cortisol, leading to moon facies (rounded face),
buffalo hump (fat deposition at the back of the neck), truncal obesity, and thin extremities. Weight loss (A)
and hyperpigmentation (C) are associated with Addison's disease.
Question 7
A patient is diagnosed with Addison's disease. The nurse should teach the patient about which
medication?
A) Levothyroxine
B) Hydrocortisone
C) Methimazole
D) Desmopressin
Correct Answer: B
Rationale: Addison's disease is caused by adrenal insufficiency, requiring replacement therapy with
glucocorticoids such as hydrocortisone. Levothyroxine (A) is for hypothyroidism, methimazole (C) for
hyperthyroidism, and desmopressin (D) for diabetes insipidus.
, Question 8
A patient with Addison's disease is at risk for adrenal crisis. Which sign indicates adrenal crisis?
A) Hypertension and tachycardia
B) Hypotension and hyperkalemia
C) Hyperglycemia and polyuria
D) Bradycardia and hypothermia
Correct Answer: B
Rationale: Adrenal crisis is characterized by severe hypotension, hyperkalemia, hyponatremia,
hypoglycemia, and dehydration. It is a life-threatening emergency requiring immediate glucocorticoid
administration and IV fluids.
Question 9
A nurse is caring for a client following a transsphenoidal hypophysectomy. Which data warrants
immediate intervention?
A) Client is alert to name but unable to tell nurse the location
B) Client has output of 2500 mL since surgery and intake of 1000 mL
C) Client vital signs are T 97.6°F, P 88, RR 22, BP 130/80
D) Client has 3 cm of dark red drainage on turban dressing
Correct Answer: B
Rationale: A urine output of 2500 mL with intake of only 1000 mL suggests diabetes insipidus (DI), a
complication of pituitary surgery. DI results from decreased ADH and can lead to severe dehydration and
hypernatremia. Immediate intervention is required.
Question 10
A patient is post-operative following a transsphenoidal hypophysectomy. Which finding is
indicative of a cerebrospinal fluid (CSF) leak?
A) Client states he feels a lot of drainage at the back of his throat
B) Eyes that are swollen post-op
C) Mild headache
D) Temperature of 99.2°F
Rationales GRADED A+
SECTION 1: ENDOCRINE DISORDERS – PITUITARY & ADRENAL
(Questions 1-25)
Question 1
Excessive ADH secretion from the pituitary gland results in concentrated urine, fluid retention,
and dilutional hyponatremia. This describes which disorder?
A) Diabetes Insipidus
B) Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
C) Addison's Disease
D) Cushing's Syndrome
Correct Answer: B
Rationale: SIADH is characterized by excessive ADH secretion, leading to water retention, concentrated
urine, and dilutional hyponatremia. Diabetes Insipidus (A) is caused by a deficiency of ADH, not excess.
Addison's Disease (C) involves adrenal insufficiency, and Cushing's Syndrome (D) involves excess
cortisol.
Question 2
Which disorder is the most common disorder of the posterior lobe of the pituitary gland and is
characterized by a deficiency of ADH?
A) SIADH
B) Diabetes Insipidus
C) Addison's Disease
D) Cushing's Syndrome
Correct Answer: B
,Rationale: Diabetes Insipidus (DI) is the most common disorder of the posterior pituitary and is
characterized by a deficiency of antidiuretic hormone (ADH). This leads to excessive thirst and large
volumes of dilute urine.
Question 3
Which of the following are clinical manifestations of Diabetes Insipidus? (Select all that apply)
A) Excessive thirst (polydipsia)
B) Large amounts of dilute urine
C) Nocturia
D) Fluid retention
E) Weight gain
Correct Answer: A, B, C
Rationale: Clinical manifestations of DI include excessive thirst (polydipsia), large amounts of dilute
urine, and nocturia. Fluid retention and weight gain are characteristic of SIADH, not DI.
Question 4
A patient with Diabetes Insipidus is prescribed desmopressin (DDAVP). The nurse understands
that this medication works by:
A) Increasing urine output
B) Replacing ADH to reduce urine output
C) Blocking aldosterone receptors
D) Stimulating the adrenal cortex
Correct Answer: B
Rationale: Desmopressin (DDAVP) is a synthetic form of ADH used to replace the deficient hormone in
Diabetes Insipidus, thereby reducing urine output. It does not increase urine output (A), block aldosterone
(C), or stimulate the adrenal cortex (D).
Question 5
A client with a diagnosis of Addisonian crisis is being admitted to the ICU. Which findings will the
interprofessional care team focus on? (Select all that apply)
,A) Hyperkalemia
B) Hyponatremia
C) Hyperglycemia
D) Hypotension
E) Hypoglycemia
Correct Answer: A, B, D, E
Rationale: Addisonian crisis (acute adrenal insufficiency) is characterized by hyperkalemia,
hyponatremia, hypotension, and hypoglycemia. Hyperglycemia (C) is not associated with adrenal
insufficiency; it is seen in Cushing's syndrome and diabetes.
Question 6
A patient with Cushing's syndrome is likely to exhibit which physical findings?
A) Weight loss and muscle wasting
B) Moon facies and buffalo hump
C) Hyperpigmentation and hypotension
D) Exophthalmos and goiter
Correct Answer: B
Rationale: Cushing's syndrome results from excess cortisol, leading to moon facies (rounded face),
buffalo hump (fat deposition at the back of the neck), truncal obesity, and thin extremities. Weight loss (A)
and hyperpigmentation (C) are associated with Addison's disease.
Question 7
A patient is diagnosed with Addison's disease. The nurse should teach the patient about which
medication?
A) Levothyroxine
B) Hydrocortisone
C) Methimazole
D) Desmopressin
Correct Answer: B
Rationale: Addison's disease is caused by adrenal insufficiency, requiring replacement therapy with
glucocorticoids such as hydrocortisone. Levothyroxine (A) is for hypothyroidism, methimazole (C) for
hyperthyroidism, and desmopressin (D) for diabetes insipidus.
, Question 8
A patient with Addison's disease is at risk for adrenal crisis. Which sign indicates adrenal crisis?
A) Hypertension and tachycardia
B) Hypotension and hyperkalemia
C) Hyperglycemia and polyuria
D) Bradycardia and hypothermia
Correct Answer: B
Rationale: Adrenal crisis is characterized by severe hypotension, hyperkalemia, hyponatremia,
hypoglycemia, and dehydration. It is a life-threatening emergency requiring immediate glucocorticoid
administration and IV fluids.
Question 9
A nurse is caring for a client following a transsphenoidal hypophysectomy. Which data warrants
immediate intervention?
A) Client is alert to name but unable to tell nurse the location
B) Client has output of 2500 mL since surgery and intake of 1000 mL
C) Client vital signs are T 97.6°F, P 88, RR 22, BP 130/80
D) Client has 3 cm of dark red drainage on turban dressing
Correct Answer: B
Rationale: A urine output of 2500 mL with intake of only 1000 mL suggests diabetes insipidus (DI), a
complication of pituitary surgery. DI results from decreased ADH and can lead to severe dehydration and
hypernatremia. Immediate intervention is required.
Question 10
A patient is post-operative following a transsphenoidal hypophysectomy. Which finding is
indicative of a cerebrospinal fluid (CSF) leak?
A) Client states he feels a lot of drainage at the back of his throat
B) Eyes that are swollen post-op
C) Mild headache
D) Temperature of 99.2°F
