NSG 4100 Exam 2: Endocrine & Metabolic
Disorders
Comprehensive Question Bank with ANSWERs and
Rationales 2026
Question 1:
A nurse is performing a Cushing intervention assessment. Which areas should the nurse prioritize when
assessing bony structures?
A) Assess for presence of obesity and weight gain patterns
B) Assess bony areas for signs of fractures, osteoporosis, and bone pain
C) Assess skin for bruising and striae development
D) Assess for muscle weakness and fatigue
ANSWER: B
Rationale:
Option A: While obesity is a hallmark of Cushing syndrome, this is not specifically a bony assessment
Option B: CORRECT - Cushing syndrome leads to osteoporosis and bone loss due to excess cortisol,
making bony areas susceptible to fractures; priority assessment includes checking for bone pain,
tenderness, and previous fracture sites
Option C: Skin assessment is important but not specifically "bony areas"
,Option D: Muscle weakness is related to protein catabolism but not a bony structure assessment
Question 2:
A patient with Cushing syndrome is receiving dietary education. The nurse should instruct the patient to
maintain which dietary pattern?
A) Low protein, high fat diet
B) High carbohydrate, low sodium diet
C) High carbohydrate diet with increased protein and potassium
D) Low carbohydrate, high protein diet
ANSWER: C
Rationale:
Option A: High fat diet is not recommended for Cushing patients
Option B: While low sodium is important, low protein is not appropriate
Option C: CORRECT - Patients with Cushing syndrome require a high carbohydrate diet to prevent
protein breakdown, increased protein for tissue repair, and increased potassium to counteract
hypokalemia caused by mineralocorticoid effects
Option D: Low carbohydrate would worsen protein catabolism and muscle wasting
Question 3:
A patient presents with baldness and virilization. The nurse suspects which condition?
A) Cushing syndrome
B) Addison disease
,C) Congenital adrenal hyperplasia
D) Hyperthyroidism
ANSWER: C
Rationale:
Option A: Cushing syndrome causes hirsutism, not typically baldness pattern with virilization
Option B: Addison disease causes decreased androgens, not virilization
Option C: CORRECT - Congenital adrenal hyperplasia causes excess androgen production leading to
virilization in females and premature puberty in males; baldness can occur due to hormonal imbalances
Option D: Hyperthyroidism may cause hair thinning but not the specific pattern seen in CAH
Question 4:
A patient diagnosed with Cushing syndrome asks about appropriate food choices. Which meal selection
indicates understanding of dietary teaching?
A) Fried chicken, mashed potatoes with gravy, whole milk
B) Grilled chicken, baked potato, skim milk
C) Pork chops, rice, cream soup
D) Beef steak, french fries, milkshake
ANSWER: B
Rationale:
, Option A: Fried foods and whole milk contain excess fat and sodium
Option B: CORRECT - Raised (grilled/baked) chicken provides lean protein, baked potato offers
carbohydrates and potassium, and skim milk provides calcium without excess fat; this combination
supports the high carb, high protein, low sodium diet needed for Cushing patients
Option C: Cream soup is high in sodium and fat
Option D: Beef and milkshake are high in fat and calories
Question 5:
Which patient has the highest risk factor for developing Cushing syndrome?
A) A male patient with a history of diabetes
B) A female patient using a steroid inhaler for asthma
C) An elderly patient with hypertension
D) A young adult with obesity
ANSWER: B
Rationale:
Option A: Diabetes is a consequence of Cushing but not a primary risk factor
Option B: CORRECT - Exogenous steroid use, including inhaled corticosteroids, is a significant risk factor
for iatrogenic Cushing syndrome; even inhaled steroids can be systemically absorbed
Option C: Hypertension is a manifestation, not a risk factor
Option D: Obesity can be a manifestation but is not the highest risk factor
Disorders
Comprehensive Question Bank with ANSWERs and
Rationales 2026
Question 1:
A nurse is performing a Cushing intervention assessment. Which areas should the nurse prioritize when
assessing bony structures?
A) Assess for presence of obesity and weight gain patterns
B) Assess bony areas for signs of fractures, osteoporosis, and bone pain
C) Assess skin for bruising and striae development
D) Assess for muscle weakness and fatigue
ANSWER: B
Rationale:
Option A: While obesity is a hallmark of Cushing syndrome, this is not specifically a bony assessment
Option B: CORRECT - Cushing syndrome leads to osteoporosis and bone loss due to excess cortisol,
making bony areas susceptible to fractures; priority assessment includes checking for bone pain,
tenderness, and previous fracture sites
Option C: Skin assessment is important but not specifically "bony areas"
,Option D: Muscle weakness is related to protein catabolism but not a bony structure assessment
Question 2:
A patient with Cushing syndrome is receiving dietary education. The nurse should instruct the patient to
maintain which dietary pattern?
A) Low protein, high fat diet
B) High carbohydrate, low sodium diet
C) High carbohydrate diet with increased protein and potassium
D) Low carbohydrate, high protein diet
ANSWER: C
Rationale:
Option A: High fat diet is not recommended for Cushing patients
Option B: While low sodium is important, low protein is not appropriate
Option C: CORRECT - Patients with Cushing syndrome require a high carbohydrate diet to prevent
protein breakdown, increased protein for tissue repair, and increased potassium to counteract
hypokalemia caused by mineralocorticoid effects
Option D: Low carbohydrate would worsen protein catabolism and muscle wasting
Question 3:
A patient presents with baldness and virilization. The nurse suspects which condition?
A) Cushing syndrome
B) Addison disease
,C) Congenital adrenal hyperplasia
D) Hyperthyroidism
ANSWER: C
Rationale:
Option A: Cushing syndrome causes hirsutism, not typically baldness pattern with virilization
Option B: Addison disease causes decreased androgens, not virilization
Option C: CORRECT - Congenital adrenal hyperplasia causes excess androgen production leading to
virilization in females and premature puberty in males; baldness can occur due to hormonal imbalances
Option D: Hyperthyroidism may cause hair thinning but not the specific pattern seen in CAH
Question 4:
A patient diagnosed with Cushing syndrome asks about appropriate food choices. Which meal selection
indicates understanding of dietary teaching?
A) Fried chicken, mashed potatoes with gravy, whole milk
B) Grilled chicken, baked potato, skim milk
C) Pork chops, rice, cream soup
D) Beef steak, french fries, milkshake
ANSWER: B
Rationale:
, Option A: Fried foods and whole milk contain excess fat and sodium
Option B: CORRECT - Raised (grilled/baked) chicken provides lean protein, baked potato offers
carbohydrates and potassium, and skim milk provides calcium without excess fat; this combination
supports the high carb, high protein, low sodium diet needed for Cushing patients
Option C: Cream soup is high in sodium and fat
Option D: Beef and milkshake are high in fat and calories
Question 5:
Which patient has the highest risk factor for developing Cushing syndrome?
A) A male patient with a history of diabetes
B) A female patient using a steroid inhaler for asthma
C) An elderly patient with hypertension
D) A young adult with obesity
ANSWER: B
Rationale:
Option A: Diabetes is a consequence of Cushing but not a primary risk factor
Option B: CORRECT - Exogenous steroid use, including inhaled corticosteroids, is a significant risk factor
for iatrogenic Cushing syndrome; even inhaled steroids can be systemically absorbed
Option C: Hypertension is a manifestation, not a risk factor
Option D: Obesity can be a manifestation but is not the highest risk factor
