, NSG 430 Final Exam – Adult Health
Nursing II Actual Questions & Answers
(GCU) 100% Guarantee Pass
Question 1: A patient with hypothyroidism is lethargic, difficult to arouse, with HR 62
and temperature 97.2°F. Which condition should the nurse suspect?
A. Thyroid storm
B. Myxedema coma
C. Addisonian crisis
D. Cushing syndrome
Answer: B
Rationale: Myxedema coma is a life-threatening hypothyroid state with hypothermia,
bradycardia, and altered mental status. IV levothyroxine is the treatment. Thyroid storm
is an exacerbation of hyperthyroidism with fever and tachycardia.
Question 2: What is the treatment for myxedema coma?
A. Methimazole
B. Propylthiouracil
C. IV levothyroxine
D. Beta-blocker
Answer: C
Rationale: Myxedema coma requires IV levothyroxine for rapid hormone replacement.
Warming and supportive care are also needed.
Question 3: Which laboratory finding supports a diagnosis of myxedema coma?
A. Elevated TSH
B. Elevated cortisol
,C. Elevated T3 and T4
D. Elevated ACTH
Answer: A
Rationale: Primary hypothyroidism is characterized by an elevated TSH with low T3 and
T4 levels. The elevated TSH indicates the pituitary is trying to stimulate an underactive
thyroid gland.
Question 4: A patient presents to the ED with pulse 132 bpm, BP 88/50 mm Hg, RR 32,
blood sugar 60 mg/dL, fatigue, dizziness, and darkening of skin. These signs are
consistent with:
A. SIADH
B. Thyroid storm
C. Myxedema coma
D. Adrenal crisis (Addisonian crisis)
Answer: D
Rationale: Addisonian crisis is life-threatening adrenal insufficiency with hypotension,
hyponatremia, hyperkalemia, hypoglycemia, and shock. Darkening of skin
(hyperpigmentation) is a classic sign of Addison's disease due to excess ACTH. Thyroid
storm presents with fever and tachycardia.
Question 5: What is the treatment for Addisonian crisis?
A. Insulin and IV fluids
B. High-dose hydrocortisone and IV fluids
C. Oral corticosteroids
D. Antihypertensives
Answer: B
Rationale: Addisonian crisis requires high-dose IV hydrocortisone and IV fluids to
correct hypotension and electrolyte imbalances. Oral corticosteroids are not adequate in
a crisis.
, Question 6: A patient with hyperthyroidism has a fever of 101.5°F, tachycardia, and
agitation. The nurse suspects:
A. Thyroid storm
B. Myxedema coma
C. Addisonian crisis
D. DKA
Answer: A
Rationale: Thyroid storm is a life-threatening hyperthyroidism exacerbation with high
fever, tachycardia, and agitation. Treatment includes rest, minimal stimulation, and
dysrhythmia management.
Question 7: Treatment for thyroid storm includes: (Select all that apply)
A. Rest
B. Minimal stimulation
C. Artificial tears
D. Dysrhythmia management
Answer: A, B, C, D
Rationale: Thyroid storm treatment includes rest, minimal stimulation (quiet
environment), artificial tears (for eye protection), and dysrhythmia management.
Antithyroid medications and beta-blockers are also used.
Question 8: Which medication is contraindicated in thyroid storm?
A. Methimazole
B. Propranolol
C. Aspirin
D. Propylthiouracil
Answer: C
Nursing II Actual Questions & Answers
(GCU) 100% Guarantee Pass
Question 1: A patient with hypothyroidism is lethargic, difficult to arouse, with HR 62
and temperature 97.2°F. Which condition should the nurse suspect?
A. Thyroid storm
B. Myxedema coma
C. Addisonian crisis
D. Cushing syndrome
Answer: B
Rationale: Myxedema coma is a life-threatening hypothyroid state with hypothermia,
bradycardia, and altered mental status. IV levothyroxine is the treatment. Thyroid storm
is an exacerbation of hyperthyroidism with fever and tachycardia.
Question 2: What is the treatment for myxedema coma?
A. Methimazole
B. Propylthiouracil
C. IV levothyroxine
D. Beta-blocker
Answer: C
Rationale: Myxedema coma requires IV levothyroxine for rapid hormone replacement.
Warming and supportive care are also needed.
Question 3: Which laboratory finding supports a diagnosis of myxedema coma?
A. Elevated TSH
B. Elevated cortisol
,C. Elevated T3 and T4
D. Elevated ACTH
Answer: A
Rationale: Primary hypothyroidism is characterized by an elevated TSH with low T3 and
T4 levels. The elevated TSH indicates the pituitary is trying to stimulate an underactive
thyroid gland.
Question 4: A patient presents to the ED with pulse 132 bpm, BP 88/50 mm Hg, RR 32,
blood sugar 60 mg/dL, fatigue, dizziness, and darkening of skin. These signs are
consistent with:
A. SIADH
B. Thyroid storm
C. Myxedema coma
D. Adrenal crisis (Addisonian crisis)
Answer: D
Rationale: Addisonian crisis is life-threatening adrenal insufficiency with hypotension,
hyponatremia, hyperkalemia, hypoglycemia, and shock. Darkening of skin
(hyperpigmentation) is a classic sign of Addison's disease due to excess ACTH. Thyroid
storm presents with fever and tachycardia.
Question 5: What is the treatment for Addisonian crisis?
A. Insulin and IV fluids
B. High-dose hydrocortisone and IV fluids
C. Oral corticosteroids
D. Antihypertensives
Answer: B
Rationale: Addisonian crisis requires high-dose IV hydrocortisone and IV fluids to
correct hypotension and electrolyte imbalances. Oral corticosteroids are not adequate in
a crisis.
, Question 6: A patient with hyperthyroidism has a fever of 101.5°F, tachycardia, and
agitation. The nurse suspects:
A. Thyroid storm
B. Myxedema coma
C. Addisonian crisis
D. DKA
Answer: A
Rationale: Thyroid storm is a life-threatening hyperthyroidism exacerbation with high
fever, tachycardia, and agitation. Treatment includes rest, minimal stimulation, and
dysrhythmia management.
Question 7: Treatment for thyroid storm includes: (Select all that apply)
A. Rest
B. Minimal stimulation
C. Artificial tears
D. Dysrhythmia management
Answer: A, B, C, D
Rationale: Thyroid storm treatment includes rest, minimal stimulation (quiet
environment), artificial tears (for eye protection), and dysrhythmia management.
Antithyroid medications and beta-blockers are also used.
Question 8: Which medication is contraindicated in thyroid storm?
A. Methimazole
B. Propranolol
C. Aspirin
D. Propylthiouracil
Answer: C
