Galen College NUR 255 Exam 4 (pdf) | 2026/2027 | Aging & Chronic
Illness | Nursing
1. A nurse is assessing a patient with a suspected endocrine disorder. Which
of the following is the most important function of the hypothalamus?
A) Producing thyroid-stimulating hormone (TSH)
B) Storing antidiuretic hormone (ADH)
C) Maintaining homeostasis by regulating autonomic activities
D) Secreting growth hormone (GH)
Correct Answer: Maintaining homeostasis by regulating autonomic activities
Rationale: The hypothalamus is the control center for all autonomic
regulatory activities of the body, with its main function being homeostasis. It
controls blood pressure, temperature, fluid and electrolyte balance, and body
weight. The anterior pituitary produces TSH, the posterior pituitary stores
ADH, and the anterior pituitary secretes GH.
2. A patient's laboratory results show an elevated blood cortisol level. The
nurse should suspect which condition?
A) Addison's disease
B) Cushing's disease
C) Diabetes insipidus
D) SIADH
Correct Answer: Cushing's disease
Rationale: An increased blood cortisol level is indicative of Cushing's disease,
while a decreased level is characteristic of Addison's disease. Cortisol levels
vary throughout the day, peaking in the early morning between 4 AM and 8
AM.
,3. A patient with Addison's disease is at risk for which of the following
complications?
A) Hypernatremia
B) Hypokalemia
C) Adrenal crisis
D) Cushing's syndrome
Correct Answer: Adrenal crisis
Rationale: Adrenal crisis is a life-threatening complication of Addison's
disease, characterized by profound fatigue, dehydration, vascular collapse
(decreased BP), and renal shutdown. It is caused by a sudden deficiency of
cortisol and aldosterone. The primary nursing goal is to prevent circulatory
shock.
4. A patient with Addison's disease is experiencing postural hypotension and
weakness. The nurse should monitor for which electrolyte imbalance?
A) Hyperkalemia and hyponatremia
B) Hypokalemia and hypernatremia
C) Hypercalcemia and hypernatremia
D) Hypocalcemia and hyponatremia
Correct Answer: Hyperkalemia and hyponatremia
Rationale: Addison's disease results from adrenal cortex dysfunction leading
to decreased aldosterone and cortisol. Aldosterone deficiency causes sodium
loss and potassium retention, resulting in hyponatremia and hyperkalemia.
The nurse should monitor for hyperkalemia and obtain an ECG.
,5. A patient with Addison's disease is being discharged. Which statement by
the patient indicates a need for further teaching?
A) "I will avoid strenuous activity and stress."
B) "I will carry an emergency kit with hydrocortisone."
C) "I can stop taking my medication if I start feeling better."
D) "I will report fever, fatigue, and muscle weakness."
Correct Answer: "I can stop taking my medication if I start feeling better."
Rationale: Patients with Addison's disease require lifelong glucocorticoid
replacement therapy. They should never stop taking their medication
abruptly, as this can precipitate an adrenal crisis. They should report
manifestations of adrenal insufficiency such as fever, fatigue, and muscle
weakness, and avoid stress.
6. A patient is diagnosed with Cushing's syndrome. Which of the following
findings is most consistent with this diagnosis?
A) Bronze pigmentation of the skin
B) Weight loss and muscle wasting
C) Moon face and buffalo hump
D) Postural hypotension
Correct Answer: Moon face and buffalo hump
Rationale: Cushing's syndrome is caused by excess cortisol, leading to
central obesity, moon face, buffalo hump (fat deposition on the back of the
neck), purple striae, and hypertension. Bronze pigmentation, weight loss,
and postural hypotension are characteristic of Addison's disease.
, 7. A patient is exhibiting signs of syndrome of inappropriate antidiuretic
hormone (SIADH). The nurse should expect which laboratory finding?
A) Hyponatremia and low serum osmolality
B) Hypernatremia and high serum osmolality
C) Hyperkalemia and low serum osmolality
D) Hypokalemia and high serum osmolality
Correct Answer: Hyponatremia and low serum osmolality
Rationale: SIADH is characterized by excessive ADH release, leading to water
retention and dilutional hyponatremia. Serum osmolality is low due to the
excess water relative to solutes.
8. A patient is diagnosed with diabetes insipidus (DI). Which of the following
is a characteristic finding?
A) Polyuria and polydipsia with dilute urine
B) Polyuria and polydipsia with concentrated urine
C) Oliguria and edema
D) Hypertension and bradycardia
Correct Answer: Polyuria and polydipsia with dilute urine
Rationale: Diabetes insipidus is caused by a deficiency of ADH, leading to the
excretion of abnormally large amounts of dilute urine (polyuria) and
excessive thirst (polydipsia).
9. A patient with hypothyroidism is prescribed levothyroxine. The nurse
should instruct the patient to take this medication:
A) With a high-fat meal to improve absorption
Illness | Nursing
1. A nurse is assessing a patient with a suspected endocrine disorder. Which
of the following is the most important function of the hypothalamus?
A) Producing thyroid-stimulating hormone (TSH)
B) Storing antidiuretic hormone (ADH)
C) Maintaining homeostasis by regulating autonomic activities
D) Secreting growth hormone (GH)
Correct Answer: Maintaining homeostasis by regulating autonomic activities
Rationale: The hypothalamus is the control center for all autonomic
regulatory activities of the body, with its main function being homeostasis. It
controls blood pressure, temperature, fluid and electrolyte balance, and body
weight. The anterior pituitary produces TSH, the posterior pituitary stores
ADH, and the anterior pituitary secretes GH.
2. A patient's laboratory results show an elevated blood cortisol level. The
nurse should suspect which condition?
A) Addison's disease
B) Cushing's disease
C) Diabetes insipidus
D) SIADH
Correct Answer: Cushing's disease
Rationale: An increased blood cortisol level is indicative of Cushing's disease,
while a decreased level is characteristic of Addison's disease. Cortisol levels
vary throughout the day, peaking in the early morning between 4 AM and 8
AM.
,3. A patient with Addison's disease is at risk for which of the following
complications?
A) Hypernatremia
B) Hypokalemia
C) Adrenal crisis
D) Cushing's syndrome
Correct Answer: Adrenal crisis
Rationale: Adrenal crisis is a life-threatening complication of Addison's
disease, characterized by profound fatigue, dehydration, vascular collapse
(decreased BP), and renal shutdown. It is caused by a sudden deficiency of
cortisol and aldosterone. The primary nursing goal is to prevent circulatory
shock.
4. A patient with Addison's disease is experiencing postural hypotension and
weakness. The nurse should monitor for which electrolyte imbalance?
A) Hyperkalemia and hyponatremia
B) Hypokalemia and hypernatremia
C) Hypercalcemia and hypernatremia
D) Hypocalcemia and hyponatremia
Correct Answer: Hyperkalemia and hyponatremia
Rationale: Addison's disease results from adrenal cortex dysfunction leading
to decreased aldosterone and cortisol. Aldosterone deficiency causes sodium
loss and potassium retention, resulting in hyponatremia and hyperkalemia.
The nurse should monitor for hyperkalemia and obtain an ECG.
,5. A patient with Addison's disease is being discharged. Which statement by
the patient indicates a need for further teaching?
A) "I will avoid strenuous activity and stress."
B) "I will carry an emergency kit with hydrocortisone."
C) "I can stop taking my medication if I start feeling better."
D) "I will report fever, fatigue, and muscle weakness."
Correct Answer: "I can stop taking my medication if I start feeling better."
Rationale: Patients with Addison's disease require lifelong glucocorticoid
replacement therapy. They should never stop taking their medication
abruptly, as this can precipitate an adrenal crisis. They should report
manifestations of adrenal insufficiency such as fever, fatigue, and muscle
weakness, and avoid stress.
6. A patient is diagnosed with Cushing's syndrome. Which of the following
findings is most consistent with this diagnosis?
A) Bronze pigmentation of the skin
B) Weight loss and muscle wasting
C) Moon face and buffalo hump
D) Postural hypotension
Correct Answer: Moon face and buffalo hump
Rationale: Cushing's syndrome is caused by excess cortisol, leading to
central obesity, moon face, buffalo hump (fat deposition on the back of the
neck), purple striae, and hypertension. Bronze pigmentation, weight loss,
and postural hypotension are characteristic of Addison's disease.
, 7. A patient is exhibiting signs of syndrome of inappropriate antidiuretic
hormone (SIADH). The nurse should expect which laboratory finding?
A) Hyponatremia and low serum osmolality
B) Hypernatremia and high serum osmolality
C) Hyperkalemia and low serum osmolality
D) Hypokalemia and high serum osmolality
Correct Answer: Hyponatremia and low serum osmolality
Rationale: SIADH is characterized by excessive ADH release, leading to water
retention and dilutional hyponatremia. Serum osmolality is low due to the
excess water relative to solutes.
8. A patient is diagnosed with diabetes insipidus (DI). Which of the following
is a characteristic finding?
A) Polyuria and polydipsia with dilute urine
B) Polyuria and polydipsia with concentrated urine
C) Oliguria and edema
D) Hypertension and bradycardia
Correct Answer: Polyuria and polydipsia with dilute urine
Rationale: Diabetes insipidus is caused by a deficiency of ADH, leading to the
excretion of abnormally large amounts of dilute urine (polyuria) and
excessive thirst (polydipsia).
9. A patient with hypothyroidism is prescribed levothyroxine. The nurse
should instruct the patient to take this medication:
A) With a high-fat meal to improve absorption
