NSG 430 EXAM 1 QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026

NSG 430 EXAM 1 QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026 Palliative Care - Answers Care or treatment focusing on reducing the severity of symptoms; curative treatment can be involved Hospice Care - Answers treatment of the terminally ill with the goal of helping them to die comfortably, without pain; curative care is forgone Physical manifestations of EOL - respiratory - Answers Cheyne-Stokes respirations, death rattle, terminal secretions, loss of gag reflex (risk for aspiration) Physical manifestations of EOL - integumentary - Answers Mottling, cyanosis in nail beds, cold/clammy skin, and "waxlike" skin very near death Decisional capacity - Answers ability to consent to or refuse care Tissue/Organ donation - Answers Some used within hours, notify physician immediately What guides our care? - Answers Code of Ethics - relieve suffering Principle of Beneficence - care is provided to benefit Standard of Care - define nursing acts that are required for safe and competent care Assessments - last hours of life - Answers limit to comfort measures, concerns about pain and respiratory should be addressed, emotional/comfort support Postmortem Care - Answers close pt's eyes, replace dentures, wash/position body - allow family privacy Classic triad of DKA - Answers hyperglycemia (250) ketones acidosis Other manifestations of DKA include - Answers profound dehydration tachycardia fruity breath (early signs) - weakness/lethargy DKA treatment includes - Answers IV fluids regular insulin - 0.1 U/kg/hr electrolytes (potassium esp.) - PRN HHS occurs when - Answers Blood glucose 600 HHS vs DKA - Answers no ketones (has enough insulin to prevent this) severe hyperglycemia (600) occurs gradually Other HHS manifestations - Answers increased serum osmolality (concentrated) normal blood pH fever/warm dry skin Treatment for HHS - Answers Same as DKA however fluids help as much as insulin therapy because of the correction of the osmolarity issue Addison's disease - Answers insufficient corticosteroids (need to ADD) Manifestations of Addison's disease - Answers hyper-pigmented skin hypoglycemia muscle weakness orthostatic hypotension salt craving hyperkalemia Interprofessional care for Addison's - Answers hormone therapy (hydrocortisone) watch for s/s of Cushings increase dietary salt intake protect from extremes (light, noise, temp) Important patient teaching for Addison's - Answers meds taken with food need to increase corticosteroids during times of stress how to administer IM hydrocortisone report s/s of deficiency or excess corticosteroids to HCP Medical ID bracelet Addisonian's crisis - Answers a life-threatening emergency caused by insufficient adrenocortical hormones or a sudden sharp decrease in these hormone Manifestations of addisionian's crisis - Answers Dehydration Change in mental status Hypotension Tachycardia, and shock Decreased blood sugar Elevated K Treatment for addisonian's crisis - Answers Hydrocortisone IV first 24 hr and then taper to PO BP support- vasopressors Fluid and electrolyte replacement Abx if infection Expected effects of corticosteroid therapy - Answers anti-inflammatory action immunosuppression maintenance of normal BP Cushing's syndrome - Answers chronic exposure to excess corticosteroids Manifestations of Cushings - Answers moon face, buffalo hump pot belly Hyperglycemia HTN delayed wound healing elevated cholesterol Treatment of Cushings - Answers Specific to underlying cause pituitary adenoma - transsphenoidal surgery radiation therapy for patients who are not candidates for surgery Pre-/Post-Op care (in case of surgical removal of pituitary adenoma) - Answers Pre: high protein diet, correct hypokalemia (diet/supplements), control HTN / hyperglycemia Post: increased risk of hemorrhage, meticulous care to prevent infection, give high doses of corticosteroids (taper with caution), avoid exposure to extremes (temp, infection, stress) Drugs used for Cushings - Answers Suppression of synthesis and secretion of cortisol - aminoglutethimide Avoid adrenal insufficiency - hydrocortisone/prednisone Control hyperglycemia in T2 Diabetics - Mifepristone Hyperthyroidism - Answers excess production of thyroid hormones Common causes of Hyperthyroidism - Answers too much iodine Graves' disease thyroid replacement medication toxicity Manifestations of hyperthyroidism - Answers weight loss heat intolerance goiter restless diarrhea high fever (104) pretrial myxedema Treatment for Hyperthyroidism - Answers Tapazole / PTU Iodine solution Radioactive iodine therapy thyroidectomy acute thyrotoxicosis (thyroid storm) - Answers excessive amounts of thyroid hormones released into circulation life threatening stress triggers the response Manifestations of Acute Thyrotoxicosis - Answers severe tachycardia skyrocketing BP (can give propranolol) hyperthermia seizures delirium Hypothyroidism - Answers a deficiency of thyroid hormone Common causes of Hypothyroidism - Answers Insufficient iodine Hashimoto's Antithyroid medication toxicity Manifestations of Hypothyroidism - Answers weight gain unable to tolerate cold constipation sensitivity to sedatives/narcotics Treatment for Hypothyroidism - Answers thyroid hormone replacement (Synthroid) Myxedema Coma - Answers severe hypothyroidism leading to s/s related to slowing of function in multiple organs (give IV thyroid meds) Manifestations of Myxedema Coma - Answers Subnormal temperatures impaired consciousness cardiovascular collapse (eg: cyanosis, paresthesia) Diabetes insipidus - Answers "dry inside"; insufficiency of ADH Manifestations of DI - Answers Excess voiding (2 - 20L/day) dehydration low urine specific gravity (urine will be very diluted) high serum osmolality hypernatremia polydipsia hypotension tachycardia Nursing Management for DI - Answers early detection, adequate hydration, and patient teaching for long term management avoid diuretic foods (caffeine/energy drinks) therapeutic goal - maintain fluid/electrolyte balance