NUR 242 EXAM 3 PRACTICE QUESTIONS AND ANSWERS–
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EXAM 2026-2027
1. A nurse is caring for a client newly diagnosed with type 1 diabetes mellitus. Which
clinical manifestation should the nurse expect the client to exhibit due to osmotic diuresis?
A. Polyuria
B. Bradycardia
C. Hypoglycemia
D. Weight gain
Answer: A
Osmotic diuresis occurs when excess serum glucose spills into the urine, pulling water with it
and resulting in frequent urination (polyuria), polydipsia, and polyphagia.
2. A nurse is evaluating laboratory results for a client with suspected diabetic ketoacidosis
(DKA). Which arterial blood gas finding is characteristic of this condition?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Respiratory acidosis
Answer: B
The accumulation of ketone bodies in the blood lowers serum pH and bicarbonate levels,
resulting in a primary metabolic acidosis accompanied by a high anion gap.
3. A nurse is administering regular insulin via continuous intravenous infusion to a client
experiencing a hyperglycemic hyperosmolar state (HHS). Which priority electrolyte must
the nurse monitor closely during this therapy?
A. Sodium
,B. Potassium
C. Calcium
D. Magnesium
Answer: B
Insulin drives potassium back into the intracellular space, which can rapidly precipitate life-
threatening hypokalemia; serum potassium must be monitored and repleted as ordered.
4. A nurse is providing discharge teaching to a client with type 2 diabetes mellitus
regarding foot care. Which statement by the client indicates an understanding of the
instructions?
A. "I will soak my feet in warm water every evening for 30 minutes."
B. "I will apply lotion between my toes to keep the skin soft."
C. "I will inspect my feet daily using a mirror to check for cuts or redness."
D. "I can walk barefoot inside my house if the floors are clean."
Answer: C
Daily visual inspection using a mirror allows clients with decreased sensation or mobility to
catch early signs of trauma, ulcers, or infection.
5. A nurse is assessing a client with Cushing's disease. Which physical characteristic is
commonly associated with excess cortisol production?
A. Truncal obesity with a buffalo hump
B. Significant weight loss and muscle wasting
C. Hyperpigmentation of the palmar creases
D. Extreme lethargy and cold intolerance
Answer: A
Hypercortisolism alters fat metabolism and distribution, causing central adiposity, facial
rounding (moon face), and a dorsocervical fat pad (buffalo hump).
,6. A nurse is caring for a client post-adrenalectomy. Which finding indicates the potential
development of acute adrenal crisis?
A. Blood pressure of 82/50 mm Hg and tachycardia
B. Blood pressure of 160/95 mm Hg and headache
C. Serum sodium of 148 mEq/L
D. Blood glucose of 180 mg/dL
Answer: A
Acute adrenal crisis is a life-threatening emergency characterized by profound
mineralocorticoid and glucocorticoid deficiency leading to vascular collapse, severe
hypotension, and shock.
7. A nurse is reviewing lab values for a client with primary hypothyroidism. Which
hormone profile is expected?
A. Elevated TSH and decreased free T4
B. Decreased TSH and elevated free T4
C. Elevated TSH and elevated free T4
D. Decreased TSH and decreased free T4
Answer: A
In primary hypothyroidism, the failing thyroid gland produces insufficient thyroid hormone,
prompting the anterior pituitary to secrete excess Thyroid Stimulating Hormone (TSH) as a
feedback response.
8. A nurse is caring for a client admitted with myxedema coma. Which immediate nursing
intervention takes highest priority?
A. Initiating rapid cooling measures
B. Maintaining a patent airway and providing respiratory support
C. Administering oral carbohydrate snacks
D. Encouraging active range-of-motion exercises
Answer: B
, Myxedema coma involves severe hypoventilation, hypothermia, and decreased mental status;
airway protection and mechanical ventilation are critical life-saving priorities.
9. A nurse is monitoring a client who has returned from a subtotal thyroidectomy. Which
clinical indicator suggests possible damage to the parathyroid glands?
A. Hoarseness when speaking
B. Positive Trousseau's sign and muscle twitching
C. Continuous serosanguineous drainage from the JP drain
D. Heart rate of 110 beats per minute
Answer: B
Inadvertent removal or trauma to the parathyroid glands during thyroid surgery causes
hypocalcemia, manifesting as neuromuscular irritability, tetany, and positive Trousseau's or
Chvostek's signs.
10. A nurse is educating a client prescribed levothyroxine for hypothyroidism. When is the
best time for the client to take this medication?
A. At bedtime with a high-fiber snack
B. In the morning on an empty stomach with a full glass of water
C. 30 minutes after a heavy breakfast containing dairy
D. Intermittently whenever fatigue symptoms worsen
Answer: B
Levothyroxine absorption is optimized when taken on an empty stomach in the morning, at
least 30 to 60 minutes before food or other medications.
11. A nurse is assessing a client with Graves' disease. Which clinical manifestation is most
characteristic of hyperthyroidism?
A. Heat intolerance and weight loss despite increased appetite
B. Cold intolerance and severe constipation
C. Dry, coarse skin and brittle hair
D. Bradycardia and lethargy
COMPLETE STUDY GUIDE | PRACTICE QUESTIONS AND
ANSWERS| DETAILED RATIONALES | EXAM PREP |
DOWNLOAD INSTANT PDF | GUARANTEED PASS || LATEST
EXAM 2026-2027
1. A nurse is caring for a client newly diagnosed with type 1 diabetes mellitus. Which
clinical manifestation should the nurse expect the client to exhibit due to osmotic diuresis?
A. Polyuria
B. Bradycardia
C. Hypoglycemia
D. Weight gain
Answer: A
Osmotic diuresis occurs when excess serum glucose spills into the urine, pulling water with it
and resulting in frequent urination (polyuria), polydipsia, and polyphagia.
2. A nurse is evaluating laboratory results for a client with suspected diabetic ketoacidosis
(DKA). Which arterial blood gas finding is characteristic of this condition?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Respiratory acidosis
Answer: B
The accumulation of ketone bodies in the blood lowers serum pH and bicarbonate levels,
resulting in a primary metabolic acidosis accompanied by a high anion gap.
3. A nurse is administering regular insulin via continuous intravenous infusion to a client
experiencing a hyperglycemic hyperosmolar state (HHS). Which priority electrolyte must
the nurse monitor closely during this therapy?
A. Sodium
,B. Potassium
C. Calcium
D. Magnesium
Answer: B
Insulin drives potassium back into the intracellular space, which can rapidly precipitate life-
threatening hypokalemia; serum potassium must be monitored and repleted as ordered.
4. A nurse is providing discharge teaching to a client with type 2 diabetes mellitus
regarding foot care. Which statement by the client indicates an understanding of the
instructions?
A. "I will soak my feet in warm water every evening for 30 minutes."
B. "I will apply lotion between my toes to keep the skin soft."
C. "I will inspect my feet daily using a mirror to check for cuts or redness."
D. "I can walk barefoot inside my house if the floors are clean."
Answer: C
Daily visual inspection using a mirror allows clients with decreased sensation or mobility to
catch early signs of trauma, ulcers, or infection.
5. A nurse is assessing a client with Cushing's disease. Which physical characteristic is
commonly associated with excess cortisol production?
A. Truncal obesity with a buffalo hump
B. Significant weight loss and muscle wasting
C. Hyperpigmentation of the palmar creases
D. Extreme lethargy and cold intolerance
Answer: A
Hypercortisolism alters fat metabolism and distribution, causing central adiposity, facial
rounding (moon face), and a dorsocervical fat pad (buffalo hump).
,6. A nurse is caring for a client post-adrenalectomy. Which finding indicates the potential
development of acute adrenal crisis?
A. Blood pressure of 82/50 mm Hg and tachycardia
B. Blood pressure of 160/95 mm Hg and headache
C. Serum sodium of 148 mEq/L
D. Blood glucose of 180 mg/dL
Answer: A
Acute adrenal crisis is a life-threatening emergency characterized by profound
mineralocorticoid and glucocorticoid deficiency leading to vascular collapse, severe
hypotension, and shock.
7. A nurse is reviewing lab values for a client with primary hypothyroidism. Which
hormone profile is expected?
A. Elevated TSH and decreased free T4
B. Decreased TSH and elevated free T4
C. Elevated TSH and elevated free T4
D. Decreased TSH and decreased free T4
Answer: A
In primary hypothyroidism, the failing thyroid gland produces insufficient thyroid hormone,
prompting the anterior pituitary to secrete excess Thyroid Stimulating Hormone (TSH) as a
feedback response.
8. A nurse is caring for a client admitted with myxedema coma. Which immediate nursing
intervention takes highest priority?
A. Initiating rapid cooling measures
B. Maintaining a patent airway and providing respiratory support
C. Administering oral carbohydrate snacks
D. Encouraging active range-of-motion exercises
Answer: B
, Myxedema coma involves severe hypoventilation, hypothermia, and decreased mental status;
airway protection and mechanical ventilation are critical life-saving priorities.
9. A nurse is monitoring a client who has returned from a subtotal thyroidectomy. Which
clinical indicator suggests possible damage to the parathyroid glands?
A. Hoarseness when speaking
B. Positive Trousseau's sign and muscle twitching
C. Continuous serosanguineous drainage from the JP drain
D. Heart rate of 110 beats per minute
Answer: B
Inadvertent removal or trauma to the parathyroid glands during thyroid surgery causes
hypocalcemia, manifesting as neuromuscular irritability, tetany, and positive Trousseau's or
Chvostek's signs.
10. A nurse is educating a client prescribed levothyroxine for hypothyroidism. When is the
best time for the client to take this medication?
A. At bedtime with a high-fiber snack
B. In the morning on an empty stomach with a full glass of water
C. 30 minutes after a heavy breakfast containing dairy
D. Intermittently whenever fatigue symptoms worsen
Answer: B
Levothyroxine absorption is optimized when taken on an empty stomach in the morning, at
least 30 to 60 minutes before food or other medications.
11. A nurse is assessing a client with Graves' disease. Which clinical manifestation is most
characteristic of hyperthyroidism?
A. Heat intolerance and weight loss despite increased appetite
B. Cold intolerance and severe constipation
C. Dry, coarse skin and brittle hair
D. Bradycardia and lethargy
