NU 673 Exam 1 Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales
1. A patient reports fatigue, weight gain, cold intolerance, and
constipation. Which condition is most consistent with these findings?
A. Hyperthyroidism
B. Hypothyroidism
C. Cushing syndrome
D. Diabetes insipidus
Answer: B. Hypothyroidism
Rationale: Reduced thyroid hormone slows metabolic processes,
producing fatigue, weight gain, cold intolerance, dry skin, and
constipation.
2. Which laboratory finding is most consistent with primary
hypothyroidism?
A. Low TSH and high free T4
B. High TSH and low free T4
C. Low TSH and low free T4
D. High TSH and high free T4
Answer: B. High TSH and low free T4
Rationale: In primary thyroid failure, the thyroid produces inadequate
T4, causing the pituitary to increase TSH secretion.
3. A patient with hyperthyroidism develops fever, severe tachycardia,
agitation, and vomiting. Which complication should the nurse suspect?
A. Myxedema coma
,B. Thyroid storm
C. Adrenal crisis
D. Hypoglycemia
Answer: B. Thyroid storm
Rationale: Thyroid storm is an acute, life-threatening exacerbation of
thyrotoxicosis characterized by hyperthermia, marked tachycardia, CNS
changes, and gastrointestinal symptoms.
4. Which hormone is primarily responsible for increasing blood glucose
during physiologic stress?
A. Insulin
B. Glucagon
C. Cortisol
D. Aldosterone
Answer: C. Cortisol
Rationale: Cortisol promotes gluconeogenesis and decreases peripheral
glucose utilization, helping maintain blood glucose during stress.
5. Which finding is characteristic of Cushing syndrome?
A. Weight loss and hyperpigmentation
B. Central obesity and proximal muscle weakness
C. Severe dehydration and hypernatremia
D. Hypoglycemia and hypotension
Answer: B. Central obesity and proximal muscle weakness
Rationale: Excess cortisol causes central fat deposition, muscle
catabolism, skin changes, hypertension, and glucose intolerance.
,6. Which assessment finding is most concerning for adrenal
insufficiency?
A. Hypertension
B. Hyperglycemia
C. Hypotension
D. Bradycardia
Answer: C. Hypotension
Rationale: Cortisol deficiency can impair vascular responsiveness and
contribute to hypotension. Severe deficiency can result in adrenal crisis.
7. Which electrolyte abnormality commonly occurs with primary
adrenal insufficiency?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypercalcemia
Answer: B. Hyperkalemia
Rationale: Reduced aldosterone secretion decreases renal sodium
retention and potassium excretion, resulting in hyponatremia and
hyperkalemia.
8. Which hormone promotes sodium retention and potassium excretion
in the kidneys?
A. Cortisol
B. Aldosterone
C. Insulin
D. ADH
, Answer: B. Aldosterone
Rationale: Aldosterone acts primarily on the distal nephron to increase
sodium and water retention while increasing potassium excretion.
9. A patient has polyuria, polydipsia, and dilute urine with elevated
serum sodium. Which disorder is most likely?
A. SIADH
B. Diabetes insipidus
C. Addison disease
D. Nephrotic syndrome
Answer: B. Diabetes insipidus
Rationale: Diabetes insipidus results from inadequate ADH activity and
causes excessive excretion of dilute urine, often leading to
hypernatremia.
10. Which laboratory pattern is expected in SIADH?
A. Hypernatremia and concentrated serum
B. Hyponatremia and low serum osmolality
C. Hyperkalemia and high serum osmolality
D. Hypercalcemia and dilute urine
Answer: B. Hyponatremia and low serum osmolality
Rationale: Excess ADH causes water retention, producing dilutional
hyponatremia and decreased serum osmolality.
11. Which hormone is secreted by pancreatic beta cells?
A. Glucagon
B. Insulin
Style Questions with Detailed Rationales
1. A patient reports fatigue, weight gain, cold intolerance, and
constipation. Which condition is most consistent with these findings?
A. Hyperthyroidism
B. Hypothyroidism
C. Cushing syndrome
D. Diabetes insipidus
Answer: B. Hypothyroidism
Rationale: Reduced thyroid hormone slows metabolic processes,
producing fatigue, weight gain, cold intolerance, dry skin, and
constipation.
2. Which laboratory finding is most consistent with primary
hypothyroidism?
A. Low TSH and high free T4
B. High TSH and low free T4
C. Low TSH and low free T4
D. High TSH and high free T4
Answer: B. High TSH and low free T4
Rationale: In primary thyroid failure, the thyroid produces inadequate
T4, causing the pituitary to increase TSH secretion.
3. A patient with hyperthyroidism develops fever, severe tachycardia,
agitation, and vomiting. Which complication should the nurse suspect?
A. Myxedema coma
,B. Thyroid storm
C. Adrenal crisis
D. Hypoglycemia
Answer: B. Thyroid storm
Rationale: Thyroid storm is an acute, life-threatening exacerbation of
thyrotoxicosis characterized by hyperthermia, marked tachycardia, CNS
changes, and gastrointestinal symptoms.
4. Which hormone is primarily responsible for increasing blood glucose
during physiologic stress?
A. Insulin
B. Glucagon
C. Cortisol
D. Aldosterone
Answer: C. Cortisol
Rationale: Cortisol promotes gluconeogenesis and decreases peripheral
glucose utilization, helping maintain blood glucose during stress.
5. Which finding is characteristic of Cushing syndrome?
A. Weight loss and hyperpigmentation
B. Central obesity and proximal muscle weakness
C. Severe dehydration and hypernatremia
D. Hypoglycemia and hypotension
Answer: B. Central obesity and proximal muscle weakness
Rationale: Excess cortisol causes central fat deposition, muscle
catabolism, skin changes, hypertension, and glucose intolerance.
,6. Which assessment finding is most concerning for adrenal
insufficiency?
A. Hypertension
B. Hyperglycemia
C. Hypotension
D. Bradycardia
Answer: C. Hypotension
Rationale: Cortisol deficiency can impair vascular responsiveness and
contribute to hypotension. Severe deficiency can result in adrenal crisis.
7. Which electrolyte abnormality commonly occurs with primary
adrenal insufficiency?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypercalcemia
Answer: B. Hyperkalemia
Rationale: Reduced aldosterone secretion decreases renal sodium
retention and potassium excretion, resulting in hyponatremia and
hyperkalemia.
8. Which hormone promotes sodium retention and potassium excretion
in the kidneys?
A. Cortisol
B. Aldosterone
C. Insulin
D. ADH
, Answer: B. Aldosterone
Rationale: Aldosterone acts primarily on the distal nephron to increase
sodium and water retention while increasing potassium excretion.
9. A patient has polyuria, polydipsia, and dilute urine with elevated
serum sodium. Which disorder is most likely?
A. SIADH
B. Diabetes insipidus
C. Addison disease
D. Nephrotic syndrome
Answer: B. Diabetes insipidus
Rationale: Diabetes insipidus results from inadequate ADH activity and
causes excessive excretion of dilute urine, often leading to
hypernatremia.
10. Which laboratory pattern is expected in SIADH?
A. Hypernatremia and concentrated serum
B. Hyponatremia and low serum osmolality
C. Hyperkalemia and high serum osmolality
D. Hypercalcemia and dilute urine
Answer: B. Hyponatremia and low serum osmolality
Rationale: Excess ADH causes water retention, producing dilutional
hyponatremia and decreased serum osmolality.
11. Which hormone is secreted by pancreatic beta cells?
A. Glucagon
B. Insulin
