NSG 430 EXAM 1 | COMPREHENSIVE NURSING STUDY GUIDE,
PRACTICE QUESTIONS & ANSWERS 2026/2027
Palliative Care - ANS ✔✔Care or treatment focusing on reducing the severity of symptoms; curative
treatment can be involved
Hospice Care - ANS ✔✔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 - ANS ✔✔Cheyne-Stokes respirations, death rattle, terminal
secretions, loss of gag reflex (risk for aspiration)
Physical manifestations of EOL - integumentary - ANS ✔✔Mottling, cyanosis in nail beds, cold/clammy
skin, and "waxlike" skin very near death
Decisional capacity - ANS ✔✔ability to consent to or refuse care
Tissue/Organ donation - ANS ✔✔Some used within hours, notify physician immediately
What guides our care? - ANS ✔✔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 - ANS ✔✔limit to comfort measures, concerns about pain and respiratory
should be addressed, emotional/comfort support
Postmortem Care - ANS ✔✔close pt's eyes, replace dentures, wash/position body - allow family privacy
Classic triad of DKA - ANS ✔✔hyperglycemia (>250)
ketones
acidosis
Other manifestations of DKA include - ANS ✔✔profound dehydration
tachycardia
fruity breath
(early signs) - weakness/lethargy
DKA treatment includes - ANS ✔✔IV fluids
regular insulin - 0.1 U/kg/hr
electrolytes (potassium esp.) - PRN
HHS occurs when - ANS ✔✔Blood glucose >600
HHS vs DKA - ANS ✔✔no ketones (has enough insulin to prevent this)
severe hyperglycemia (>600)
occurs gradually
, Other HHS manifestations - ANS ✔✔increased serum osmolality (concentrated)
normal blood pH
fever/warm dry skin
Treatment for HHS - ANS ✔✔Same as DKA however fluids help as much as insulin therapy because of the
correction of the osmolarity issue
Addison's disease - ANS ✔✔insufficient corticosteroids (need to ADD)
Manifestations of Addison's disease - ANS ✔✔hyper-pigmented skin
hypoglycemia
muscle weakness
orthostatic hypotension
salt craving
hyperkalemia
Interprofessional care for Addison's - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔a life-threatening emergency caused by insufficient adrenocortical
hormones or a sudden sharp decrease in these hormone
Manifestations of addisionian's crisis - ANS ✔✔Dehydration
Change in mental status
Hypotension
Tachycardia, and shock
Decreased blood sugar
Elevated K
Treatment for addisonian's crisis - ANS ✔✔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 - ANS ✔✔anti-inflammatory action
immunosuppression
maintenance of normal BP
Cushing's syndrome - ANS ✔✔chronic exposure to excess corticosteroids
PRACTICE QUESTIONS & ANSWERS 2026/2027
Palliative Care - ANS ✔✔Care or treatment focusing on reducing the severity of symptoms; curative
treatment can be involved
Hospice Care - ANS ✔✔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 - ANS ✔✔Cheyne-Stokes respirations, death rattle, terminal
secretions, loss of gag reflex (risk for aspiration)
Physical manifestations of EOL - integumentary - ANS ✔✔Mottling, cyanosis in nail beds, cold/clammy
skin, and "waxlike" skin very near death
Decisional capacity - ANS ✔✔ability to consent to or refuse care
Tissue/Organ donation - ANS ✔✔Some used within hours, notify physician immediately
What guides our care? - ANS ✔✔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 - ANS ✔✔limit to comfort measures, concerns about pain and respiratory
should be addressed, emotional/comfort support
Postmortem Care - ANS ✔✔close pt's eyes, replace dentures, wash/position body - allow family privacy
Classic triad of DKA - ANS ✔✔hyperglycemia (>250)
ketones
acidosis
Other manifestations of DKA include - ANS ✔✔profound dehydration
tachycardia
fruity breath
(early signs) - weakness/lethargy
DKA treatment includes - ANS ✔✔IV fluids
regular insulin - 0.1 U/kg/hr
electrolytes (potassium esp.) - PRN
HHS occurs when - ANS ✔✔Blood glucose >600
HHS vs DKA - ANS ✔✔no ketones (has enough insulin to prevent this)
severe hyperglycemia (>600)
occurs gradually
, Other HHS manifestations - ANS ✔✔increased serum osmolality (concentrated)
normal blood pH
fever/warm dry skin
Treatment for HHS - ANS ✔✔Same as DKA however fluids help as much as insulin therapy because of the
correction of the osmolarity issue
Addison's disease - ANS ✔✔insufficient corticosteroids (need to ADD)
Manifestations of Addison's disease - ANS ✔✔hyper-pigmented skin
hypoglycemia
muscle weakness
orthostatic hypotension
salt craving
hyperkalemia
Interprofessional care for Addison's - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔a life-threatening emergency caused by insufficient adrenocortical
hormones or a sudden sharp decrease in these hormone
Manifestations of addisionian's crisis - ANS ✔✔Dehydration
Change in mental status
Hypotension
Tachycardia, and shock
Decreased blood sugar
Elevated K
Treatment for addisonian's crisis - ANS ✔✔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 - ANS ✔✔anti-inflammatory action
immunosuppression
maintenance of normal BP
Cushing's syndrome - ANS ✔✔chronic exposure to excess corticosteroids
