,Herzing NU 623 Final Exam | Adult Healthcare (2026)
Q&A
1. A 55-year-old patient with a history of type 2 diabetes and hypertension presents
with a serum creatinine of 2.5 mg/dL and an eGFR of 28 mL/min/1.73m². According
to the Kidney Disease Outcomes Quality Initiative (KDOQI), at which stage of chronic
kidney disease is this patient?
A) Stage 2
B) Stage 3b
C) Stage 4
D) Stage 5
Correct Answer: C) Stage 4
Rationale: CKD stages are defined by eGFR: Stage 1 (≥90), Stage 2 (60-89), Stage 3a
(45-59), Stage 3b (30-44), Stage 4 (15-29), and Stage 5 (<15 or dialysis). An eGFR of
28 mL/min/1.73m² falls into Stage 4, indicating severe kidney dysfunction and
preparation for renal replacement therapy.
2. A patient with chronic kidney disease is receiving erythropoietin therapy for
anemia. The nurse should assess for which potential complication?
A) Hypotension
B) Bradycardia
C) Hypertension
D) Hypokalemia
Correct Answer: C) Hypertension
,Rationale: Erythropoietin can cause hypertension as a side effect due to increased
red blood cell mass and viscosity. Blood pressure should be monitored closely during
therapy. Hypotension, bradycardia, and hypokalemia are not typical side effects.
3. A patient with a 20-year history of Cushing's disease who has been taking
hydrocortisone presents with a thick trunk, thin extremities, moon face, buffalo
hump, thin skin with visible capillaries, and slow-healing bruises. To what do you
attribute these symptoms?
A) Decreased adrenal androgen glands
B) Malfunctioning of the adrenal cortex
C) Excessive levels of circulating cortisol
D) Ectopic secretion of adrenocorticotropic hormone
Correct Answer: C) Excessive levels of circulating cortisol
Rationale: The classic physical findings of Cushing's syndrome—truncal obesity, thin
extremities, moon facies, buffalo hump, thin skin, and easy bruising—are caused by
prolonged exposure to excessive circulating cortisol. This can be due to endogenous
overproduction or exogenous corticosteroid use.
4. A 56-year-old woman with rheumatoid arthritis has been taking oral
corticosteroids for the past two years and is diagnosed with Cushing's syndrome.
What is the first-line treatment approach?
A) Gradually tapering corticosteroid use
B) Referral for surgery
C) Consideration of radiation therapy
D) Prescribing mifepristone
Correct Answer: A) Gradually tapering corticosteroid use
, Rationale: For Cushing's syndrome caused by exogenous corticosteroid use, the
first-line treatment is to gradually taper the corticosteroid dose to allow the
hypothalamic-pituitary-adrenal (HPA) axis to recover. Abrupt withdrawal can lead to
adrenal crisis.
5. Untreated Cushing's syndrome can lead to all of the following EXCEPT:
A) Rheumatoid arthritis
B) Hypertension
C) Type 2 diabetes
D) Osteoporosis
Correct Answer: A) Rheumatoid arthritis
Rationale: Chronic hypercortisolism from untreated Cushing's syndrome leads to
significant comorbidities, including hypertension, type 2 diabetes, and osteoporosis.
Rheumatoid arthritis is an autoimmune condition that is not caused by Cushing's
syndrome; in fact, corticosteroids are used to treat it.
6. A 45-year-old patient with a history of hypertension and type 2 diabetes presents
with a serum creatinine of 2.5 mg/dL and an eGFR of 28 mL/min/1.73m². Which stage
of CKD does this represent?
A) Stage 2
B) Stage 3b
C) Stage 4
D) Stage 5
Correct Answer: C) Stage 4
Q&A
1. A 55-year-old patient with a history of type 2 diabetes and hypertension presents
with a serum creatinine of 2.5 mg/dL and an eGFR of 28 mL/min/1.73m². According
to the Kidney Disease Outcomes Quality Initiative (KDOQI), at which stage of chronic
kidney disease is this patient?
A) Stage 2
B) Stage 3b
C) Stage 4
D) Stage 5
Correct Answer: C) Stage 4
Rationale: CKD stages are defined by eGFR: Stage 1 (≥90), Stage 2 (60-89), Stage 3a
(45-59), Stage 3b (30-44), Stage 4 (15-29), and Stage 5 (<15 or dialysis). An eGFR of
28 mL/min/1.73m² falls into Stage 4, indicating severe kidney dysfunction and
preparation for renal replacement therapy.
2. A patient with chronic kidney disease is receiving erythropoietin therapy for
anemia. The nurse should assess for which potential complication?
A) Hypotension
B) Bradycardia
C) Hypertension
D) Hypokalemia
Correct Answer: C) Hypertension
,Rationale: Erythropoietin can cause hypertension as a side effect due to increased
red blood cell mass and viscosity. Blood pressure should be monitored closely during
therapy. Hypotension, bradycardia, and hypokalemia are not typical side effects.
3. A patient with a 20-year history of Cushing's disease who has been taking
hydrocortisone presents with a thick trunk, thin extremities, moon face, buffalo
hump, thin skin with visible capillaries, and slow-healing bruises. To what do you
attribute these symptoms?
A) Decreased adrenal androgen glands
B) Malfunctioning of the adrenal cortex
C) Excessive levels of circulating cortisol
D) Ectopic secretion of adrenocorticotropic hormone
Correct Answer: C) Excessive levels of circulating cortisol
Rationale: The classic physical findings of Cushing's syndrome—truncal obesity, thin
extremities, moon facies, buffalo hump, thin skin, and easy bruising—are caused by
prolonged exposure to excessive circulating cortisol. This can be due to endogenous
overproduction or exogenous corticosteroid use.
4. A 56-year-old woman with rheumatoid arthritis has been taking oral
corticosteroids for the past two years and is diagnosed with Cushing's syndrome.
What is the first-line treatment approach?
A) Gradually tapering corticosteroid use
B) Referral for surgery
C) Consideration of radiation therapy
D) Prescribing mifepristone
Correct Answer: A) Gradually tapering corticosteroid use
, Rationale: For Cushing's syndrome caused by exogenous corticosteroid use, the
first-line treatment is to gradually taper the corticosteroid dose to allow the
hypothalamic-pituitary-adrenal (HPA) axis to recover. Abrupt withdrawal can lead to
adrenal crisis.
5. Untreated Cushing's syndrome can lead to all of the following EXCEPT:
A) Rheumatoid arthritis
B) Hypertension
C) Type 2 diabetes
D) Osteoporosis
Correct Answer: A) Rheumatoid arthritis
Rationale: Chronic hypercortisolism from untreated Cushing's syndrome leads to
significant comorbidities, including hypertension, type 2 diabetes, and osteoporosis.
Rheumatoid arthritis is an autoimmune condition that is not caused by Cushing's
syndrome; in fact, corticosteroids are used to treat it.
6. A 45-year-old patient with a history of hypertension and type 2 diabetes presents
with a serum creatinine of 2.5 mg/dL and an eGFR of 28 mL/min/1.73m². Which stage
of CKD does this represent?
A) Stage 2
B) Stage 3b
C) Stage 4
D) Stage 5
Correct Answer: C) Stage 4
