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RECALLS 7 - NP4 COMPREHENSIVE EXAM FULLY SOLVED SET.

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SITUATION 1: You are caring for patient Igaram, a patient with Addison's disease. You utilize your knowledge on this concept to help care for the patient. -- Igaram was just recently diagnosed with Addison's disease. He still lacks knowledge about his disease so he decided to ask you some questions. Igaram asked you, "How does the disease happen?" You answer him correctly by stating that this disease results from: A. Insufficient secretion of growth hormone (GH). B. Dysfunction of the hypothalamic pituitary. C. Idiopathic atrophy of the adrenal gland. D. Oversecretion of the adrenal medulla. - Answer C. Idiopathic atrophy of the adrenal gland. SITUATION 1: You are caring for patient Igaram, a patient with Addison's disease. You utilize your knowledge on this concept to help care for the patient. -- Igaram is admitted to your unit. After your assessment on him, you formulated the nursing diagnosis Deficient fluid volume related to inadequate fluid intake and to fluid loss secondary to inadequate adrenal hormone secretion. As Igaram's oral intake increases, which of the following fluids would be the most appropriate for him? A. Milk and diet soda. B. Water and eggnog. C. Bouillon and juice. D. Coffee and milkshakes. - Answer C. Bouillon and juice. SITUATION 1: You are caring for patient Igaram, a patient with Addison's disease. You utilize your knowledge on this concept to help care for the patient. -- You are instructing Igaram how to adjust the dose of the glucocorticoids he is taking. As his nurse, you should explain to him that he may need an increased dosage of glucocorticoids in which of the following scenarios? A. Completing the spring semester of school. B. Gaining 4 pounds. C. Becoming engaged. D. Undergoing a root canal. - Answer D. Undergoing a root

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RECALLS 7 - NP4 COMPREHENSIVE
EXAM FULLY SOLVED 2026-2027 SET.
SITUATION 1: You are caring for patient Igaram, a patient with Addison's disease. You utilize your
knowledge on this concept to help care for the patient.

--

Igaram was just recently diagnosed with Addison's disease. He still lacks knowledge about his
disease so he decided to ask you some questions. Igaram asked you, "How does the disease
happen?" You answer him correctly by stating that this disease results from:



A. Insufficient secretion of growth hormone (GH).

B. Dysfunction of the hypothalamic pituitary.

C. Idiopathic atrophy of the adrenal gland.

D. Oversecretion of the adrenal medulla. - Answer C. Idiopathic atrophy of the adrenal gland.



SITUATION 1: You are caring for patient Igaram, a patient with Addison's disease. You utilize your
knowledge on this concept to help care for the patient.

--

Igaram is admitted to your unit. After your assessment on him, you formulated the nursing
diagnosis Deficient fluid volume related to inadequate fluid intake and to fluid loss secondary to
inadequate adrenal hormone secretion. As Igaram's oral intake increases, which of the following
fluids would be the most appropriate for him?



A. Milk and diet soda.

B. Water and eggnog.

C. Bouillon and juice.

D. Coffee and milkshakes. - Answer C. Bouillon and juice.



SITUATION 1: You are caring for patient Igaram, a patient with Addison's disease. You utilize your
knowledge on this concept to help care for the patient.

--

You are instructing Igaram how to adjust the dose of the glucocorticoids he is taking. As his
nurse, you should explain to him that he may need an increased dosage of glucocorticoids in
which of the following scenarios?



A. Completing the spring semester of school.

B. Gaining 4 pounds.

C. Becoming engaged.

,D. Undergoing a root canal. - Answer D. Undergoing a root canal.



SITUATION 1: You are caring for patient Igaram, a patient with Addison's disease. You utilize your
knowledge on this concept to help care for the patient.

--

Igaram is diagnosed with Addison's disease. As a knowledgeable nurse, you know that this
condition may lead to Addisonian crisis if not adequately managed. Which of the following
manifestations would be expected in Igaram if he develops this condition?



A. Fluid retention.

B. Pain.

C. Peripheral edema.

D. Hunger. - Answer B. Pain.



SITUATION 1: You are caring for patient Igaram, a patient with Addison's disease. You utilize your
knowledge on this concept to help care for the patient.

--

If Igaram develops Addisonian crisis, which of the following would be your priority as Igaram's
primary nurse?



A. Controlling hypertension.

B. Preventing irreversible shock.

C. Preventing infection.

D. Relieving anxiety. - Answer B. Preventing irreversible shock.



SITUATION 2: You are a nurse tasked to care for patients with different pituitary disorders. You
are to take care of Karoo and Koza, both diagnosed with SIADH, and Paula, who is diagnosed
with diabetes insipidus. You utilize your knowledge on this concept to help care for your
patients safely.

--

One of the clients in your unit, Karoo, is diagnosed to have a pituitary tumor. Karoo developed
Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Which of the following interventions
should you implement as Karoo's primary nurse?



A. Assess for dehydration and monitor blood glucose levels.

B. Assess for nausea and vomiting and weigh daily.

C. Monitor potassium levels and encourage fluid intake.

,D. Administer vasopressin IV and conduct a fluid deprivation test. - Answer B. Assess for
nausea and vomiting and weigh daily.



SITUATION 2: You are a nurse tasked to care for patients with different pituitary disorders. You
are to take care of Karoo and Koza, both diagnosed with SIADH, and Paula, who is diagnosed
with diabetes insipidus. You utilize your knowledge on this concept to help care for your
patients safely.

--

You are reviewing the chart of Karoo who has SIADH. Which of the following clinical
manifestations you noted in Karoo's chart should be reported to his primary care physician?



A. Serum sodium of 112 mEq/L and a headache.

B. Serum potassium of 5.0 mEq/L and a heightened awareness.

C. Serum calcium of 10 mg/dL and tented tissue turgor.

D. Serum magnesium of 1.2 mg/dL and large urinary output. - Answer A. Serum sodium of 112
mEq/L and a headache.



SITUATION 2: You are a nurse tasked to care for patients with different pituitary disorders. You
are to take care of Karoo and Koza, both diagnosed with SIADH, and Paula, who is diagnosed
with diabetes insipidus. You utilize your knowledge on this concept to help care for your
patients safely.

--

Another patient in your unit, Koza, was diagnosed with SIADH secondary to cancer of the lung.
He tells you that he wants to discontinue his fluid restriction and that he does not care if he
dies. Which of the following actions by the nurse is an example of the ethical principle of
autonomy?



A. Discuss the information the client told the nurse with the health-care provider and significant
other.

B. Explain it is possible the client could have a seizure if he drank fluid beyond the restrictions.

C. Notify the health-care provider of the client's wishes and give the client fluids as desired.

D. Allow the client an extra drink - Answer C. Notify the health-care provider of the client's
wishes and give the client fluids as desired.



SITUATION 2: You are a nurse tasked to care for patients with different pituitary disorders. You
are to take care of Karoo and Koza, both diagnosed with SIADH, and Paula, who is diagnosed
with diabetes insipidus. You utilize your knowledge on this concept to help care for your
patients safely.

--

Paula, another patient assigned to you in the unit, is recently diagnosed with diabetes insipidus.
Which of the following interventions should you implement as Paula's primary nurse?

, A. Administer sliding-scale insulin as ordered.

B. Restrict caffeinated beverages.

C. Check urine ketones if blood glucose is >250.

D. Assess tissue turgor every four (4) hours - Answer D. Assess tissue turgor every four (4)
hours



SITUATION 2: You are a nurse tasked to care for patients with different pituitary disorders. You
are to take care of Karoo and Koza, both diagnosed with SIADH, and Paula, who is diagnosed
with diabetes insipidus. You utilize your knowledge on this concept to help care for your
patients safely.

--

Following Paula's diagnosis of diabetes insipidus, she stayed in the hospital for a few days. She is
now about to be discharged and you are conducting your health teaching regarding her
condition. Which of the following statements made by Paula warrants further intervention?



A. "I will keep a list of my medications in my wallet and wear a Medic Alert bracelet."

B. "I should take my medication in the morning and leave it refrigerated at home."

C. "I should weigh myself every morning and record any weight gain."

D. "If I develop a tightness in my chest, I will call my health-care provider." - Answer B. "I
should take my medication in the morning and leave it refrigerated at home."



SITUATION 3: You are a nurse caring for patients with inflammatory bowel disease.

--

Pierre is a patient admitted to the hospital with a diagnosis of ulcerative colitis. You are
currently reviewing his history and physical assessment chart. Based on Pierre's diagnosis,
which of the following information should you expect to see in Pierre's medical records?



A. Abdominal pain and bloody diarrhea

B. Weight gain and elevated blood glucose

C. Abdominal distension and hypoactive bowel sounds

D. Heartburn and regurgitation - Answer A. Abdominal pain and bloody diarrhea



SITUATION 3: You are a nurse caring for patients with inflammatory bowel disease.

--

Pierre had a recent exacerbation of ulcerative colitis. He is put on mesalamine (Asacol), which is
to be administered rectally via an enema. Pierre finds this procedure distasteful and he asks
you, "Why can't the medication just be given orally?". You answer Pierre correctly by saying
which of the following?

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