NSG 4100 (AH III) Exam 2 | Complex Endocrine
& Metabolic Disorders | Questions and Correct
Answers plus Rationales | New Update 2026-2027
| Galen
Question 1. The nurse is discussing ways to prevent DKA with a client newly
diagnosed with Type 1 DM. Which instruction is most important to discuss with
the client?
a. Refer them to the American Diabetes Association
b. Take the prescribed insulin even when unable to eat due to illness
c. Do not take any OTC meds
d. Explain the need to get the annual flu and pneumonia vaccines
Correct Answer: b. Take the prescribed insulin even when unable to eat due to
illness
Rationale: During illness, the body releases stress hormones that increase blood
glucose levels. Insulin must be continued even if the patient cannot eat to prevent
DKA. This is the most critical teaching point for DKA prevention.
Question 2. ED nurse is caring for a patient with HHS who has a blood glucose of
680 mg/dL. Which question should the nurse ask to determine the cause of
acute complications?
a. "When was the last time you took your insulin?"
b. "When did you have your last meal?"
c. "Have you had some type of infection lately?"
d. "How long have you had diabetes?"
Correct Answer: c. "Have you had some type of infection lately?"
,Rationale: HHS (Hyperglycemic Hyperosmolar State) is most commonly
precipitated by infection in patients with type 2 diabetes. Identifying the
underlying cause is essential for treatment.
Question 3. Client with a diagnosis of Addisonian crisis is being admitted to the
ICU. Which findings will the inter-professional care team focus on? Select all that
apply:
a. Hypotension
b. Leukocytosis
c. Hyperkalemia
d. Hypercalcemia
e. Hypernatremia
Correct Answer: a, c
Rationale: Addisonian crisis is characterized by:
• Hypotension (due to lack of aldosterone and cortisol)
• Hyperkalemia (due to lack of aldosterone)
• Hyponatremia (not hypernatremia)
• Hypoglycemia
Question 4. Nurse is caring for a client after hypophysectomy and notes clear
nasal drainage from the client's nostril. The nurse should take which initial
action?
a. Lower the head of the bed
b. Test drainage for glucose
c. Obtain culture of drainage
d. Continue to observe drainage
Correct Answer: b. Test drainage for glucose
, Rationale: Clear nasal drainage after hypophysectomy may indicate CSF leak.
Testing for glucose is the initial action because CSF contains glucose, while normal
nasal secretions do not.
Question 5. Nurse is admitting a client who is diagnosed with SIADH and has
serum sodium of 118 mEq/L. Which physician prescription should the nurse
anticipate receiving? Select all that apply:
a. Initiate infusion of 3% NaCl
b. Administer IV furosemide
c. Restrict fluids to 800 mL over 24 hours
d. Elevate HOB to high Fowler's
e. Administer a vasopressin antagonist as prescribed
Correct Answer: a, c, e
Rationale: Treatment for SIADH includes:
• 3% NaCl for severe hyponatremia
• Fluid restriction (800 mL/24 hours)
• Vasopressin antagonists (to promote water excretion)
Furosemide may be used but is not first-line. High Fowler's position is not
specific to SIADH.
Question 6. Nurse performing an assessment on a client with
pheochromocytoma. Which assessment data would indicate potential
complication with this disease?
a. Urinary output of 50 mL/h
b. Coagulation time of 5 mins
c. HR that is 90 bpm and irregular
d. BUN of 20 mg/dL
Correct Answer: c. HR that is 90 bpm and irregular
& Metabolic Disorders | Questions and Correct
Answers plus Rationales | New Update 2026-2027
| Galen
Question 1. The nurse is discussing ways to prevent DKA with a client newly
diagnosed with Type 1 DM. Which instruction is most important to discuss with
the client?
a. Refer them to the American Diabetes Association
b. Take the prescribed insulin even when unable to eat due to illness
c. Do not take any OTC meds
d. Explain the need to get the annual flu and pneumonia vaccines
Correct Answer: b. Take the prescribed insulin even when unable to eat due to
illness
Rationale: During illness, the body releases stress hormones that increase blood
glucose levels. Insulin must be continued even if the patient cannot eat to prevent
DKA. This is the most critical teaching point for DKA prevention.
Question 2. ED nurse is caring for a patient with HHS who has a blood glucose of
680 mg/dL. Which question should the nurse ask to determine the cause of
acute complications?
a. "When was the last time you took your insulin?"
b. "When did you have your last meal?"
c. "Have you had some type of infection lately?"
d. "How long have you had diabetes?"
Correct Answer: c. "Have you had some type of infection lately?"
,Rationale: HHS (Hyperglycemic Hyperosmolar State) is most commonly
precipitated by infection in patients with type 2 diabetes. Identifying the
underlying cause is essential for treatment.
Question 3. Client with a diagnosis of Addisonian crisis is being admitted to the
ICU. Which findings will the inter-professional care team focus on? Select all that
apply:
a. Hypotension
b. Leukocytosis
c. Hyperkalemia
d. Hypercalcemia
e. Hypernatremia
Correct Answer: a, c
Rationale: Addisonian crisis is characterized by:
• Hypotension (due to lack of aldosterone and cortisol)
• Hyperkalemia (due to lack of aldosterone)
• Hyponatremia (not hypernatremia)
• Hypoglycemia
Question 4. Nurse is caring for a client after hypophysectomy and notes clear
nasal drainage from the client's nostril. The nurse should take which initial
action?
a. Lower the head of the bed
b. Test drainage for glucose
c. Obtain culture of drainage
d. Continue to observe drainage
Correct Answer: b. Test drainage for glucose
, Rationale: Clear nasal drainage after hypophysectomy may indicate CSF leak.
Testing for glucose is the initial action because CSF contains glucose, while normal
nasal secretions do not.
Question 5. Nurse is admitting a client who is diagnosed with SIADH and has
serum sodium of 118 mEq/L. Which physician prescription should the nurse
anticipate receiving? Select all that apply:
a. Initiate infusion of 3% NaCl
b. Administer IV furosemide
c. Restrict fluids to 800 mL over 24 hours
d. Elevate HOB to high Fowler's
e. Administer a vasopressin antagonist as prescribed
Correct Answer: a, c, e
Rationale: Treatment for SIADH includes:
• 3% NaCl for severe hyponatremia
• Fluid restriction (800 mL/24 hours)
• Vasopressin antagonists (to promote water excretion)
Furosemide may be used but is not first-line. High Fowler's position is not
specific to SIADH.
Question 6. Nurse performing an assessment on a client with
pheochromocytoma. Which assessment data would indicate potential
complication with this disease?
a. Urinary output of 50 mL/h
b. Coagulation time of 5 mins
c. HR that is 90 bpm and irregular
d. BUN of 20 mg/dL
Correct Answer: c. HR that is 90 bpm and irregular
