N176 • EXAM 4 PRACTICE QUESTIONS • 2026–2027
N176 EXAM 4
PRACTICE QUESTIONS WITH DETAILED RATIONALES
2026–2027 | 100 Original Questions | Answers • Rationales • Clinical Pearls
Adult Health Nursing Review
Original educational practice material—not an official exam, leaked exam, or proprietary test bank.
How to Use This Practice Exam
• Answer each question before reviewing the answer and rationale.
• Use the rationale and distractor explanations to review safe nursing judgment, prioritization, and clinical principles.
• Follow current provider orders, facility policy, current clinical guidance, and applicable nursing scope of practice.
• Course assumption: N176 refers to Hondros College of Nursing NUR 176, Concepts of Adult Health Nursing for Practical
Nurse I. Confirm the current syllabus and Exam 4 blueprint before relying on course-specific alignment.
Topic Map
• Diabetes: 10 question(s)
• Endocrine: 5 question(s)
• Neurologic: 9 question(s)
• Infection: 7 question(s)
• Renal: 6 question(s)
• Respiratory: 5 question(s)
• GI: 8 question(s)
• Musculoskeletal: 6 question(s)
• Skin: 4 question(s)
• Oncology: 3 question(s)
• HIV: 1 question(s)
• Pharmacology: 7 question(s)
• Safety: 4 question(s)
• Priority: 6 question(s)
• Hematology: 1 question(s)
• Perioperative: 1 question(s)
• Electrolytes: 1 question(s)
• Clinical Judgment: 16 question(s)
Focus includes diabetes/endocrine, neurologic emergencies, infection control, renal/electrolyte disorders, respiratory and
GI complications, musculoskeletal/skin care, oncology/hematology, medication safety, perioperative care, and clinical
prioritization.
Practice Questions
Question 1. [Diabetes] An awake client with glucose 52 mg/dL is shaky and can swallow. First action?
A. Encourage exercise
B. Wait one hour
C. Give 15 g fast-acting carbohydrate
D. Give rapid-acting insulin
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, N176 • EXAM 4 PRACTICE QUESTIONS • 2026–2027
Correct Answer: C. Give 15 g fast-acting carbohydrate
Detailed Rationale: Treat symptomatic hypoglycemia promptly with fast carbohydrate, then recheck glucose in 15 minutes
and repeat per protocol if still low.
Why the Other Options Are Incorrect:
A. Encourage exercise may increase injury, aspiration, hemodynamic, or other complication risk and does not address
the priority.
B. Wait one hour delays assessment or treatment despite the risk described in this diabetes scenario.
D. Give rapid-acting insulin is not the safest response here because it may worsen the suspected problem or bypass
required assessment/orders.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 2. [Diabetes] An unconscious client with suspected severe hypoglycemia cannot swallow. What is
appropriate?
A. Wait for routine checks
B. Give oral juice
C. Give prescribed glucagon or IV dextrose and summon help
D. Give insulin
Correct Answer: C. Give prescribed glucagon or IV dextrose and summon help
Detailed Rationale: Oral intake risks aspiration. Use prescribed nonoral rescue treatment and urgent support.
Why the Other Options Are Incorrect:
A. Wait for routine checks delays assessment or treatment despite the risk described in this diabetes scenario.
B. Give oral juice is not the safest response here because it may worsen the suspected problem or bypass required
assessment/orders.
D. Give insulin is not the safest response here because it may worsen the suspected problem or bypass required
assessment/orders.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 3. [Diabetes] Deep rapid breathing, fruity breath, vomiting, and hyperglycemia suggest:
A. Peripheral neuropathy
B. Hypoglycemia
C. Simple hunger
D. Diabetic ketoacidosis
Correct Answer: D. Diabetic ketoacidosis
Detailed Rationale: These findings suggest DKA with ketone production and metabolic acidosis; urgent assessment and
protocol-based treatment are needed.
Why the Other Options Are Incorrect:
A. Peripheral neuropathy does not address the priority clinical risk identified in the stem; the selected response better
supports safe assessment and care.
B. Hypoglycemia does not address the priority clinical risk identified in the stem; the selected response better supports
safe assessment and care.
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, N176 • EXAM 4 PRACTICE QUESTIONS • 2026–2027
C. Simple hunger does not address the priority clinical risk identified in the stem; the selected response better supports
safe assessment and care.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 4. [Diabetes] When should a client generally coordinate rapid-acting lispro with food?
A. Four hours after injection
B. Only when glucose is very high
C. Only at bedtime
D. Promptly around the prescribed meal timing
Correct Answer: D. Promptly around the prescribed meal timing
Detailed Rationale: Rapid-acting insulin is coordinated closely with meals to reduce hypoglycemia risk.
Why the Other Options Are Incorrect:
A. Four hours after injection does not address the priority clinical risk identified in the stem; the selected response better
supports safe assessment and care.
B. Only when glucose is very high does not address the priority clinical risk identified in the stem; the selected response
better supports safe assessment and care.
C. Only at bedtime does not address the priority clinical risk identified in the stem; the selected response better supports
safe assessment and care.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 5. [Diabetes] A client with neuropathy has a new foot blister. Best advice?
A. Protect it and report it promptly
B. Soak in hot water
C. Use a heating pad
D. Cut the blister with scissors
Correct Answer: A. Protect it and report it promptly
Detailed Rationale: Reduced sensation and poor perfusion can delay healing; protect the area and obtain assessment.
Why the Other Options Are Incorrect:
B. Soak in hot water is not the safest response here because it may worsen the suspected problem or bypass required
assessment/orders.
C. Use a heating pad may increase injury, aspiration, hemodynamic, or other complication risk and does not address the
priority.
D. Cut the blister with scissors does not address the priority clinical risk identified in the stem; the selected response
better supports safe assessment and care.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 6. [Diabetes] A client with type 1 diabetes is ill and vomiting. Best instruction?
A. Exercise vigorously
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, N176 • EXAM 4 PRACTICE QUESTIONS • 2026–2027
B. Stop all insulin
C. Follow the sick-day plan, monitor glucose/ketones, and seek help for red flags
D. Avoid fluids
Correct Answer: C. Follow the sick-day plan, monitor glucose/ketones, and seek help for red flags
Detailed Rationale: Illness can increase glucose and ketone risk. Follow individualized sick-day guidance and monitor
closely.
Why the Other Options Are Incorrect:
A. Exercise vigorously may increase injury, aspiration, hemodynamic, or other complication risk and does not address
the priority.
B. Stop all insulin is not the safest response here because it may worsen the suspected problem or bypass required
assessment/orders.
D. Avoid fluids is not the safest response here because it may worsen the suspected problem or bypass required
assessment/orders.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 7. [Diabetes] Which statement about insulin glargine is correct?
A. Stop it whenever a meal is skipped
B. Mix it with lispro
C. Use as prescribed long-acting basal insulin
D. Take only when glucose is high
Correct Answer: C. Use as prescribed long-acting basal insulin
Detailed Rationale: Glargine provides basal insulin and should not be mixed in the same syringe with other insulins.
Why the Other Options Are Incorrect:
A. Stop it whenever a meal is skipped does not address the priority clinical risk identified in the stem; the selected
response better supports safe assessment and care.
B. Mix it with lispro does not address the priority clinical risk identified in the stem; the selected response better supports
safe assessment and care.
D. Take only when glucose is high does not address the priority clinical risk identified in the stem; the selected response
better supports safe assessment and care.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 8. [Diabetes] A client on a sulfonylurea is sweaty and tremulous before lunch. Priority?
A. Drive to the pharmacy
B. Check glucose and treat low glucose if present
C. Wait until after lunch
D. Give the next dose early
Correct Answer: B. Check glucose and treat low glucose if present
Detailed Rationale: Sulfonylureas can cause hypoglycemia; assess promptly and treat according to protocol.
Why the Other Options Are Incorrect:
Original educational practice material • Verify course alignment | Page 4
N176 EXAM 4
PRACTICE QUESTIONS WITH DETAILED RATIONALES
2026–2027 | 100 Original Questions | Answers • Rationales • Clinical Pearls
Adult Health Nursing Review
Original educational practice material—not an official exam, leaked exam, or proprietary test bank.
How to Use This Practice Exam
• Answer each question before reviewing the answer and rationale.
• Use the rationale and distractor explanations to review safe nursing judgment, prioritization, and clinical principles.
• Follow current provider orders, facility policy, current clinical guidance, and applicable nursing scope of practice.
• Course assumption: N176 refers to Hondros College of Nursing NUR 176, Concepts of Adult Health Nursing for Practical
Nurse I. Confirm the current syllabus and Exam 4 blueprint before relying on course-specific alignment.
Topic Map
• Diabetes: 10 question(s)
• Endocrine: 5 question(s)
• Neurologic: 9 question(s)
• Infection: 7 question(s)
• Renal: 6 question(s)
• Respiratory: 5 question(s)
• GI: 8 question(s)
• Musculoskeletal: 6 question(s)
• Skin: 4 question(s)
• Oncology: 3 question(s)
• HIV: 1 question(s)
• Pharmacology: 7 question(s)
• Safety: 4 question(s)
• Priority: 6 question(s)
• Hematology: 1 question(s)
• Perioperative: 1 question(s)
• Electrolytes: 1 question(s)
• Clinical Judgment: 16 question(s)
Focus includes diabetes/endocrine, neurologic emergencies, infection control, renal/electrolyte disorders, respiratory and
GI complications, musculoskeletal/skin care, oncology/hematology, medication safety, perioperative care, and clinical
prioritization.
Practice Questions
Question 1. [Diabetes] An awake client with glucose 52 mg/dL is shaky and can swallow. First action?
A. Encourage exercise
B. Wait one hour
C. Give 15 g fast-acting carbohydrate
D. Give rapid-acting insulin
Original educational practice material • Verify course alignment | Page 1
, N176 • EXAM 4 PRACTICE QUESTIONS • 2026–2027
Correct Answer: C. Give 15 g fast-acting carbohydrate
Detailed Rationale: Treat symptomatic hypoglycemia promptly with fast carbohydrate, then recheck glucose in 15 minutes
and repeat per protocol if still low.
Why the Other Options Are Incorrect:
A. Encourage exercise may increase injury, aspiration, hemodynamic, or other complication risk and does not address
the priority.
B. Wait one hour delays assessment or treatment despite the risk described in this diabetes scenario.
D. Give rapid-acting insulin is not the safest response here because it may worsen the suspected problem or bypass
required assessment/orders.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 2. [Diabetes] An unconscious client with suspected severe hypoglycemia cannot swallow. What is
appropriate?
A. Wait for routine checks
B. Give oral juice
C. Give prescribed glucagon or IV dextrose and summon help
D. Give insulin
Correct Answer: C. Give prescribed glucagon or IV dextrose and summon help
Detailed Rationale: Oral intake risks aspiration. Use prescribed nonoral rescue treatment and urgent support.
Why the Other Options Are Incorrect:
A. Wait for routine checks delays assessment or treatment despite the risk described in this diabetes scenario.
B. Give oral juice is not the safest response here because it may worsen the suspected problem or bypass required
assessment/orders.
D. Give insulin is not the safest response here because it may worsen the suspected problem or bypass required
assessment/orders.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 3. [Diabetes] Deep rapid breathing, fruity breath, vomiting, and hyperglycemia suggest:
A. Peripheral neuropathy
B. Hypoglycemia
C. Simple hunger
D. Diabetic ketoacidosis
Correct Answer: D. Diabetic ketoacidosis
Detailed Rationale: These findings suggest DKA with ketone production and metabolic acidosis; urgent assessment and
protocol-based treatment are needed.
Why the Other Options Are Incorrect:
A. Peripheral neuropathy does not address the priority clinical risk identified in the stem; the selected response better
supports safe assessment and care.
B. Hypoglycemia does not address the priority clinical risk identified in the stem; the selected response better supports
safe assessment and care.
Original educational practice material • Verify course alignment | Page 2
, N176 • EXAM 4 PRACTICE QUESTIONS • 2026–2027
C. Simple hunger does not address the priority clinical risk identified in the stem; the selected response better supports
safe assessment and care.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 4. [Diabetes] When should a client generally coordinate rapid-acting lispro with food?
A. Four hours after injection
B. Only when glucose is very high
C. Only at bedtime
D. Promptly around the prescribed meal timing
Correct Answer: D. Promptly around the prescribed meal timing
Detailed Rationale: Rapid-acting insulin is coordinated closely with meals to reduce hypoglycemia risk.
Why the Other Options Are Incorrect:
A. Four hours after injection does not address the priority clinical risk identified in the stem; the selected response better
supports safe assessment and care.
B. Only when glucose is very high does not address the priority clinical risk identified in the stem; the selected response
better supports safe assessment and care.
C. Only at bedtime does not address the priority clinical risk identified in the stem; the selected response better supports
safe assessment and care.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 5. [Diabetes] A client with neuropathy has a new foot blister. Best advice?
A. Protect it and report it promptly
B. Soak in hot water
C. Use a heating pad
D. Cut the blister with scissors
Correct Answer: A. Protect it and report it promptly
Detailed Rationale: Reduced sensation and poor perfusion can delay healing; protect the area and obtain assessment.
Why the Other Options Are Incorrect:
B. Soak in hot water is not the safest response here because it may worsen the suspected problem or bypass required
assessment/orders.
C. Use a heating pad may increase injury, aspiration, hemodynamic, or other complication risk and does not address the
priority.
D. Cut the blister with scissors does not address the priority clinical risk identified in the stem; the selected response
better supports safe assessment and care.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 6. [Diabetes] A client with type 1 diabetes is ill and vomiting. Best instruction?
A. Exercise vigorously
Original educational practice material • Verify course alignment | Page 3
, N176 • EXAM 4 PRACTICE QUESTIONS • 2026–2027
B. Stop all insulin
C. Follow the sick-day plan, monitor glucose/ketones, and seek help for red flags
D. Avoid fluids
Correct Answer: C. Follow the sick-day plan, monitor glucose/ketones, and seek help for red flags
Detailed Rationale: Illness can increase glucose and ketone risk. Follow individualized sick-day guidance and monitor
closely.
Why the Other Options Are Incorrect:
A. Exercise vigorously may increase injury, aspiration, hemodynamic, or other complication risk and does not address
the priority.
B. Stop all insulin is not the safest response here because it may worsen the suspected problem or bypass required
assessment/orders.
D. Avoid fluids is not the safest response here because it may worsen the suspected problem or bypass required
assessment/orders.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 7. [Diabetes] Which statement about insulin glargine is correct?
A. Stop it whenever a meal is skipped
B. Mix it with lispro
C. Use as prescribed long-acting basal insulin
D. Take only when glucose is high
Correct Answer: C. Use as prescribed long-acting basal insulin
Detailed Rationale: Glargine provides basal insulin and should not be mixed in the same syringe with other insulins.
Why the Other Options Are Incorrect:
A. Stop it whenever a meal is skipped does not address the priority clinical risk identified in the stem; the selected
response better supports safe assessment and care.
B. Mix it with lispro does not address the priority clinical risk identified in the stem; the selected response better supports
safe assessment and care.
D. Take only when glucose is high does not address the priority clinical risk identified in the stem; the selected response
better supports safe assessment and care.
Key Concept: Diabetes assessment and safe nursing response.
Clinical Pearl: Prioritize airway, breathing, circulation, acute changes from baseline, and prompt escalation of red-flag
findings.
Question 8. [Diabetes] A client on a sulfonylurea is sweaty and tremulous before lunch. Priority?
A. Drive to the pharmacy
B. Check glucose and treat low glucose if present
C. Wait until after lunch
D. Give the next dose early
Correct Answer: B. Check glucose and treat low glucose if present
Detailed Rationale: Sulfonylureas can cause hypoglycemia; assess promptly and treat according to protocol.
Why the Other Options Are Incorrect:
Original educational practice material • Verify course alignment | Page 4
