NSG 3130 Comprehensive Final Exam Review 2026/2027 |
Nursing Practice Questions, Answer Key & Rationales
Question 1
A nurse is assessing a client with severe Cushing's disease. Which
clinical finding should the nurse expect?
• A. Weight loss, hypotension, and bronze skin pigmentation
• B. Truncal obesity, "moon face," purple abdominal striae, and
muscle wasting
• C. Cold intolerance, bradycardia, and dry coarse skin
• D. Exophthalmos, heat intolerance, and tachycardia
Correct Answer: B. Truncal obesity, "moon face," purple abdominal
striae, and muscle wasting
Detailed Rationale: Cushing's disease results from chronic exposure to
excess circulating glucocorticoids (cortisol). Classic features include
central/truncal obesity, a dorsocervical fat pad ("buffalo hump"), a
rounded "moon face," thin fragile skin with purple striae, and muscle
wasting.
Question 2
A client with Addison's disease is admitted in acute adrenal crisis.
Which electrolyte profile should the nurse anticipate?
• A. Hypernatremia and hypokalemia
• B. Hyponatremia, hyperkalemia, and severe hypotension
• C. Hypercalcemia and hypophosphatemia
, • D. Normal electrolytes with severe hyperglycemia
Correct Answer: B. Hyponatremia, hyperkalemia, and severe
hypotension
Detailed Rationale: Mineralocorticoid (aldosterone) deficiency in
Addisonian crisis impairs renal sodium reabsorption and potassium
excretion, leading to profound hyponatremia, hyperkalemia,
hypovolemia, and vascular collapse (severe hypotension and shock).
Question 3
A client with Syndrome of Inappropriate Antidiuretic Hormone
Secretion (SIADH) has a serum sodium level of 114 mEq/Land exhibits
confusion and twitching. Which intravenous solution should the nurse
anticipate the physician ordering to correct severe symptomatic
hyponatremia?
• A. 0.45%Sodium Chloride
• B. 3%Sodium Chloride (Hypertonic Saline) administered
cautiously
• C. Lactated Ringer's solution
• D. 5%Dextrose in Water
Correct Answer: B. 3%Sodium Chloride (Hypertonic Saline)
administered cautiously
Detailed Rationale: Severe symptomatic hyponatremia (Na+ <
120 mEq/L) with neurological symptoms requires hypertonic saline (3%
NaCl) infused slowly and cautiously to raise serum sodium and prevent
cerebral edema, while avoiding rapid over-correction that can cause
central pontine myelinolysis.
,Question 4
A client with Diabetes Insipidus (DI) is receiving desmopressin (DDAVP).
Which finding indicates that the medication is effective?
• A. Polyuria and persistent intense thirst
• B. Decreased urine output, increased urine specific gravity, and
relief of polydipsia
• C. Rapid weight gain and peripheral edema
• D. Elevated serum sodium and decreased urine osmolarity
Correct Answer: B. Decreased urine output, increased urine specific
gravity, and relief of polydipsia
Detailed Rationale: Desmopressin is a synthetic antidiuretic hormone
(ADH) replacement. Effective therapy corrects water loss by
concentrating urine, reducing excessive urinary volume (polyuria),
increasing urine specific gravity, and alleviating intense thirst
(polydipsia).
Question 5
A client with Graves' disease (hyperthyroidism) is scheduled for a
subtotal thyroidectomy. Which medication is administered
preoperatively to reduce thyroid gland vascularity and size?
• A. Radioactive iodine-131
• B. Saturated solution of potassium iodide (SSKI) or Lugol's solution
• C. Regular insulin infusion
• D. High-dose oral corticosteroids
, Correct Answer: B. Saturated solution of potassium iodide (SSKI) or
Lugol's solution
Detailed Rationale: Preoperative administration of iodine solutions
(SSKI or Lugol's iodine) decreases blood flow, vascularity, and size of the
thyroid gland, significantly reducing the risk of intraoperative
hemorrhage during thyroidectomy.
Question 6
A client with diabetic ketoacidosis (DKA) is receiving an IV insulin
infusion. Serum potassium is 3.1 mEq/L. What is the nurse's priority
action?
• A. Continue insulin infusion without changes.
• B. Hold the insulin infusion temporarily and administer
intravenous potassium replacement as prescribed.
• C. Administer oral sodium bicarbonate.
• D. Increase the insulin infusion rate.
Correct Answer: B. Hold the insulin infusion temporarily and administer
intravenous potassium replacement as prescribed.
Detailed Rationale: Insulin drives potassium back into cells, which
rapidly lowers serum potassium levels. If serum potassium is below
3.3 mEq/L, continuing insulin without prior potassium replacement can
trigger lethal cardiac arrhythmias. Insulin must be temporarily held until
potassium is ≥ 3.3 mEq/L.
Question 7
Nursing Practice Questions, Answer Key & Rationales
Question 1
A nurse is assessing a client with severe Cushing's disease. Which
clinical finding should the nurse expect?
• A. Weight loss, hypotension, and bronze skin pigmentation
• B. Truncal obesity, "moon face," purple abdominal striae, and
muscle wasting
• C. Cold intolerance, bradycardia, and dry coarse skin
• D. Exophthalmos, heat intolerance, and tachycardia
Correct Answer: B. Truncal obesity, "moon face," purple abdominal
striae, and muscle wasting
Detailed Rationale: Cushing's disease results from chronic exposure to
excess circulating glucocorticoids (cortisol). Classic features include
central/truncal obesity, a dorsocervical fat pad ("buffalo hump"), a
rounded "moon face," thin fragile skin with purple striae, and muscle
wasting.
Question 2
A client with Addison's disease is admitted in acute adrenal crisis.
Which electrolyte profile should the nurse anticipate?
• A. Hypernatremia and hypokalemia
• B. Hyponatremia, hyperkalemia, and severe hypotension
• C. Hypercalcemia and hypophosphatemia
, • D. Normal electrolytes with severe hyperglycemia
Correct Answer: B. Hyponatremia, hyperkalemia, and severe
hypotension
Detailed Rationale: Mineralocorticoid (aldosterone) deficiency in
Addisonian crisis impairs renal sodium reabsorption and potassium
excretion, leading to profound hyponatremia, hyperkalemia,
hypovolemia, and vascular collapse (severe hypotension and shock).
Question 3
A client with Syndrome of Inappropriate Antidiuretic Hormone
Secretion (SIADH) has a serum sodium level of 114 mEq/Land exhibits
confusion and twitching. Which intravenous solution should the nurse
anticipate the physician ordering to correct severe symptomatic
hyponatremia?
• A. 0.45%Sodium Chloride
• B. 3%Sodium Chloride (Hypertonic Saline) administered
cautiously
• C. Lactated Ringer's solution
• D. 5%Dextrose in Water
Correct Answer: B. 3%Sodium Chloride (Hypertonic Saline)
administered cautiously
Detailed Rationale: Severe symptomatic hyponatremia (Na+ <
120 mEq/L) with neurological symptoms requires hypertonic saline (3%
NaCl) infused slowly and cautiously to raise serum sodium and prevent
cerebral edema, while avoiding rapid over-correction that can cause
central pontine myelinolysis.
,Question 4
A client with Diabetes Insipidus (DI) is receiving desmopressin (DDAVP).
Which finding indicates that the medication is effective?
• A. Polyuria and persistent intense thirst
• B. Decreased urine output, increased urine specific gravity, and
relief of polydipsia
• C. Rapid weight gain and peripheral edema
• D. Elevated serum sodium and decreased urine osmolarity
Correct Answer: B. Decreased urine output, increased urine specific
gravity, and relief of polydipsia
Detailed Rationale: Desmopressin is a synthetic antidiuretic hormone
(ADH) replacement. Effective therapy corrects water loss by
concentrating urine, reducing excessive urinary volume (polyuria),
increasing urine specific gravity, and alleviating intense thirst
(polydipsia).
Question 5
A client with Graves' disease (hyperthyroidism) is scheduled for a
subtotal thyroidectomy. Which medication is administered
preoperatively to reduce thyroid gland vascularity and size?
• A. Radioactive iodine-131
• B. Saturated solution of potassium iodide (SSKI) or Lugol's solution
• C. Regular insulin infusion
• D. High-dose oral corticosteroids
, Correct Answer: B. Saturated solution of potassium iodide (SSKI) or
Lugol's solution
Detailed Rationale: Preoperative administration of iodine solutions
(SSKI or Lugol's iodine) decreases blood flow, vascularity, and size of the
thyroid gland, significantly reducing the risk of intraoperative
hemorrhage during thyroidectomy.
Question 6
A client with diabetic ketoacidosis (DKA) is receiving an IV insulin
infusion. Serum potassium is 3.1 mEq/L. What is the nurse's priority
action?
• A. Continue insulin infusion without changes.
• B. Hold the insulin infusion temporarily and administer
intravenous potassium replacement as prescribed.
• C. Administer oral sodium bicarbonate.
• D. Increase the insulin infusion rate.
Correct Answer: B. Hold the insulin infusion temporarily and administer
intravenous potassium replacement as prescribed.
Detailed Rationale: Insulin drives potassium back into cells, which
rapidly lowers serum potassium levels. If serum potassium is below
3.3 mEq/L, continuing insulin without prior potassium replacement can
trigger lethal cardiac arrhythmias. Insulin must be temporarily held until
potassium is ≥ 3.3 mEq/L.
Question 7
