ESTUDYR
NSG 4100 EXAM 2 MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
1. The adrenal gland produces all of the following EXCEPT:
A. Cortisol
B. Aldosterone
C. Insulin
D. Androgens
Rationale: Insulin is produced by pancreatic β-cells, not the adrenal gland.
2. Cortisol primarily:
A. Lowers blood glucose and increases bone formation
B. Controls metabolism of fats/proteins/carbs, suppresses inflammation, raises blood
sugar, and can decrease bone formation
C. Causes vasodilation and lowers BP
D. Directly secretes digestive enzymes
Rationale: Cortisol is a glucocorticoid with metabolic and anti-inflammatory effects.
3. Aldosterone acts to:
A. Increase potassium reabsorption and excrete sodium
B. Promote sodium reabsorption and potassium excretion in kidneys (regulates BP)
C. Decrease blood volume
D. Inhibit renin release permanently
Rationale: Aldosterone increases Na⁺ retention and K⁺ elimination, expanding volume
and BP.
4. Androgens from the adrenal gland help:
A. Produce insulin in pancreas
B. Regulate aldosterone only
C. Assist ovaries/testes to produce estrogens/testosterone
D. Secrete TSH from pituitary
Rationale: Adrenal androgens are precursors or augment gonadal hormones.
5. Hypoadrenal (Addisonian) dysfunction leads to all EXCEPT:
A. Hypoglycemia
B. Hyponatremia and decreased volume
C. Hypotension
D. Hypokalemia
Rationale: Addison’s typically causes hyperkalemia, not hypokalemia.
,ESTUDYR
6. Hyperadrenal state (Cushing’s) commonly causes:
A. Hypoglycemia and hyponatremia
B. Hyperglycemia, hypernatremia, increased volume and hypertension
C. Hair loss and hypotension only
D. Decreased sex hormones only
Rationale: Excess cortisol/aldosterone activity raises glucose and sodium retention →
HTN.
7. Which adrenal part controls adrenaline (epinephrine) release?
A. Cortex — zona glomerulosa
B. Medulla
C. Zona reticularis only
D. Posterior pituitary
Rationale: The adrenal medulla secretes catecholamines (epinephrine, norepinephrine).
8. Hypoaldosteronism is characterized by:
A. Hypernatremia and alkalosis
B. Hyponatremia, hyperkalemia, metabolic acidosis
C. Hypertension and hypokalemia
D. Hypercalcemia only
Rationale: Low aldosterone → sodium loss, potassium retention, and acidosis.
9. A manifestation of primary adrenal insufficiency (Addison’s) can be:
A. Hair whitening only
B. Hyperpigmentation of skin/mucosa due to high ACTH
C. Hyperactivity and sweating
D. Hypernatremia
Rationale: Elevated ACTH stimulates melanocyte receptors → hyperpigmentation.
10. Common signs in hypoaldosteronism/Addison’s disease include all EXCEPT:
A. Hypoglycemia
B. Hyponatremia and hypovolemia
C. Hypotension and hyperkalemia
D. Hypernatremia
Rationale: Addison’s features low sodium (hyponatremia), not high.
11. Best initial diagnostics for Addison’s disease include:
A. Random afternoon cortisol only
B. Early morning serum cortisol, plasma ACTH, and electrolyte labs
C. Chest X-ray only
, ESTUDYR
D. EEG
Rationale: Morning cortisol/ACTH and labs help confirm adrenal insufficiency.
12. Clinical manifestations of Addison disease include:
A. Hypertension and hyperglycemia
B. Weakness, fatigue, anorexia, hyperkalemia, hyponatremia, hypotension,
hyperpigmentation
C. High energy and weight gain
D. Polyuria and polydipsia only
Rationale: Lack of cortisol/aldosterone causes the listed symptoms.
13. Treatment for chronic adrenal insufficiency includes:
A. Immediate diuretics only
B. Lifelong corticosteroid replacement with dose adjustments during stress
C. Long-term high-dose insulin
D. Alpha blockers only
Rationale: Glucocorticoid/mineralocorticoid replacement is essential; tapering required.
14. Addisonian crisis typically presents with:
A. Hypertension and euphoria
B. Hypotension, cyanosis, N/V, shock, restlessness, confusion
C. High fever and rash only
D. Bradycardia and hyperactivity
Rationale: Acute adrenal insufficiency leads to circulatory collapse.
15. Triggers of Addisonian crisis include all EXCEPT:
A. Acute infection and emotional stress
B. Cold exposure and overexertion
C. Chronic daily multivitamin use
D. Decreased salt intake
Rationale: Stressors precipitate crises; routine vitamins do not.
16. Nursing interventions in Addisonian crisis involve:
A. Withholding fluids and waiting
B. Restore circulation: IV fluids (saline, glucose), IV corticosteroids, vasopressors,
monitor K⁺
C. Immediate insulin bolus regardless of glucose
D. Routine antibiotics only with no steroids
Rationale: Prompt fluid, steroid replacement, and hemodynamic support are lifesaving.
NSG 4100 EXAM 2 MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
1. The adrenal gland produces all of the following EXCEPT:
A. Cortisol
B. Aldosterone
C. Insulin
D. Androgens
Rationale: Insulin is produced by pancreatic β-cells, not the adrenal gland.
2. Cortisol primarily:
A. Lowers blood glucose and increases bone formation
B. Controls metabolism of fats/proteins/carbs, suppresses inflammation, raises blood
sugar, and can decrease bone formation
C. Causes vasodilation and lowers BP
D. Directly secretes digestive enzymes
Rationale: Cortisol is a glucocorticoid with metabolic and anti-inflammatory effects.
3. Aldosterone acts to:
A. Increase potassium reabsorption and excrete sodium
B. Promote sodium reabsorption and potassium excretion in kidneys (regulates BP)
C. Decrease blood volume
D. Inhibit renin release permanently
Rationale: Aldosterone increases Na⁺ retention and K⁺ elimination, expanding volume
and BP.
4. Androgens from the adrenal gland help:
A. Produce insulin in pancreas
B. Regulate aldosterone only
C. Assist ovaries/testes to produce estrogens/testosterone
D. Secrete TSH from pituitary
Rationale: Adrenal androgens are precursors or augment gonadal hormones.
5. Hypoadrenal (Addisonian) dysfunction leads to all EXCEPT:
A. Hypoglycemia
B. Hyponatremia and decreased volume
C. Hypotension
D. Hypokalemia
Rationale: Addison’s typically causes hyperkalemia, not hypokalemia.
,ESTUDYR
6. Hyperadrenal state (Cushing’s) commonly causes:
A. Hypoglycemia and hyponatremia
B. Hyperglycemia, hypernatremia, increased volume and hypertension
C. Hair loss and hypotension only
D. Decreased sex hormones only
Rationale: Excess cortisol/aldosterone activity raises glucose and sodium retention →
HTN.
7. Which adrenal part controls adrenaline (epinephrine) release?
A. Cortex — zona glomerulosa
B. Medulla
C. Zona reticularis only
D. Posterior pituitary
Rationale: The adrenal medulla secretes catecholamines (epinephrine, norepinephrine).
8. Hypoaldosteronism is characterized by:
A. Hypernatremia and alkalosis
B. Hyponatremia, hyperkalemia, metabolic acidosis
C. Hypertension and hypokalemia
D. Hypercalcemia only
Rationale: Low aldosterone → sodium loss, potassium retention, and acidosis.
9. A manifestation of primary adrenal insufficiency (Addison’s) can be:
A. Hair whitening only
B. Hyperpigmentation of skin/mucosa due to high ACTH
C. Hyperactivity and sweating
D. Hypernatremia
Rationale: Elevated ACTH stimulates melanocyte receptors → hyperpigmentation.
10. Common signs in hypoaldosteronism/Addison’s disease include all EXCEPT:
A. Hypoglycemia
B. Hyponatremia and hypovolemia
C. Hypotension and hyperkalemia
D. Hypernatremia
Rationale: Addison’s features low sodium (hyponatremia), not high.
11. Best initial diagnostics for Addison’s disease include:
A. Random afternoon cortisol only
B. Early morning serum cortisol, plasma ACTH, and electrolyte labs
C. Chest X-ray only
, ESTUDYR
D. EEG
Rationale: Morning cortisol/ACTH and labs help confirm adrenal insufficiency.
12. Clinical manifestations of Addison disease include:
A. Hypertension and hyperglycemia
B. Weakness, fatigue, anorexia, hyperkalemia, hyponatremia, hypotension,
hyperpigmentation
C. High energy and weight gain
D. Polyuria and polydipsia only
Rationale: Lack of cortisol/aldosterone causes the listed symptoms.
13. Treatment for chronic adrenal insufficiency includes:
A. Immediate diuretics only
B. Lifelong corticosteroid replacement with dose adjustments during stress
C. Long-term high-dose insulin
D. Alpha blockers only
Rationale: Glucocorticoid/mineralocorticoid replacement is essential; tapering required.
14. Addisonian crisis typically presents with:
A. Hypertension and euphoria
B. Hypotension, cyanosis, N/V, shock, restlessness, confusion
C. High fever and rash only
D. Bradycardia and hyperactivity
Rationale: Acute adrenal insufficiency leads to circulatory collapse.
15. Triggers of Addisonian crisis include all EXCEPT:
A. Acute infection and emotional stress
B. Cold exposure and overexertion
C. Chronic daily multivitamin use
D. Decreased salt intake
Rationale: Stressors precipitate crises; routine vitamins do not.
16. Nursing interventions in Addisonian crisis involve:
A. Withholding fluids and waiting
B. Restore circulation: IV fluids (saline, glucose), IV corticosteroids, vasopressors,
monitor K⁺
C. Immediate insulin bolus regardless of glucose
D. Routine antibiotics only with no steroids
Rationale: Prompt fluid, steroid replacement, and hemodynamic support are lifesaving.
