NSG 3250 Exam 4 V1 | NSG 3250 Adult
Health I | Galen College of Nursing | Q&A
with Rationale (Galen NSG3250 Exam 4)
1. A nurse is caring for a client with Type 1 Diabetes Mellitus who is prescribed Lispro
(Humalog) insulin. At what time should the nurse ensure the client consumes their meal?
A. Immediately or within 15 minutes of administration
B. 30 to 60 minutes after administration
C. Only if the blood glucose is above 200 mg/dL
D. Two hours after administration
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of action between 15 to 30
minutes. The nurse must ensure the client has food available or is eating immediately to
prevent sudden hypoglycemia. If the meal is delayed after administration, the client is at
significant risk for a rapid drop in blood glucose levels.
2. Which clinical manifestation would the nurse expect to find in a client diagnosed with
Graves’ disease?
A. Bradycardia and cold intolerance
B. Weight gain and lethargy
C. Exophthalmos and tachycardia
,D. Constipation and dry skin
Answer: C
Rationale: Graves’ disease is an autoimmune form of hyperthyroidism that results in a
hypermetabolic state. Common signs include bulging eyes known as exophthalmos,
increased heart rate, and heat intolerance. The other options describe symptoms of
hypothyroidism, which is the opposite of the Graves’ disease disease process.
3. A client with Addison’s disease is being discharged. Which instruction is most critical for
the nurse to include in the teaching plan?
A. Limit fluid intake to 1 liter per day
B. Discontinue steroids if weight gain occurs
C. Wear a medical alert bracelet at all times
D. Follow a low-sodium diet
Answer: C
Rationale: Clients with Addison’s disease require lifelong hormone replacement and are at
risk for life-threatening Addisonian crisis during times of stress. A medical alert bracelet
ensures emergency personnel are aware of the need for glucocorticoids if the client is
incapacitated. Education should also emphasize that steroids must never be stopped
abruptly because this can trigger a crisis.
, 4. A client is diagnosed with Cushing’s syndrome. Which assessment finding should the nurse
anticipate?
A. Bronze-colored skin
B. Weight loss and hypotension
C. Hyponatremia and hyperkalemia
D. Truncal obesity and a ‘buffalo hump’
Answer: D
Rationale: Cushing’s syndrome is caused by an excess of corticosteroids, leading to specific
physical changes such as fat redistribution to the trunk and neck. Other common findings
include moon face, purple striae, and hypertension. These symptoms contrast with
Addison’s disease, where weight loss and hypotension are more prevalent.
5. The nurse is assessing a client with a history of Peptic Ulcer Disease (PUD). Which finding
suggests a gastric perforation?
A. Hyperactive bowel sounds in all quadrants
B. Increased hunger and dull aching pain relieved by food
C. Sudden, severe upper abdominal pain and a rigid board-like abdomen
D. Bright red emesis and melena
Answer: C
Health I | Galen College of Nursing | Q&A
with Rationale (Galen NSG3250 Exam 4)
1. A nurse is caring for a client with Type 1 Diabetes Mellitus who is prescribed Lispro
(Humalog) insulin. At what time should the nurse ensure the client consumes their meal?
A. Immediately or within 15 minutes of administration
B. 30 to 60 minutes after administration
C. Only if the blood glucose is above 200 mg/dL
D. Two hours after administration
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of action between 15 to 30
minutes. The nurse must ensure the client has food available or is eating immediately to
prevent sudden hypoglycemia. If the meal is delayed after administration, the client is at
significant risk for a rapid drop in blood glucose levels.
2. Which clinical manifestation would the nurse expect to find in a client diagnosed with
Graves’ disease?
A. Bradycardia and cold intolerance
B. Weight gain and lethargy
C. Exophthalmos and tachycardia
,D. Constipation and dry skin
Answer: C
Rationale: Graves’ disease is an autoimmune form of hyperthyroidism that results in a
hypermetabolic state. Common signs include bulging eyes known as exophthalmos,
increased heart rate, and heat intolerance. The other options describe symptoms of
hypothyroidism, which is the opposite of the Graves’ disease disease process.
3. A client with Addison’s disease is being discharged. Which instruction is most critical for
the nurse to include in the teaching plan?
A. Limit fluid intake to 1 liter per day
B. Discontinue steroids if weight gain occurs
C. Wear a medical alert bracelet at all times
D. Follow a low-sodium diet
Answer: C
Rationale: Clients with Addison’s disease require lifelong hormone replacement and are at
risk for life-threatening Addisonian crisis during times of stress. A medical alert bracelet
ensures emergency personnel are aware of the need for glucocorticoids if the client is
incapacitated. Education should also emphasize that steroids must never be stopped
abruptly because this can trigger a crisis.
, 4. A client is diagnosed with Cushing’s syndrome. Which assessment finding should the nurse
anticipate?
A. Bronze-colored skin
B. Weight loss and hypotension
C. Hyponatremia and hyperkalemia
D. Truncal obesity and a ‘buffalo hump’
Answer: D
Rationale: Cushing’s syndrome is caused by an excess of corticosteroids, leading to specific
physical changes such as fat redistribution to the trunk and neck. Other common findings
include moon face, purple striae, and hypertension. These symptoms contrast with
Addison’s disease, where weight loss and hypotension are more prevalent.
5. The nurse is assessing a client with a history of Peptic Ulcer Disease (PUD). Which finding
suggests a gastric perforation?
A. Hyperactive bowel sounds in all quadrants
B. Increased hunger and dull aching pain relieved by food
C. Sudden, severe upper abdominal pain and a rigid board-like abdomen
D. Bright red emesis and melena
Answer: C
