Galen NSG 4100 Exam 2 | Adult Health III (2026) Actual Q&A
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1. A client is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Which
assessment finding is most consistent with this diagnosis?
A) Polyuria and polydipsia
B) Hypernatremia and dehydration
C) Hyponatremia and fluid overload
D) Hyperkalemia and metabolic acidosis
Correct Answer: Hyponatremia and fluid overload
Rationale: SIADH is characterized by excessive ADH secretion from the pituitary, leading to
water retention, dilutional hyponatremia (low serum sodium), and fluid overload. Concentrated
urine is produced despite the fluid overload. Polyuria and polydipsia are signs of diabetes
insipidus, and hypernatremia is the opposite of what is seen in SIADH.
2. A client with SIADH has a serum sodium level of 120 mEq/L. Which intervention should the
nurse anticipate?
A) Administer hypertonic saline
B) Restrict oral fluids
C) Administer desmopressin
D) Encourage increased fluid intake
Correct Answer: Restrict oral fluids
Rationale: Fluid restriction is the primary treatment for SIADH to correct dilutional
hyponatremia. Hypertonic saline may be used for severe hyponatremia but is not the first-line
intervention. Desmopressin is used for diabetes insipidus.
,3. A client is diagnosed with Diabetes Insipidus (DI). Which assessment finding is most
consistent with this diagnosis?
A) Polyuria and polydipsia
B) Hyponatremia and fluid overload
C) Oliguria and hypertension
D) Hyperkalemia and metabolic acidosis
Correct Answer: Polyuria and polydipsia
Rationale: Diabetes insipidus is characterized by a deficiency of ADH (central DI) or a lack of
response to ADH (nephrogenic DI), leading to polyuria (excessive urination) and polydipsia
(excessive thirst). Serum sodium is typically elevated (hypernatremia) due to water loss. SIADH
presents with hyponatremia and fluid overload.
4. A client with Diabetes Insipidus is prescribed desmopressin (DDAVP). Which route of
administration is most commonly used?
A) Oral
B) Subcutaneous
C) Intramuscular
D) Intranasal
Correct Answer: Intranasal
Rationale: Desmopressin (DDAVP) is a synthetic analog of ADH and is commonly administered
intranasally for the treatment of central diabetes insipidus. It can also be given orally or
parenterally, but intranasal is the most common route.
,5. A nurse is assessing a client with Cushing's syndrome. Which finding is most consistent with
this condition?
A) Weight loss and hypotension
B) Moon facies and buffalo hump
C) Hyperpigmentation and hyponatremia
D) Hypoglycemia and hyperkalemia
Correct Answer: Moon facies and buffalo hump
Rationale: Cushing's syndrome is caused by excess cortisol, leading to characteristic features
such as moon facies (round face), buffalo hump (fat deposition on the back), weight gain,
hypertension, hyperglycemia, and thin skin with easy bruising. Hyperpigmentation and
hyponatremia are associated with Addison's disease (adrenal insufficiency).
6. A client with Cushing's syndrome is at risk for which complication?
A) Hypoglycemia
B) Hypotension
C) Infection
D) Hyperkalemia
Correct Answer: Infection
Rationale: Excess cortisol suppresses the immune system, increasing the risk of infection.
Hyperglycemia (not hypoglycemia) is common, and hypertension (not hypotension) is typical.
Hyperkalemia is associated with Addison's disease.
7. A client is diagnosed with Addison's disease (adrenal insufficiency). Which finding is most
consistent with this condition?
, A) Hypertension and hyperglycemia
B) Moon facies and buffalo hump
C) Hyperpigmentation and hyponatremia
D) Weight gain and hirsutism
Correct Answer: Hyperpigmentation and hyponatremia
Rationale: Addison's disease is caused by adrenal insufficiency, leading to decreased cortisol and
aldosterone. Manifestations include hyperpigmentation (due to increased ACTH), hyponatremia,
hyperkalemia, hypotension, and weight loss. Cushing's syndrome presents with moon facies and
buffalo hump.
8. A client with Addison's disease is admitted with severe hypotension, hyponatremia, and
hyperkalemia. The nurse recognizes this as:
A) Cushing's crisis
B) Thyroid storm
C) Addisonian crisis
D) Myxedema coma
Correct Answer: Addisonian crisis
Rationale: An Addisonian crisis is a life-threatening emergency characterized by severe
hypotension, hyponatremia, hyperkalemia, and shock. It is caused by acute adrenal insufficiency
and requires immediate treatment with IV corticosteroids and fluids.
9. A client with Addison's disease is prescribed hydrocortisone. The nurse should teach the
client to:
A) Take the medication on an empty stomach
1. A client is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Which
assessment finding is most consistent with this diagnosis?
A) Polyuria and polydipsia
B) Hypernatremia and dehydration
C) Hyponatremia and fluid overload
D) Hyperkalemia and metabolic acidosis
Correct Answer: Hyponatremia and fluid overload
Rationale: SIADH is characterized by excessive ADH secretion from the pituitary, leading to
water retention, dilutional hyponatremia (low serum sodium), and fluid overload. Concentrated
urine is produced despite the fluid overload. Polyuria and polydipsia are signs of diabetes
insipidus, and hypernatremia is the opposite of what is seen in SIADH.
2. A client with SIADH has a serum sodium level of 120 mEq/L. Which intervention should the
nurse anticipate?
A) Administer hypertonic saline
B) Restrict oral fluids
C) Administer desmopressin
D) Encourage increased fluid intake
Correct Answer: Restrict oral fluids
Rationale: Fluid restriction is the primary treatment for SIADH to correct dilutional
hyponatremia. Hypertonic saline may be used for severe hyponatremia but is not the first-line
intervention. Desmopressin is used for diabetes insipidus.
,3. A client is diagnosed with Diabetes Insipidus (DI). Which assessment finding is most
consistent with this diagnosis?
A) Polyuria and polydipsia
B) Hyponatremia and fluid overload
C) Oliguria and hypertension
D) Hyperkalemia and metabolic acidosis
Correct Answer: Polyuria and polydipsia
Rationale: Diabetes insipidus is characterized by a deficiency of ADH (central DI) or a lack of
response to ADH (nephrogenic DI), leading to polyuria (excessive urination) and polydipsia
(excessive thirst). Serum sodium is typically elevated (hypernatremia) due to water loss. SIADH
presents with hyponatremia and fluid overload.
4. A client with Diabetes Insipidus is prescribed desmopressin (DDAVP). Which route of
administration is most commonly used?
A) Oral
B) Subcutaneous
C) Intramuscular
D) Intranasal
Correct Answer: Intranasal
Rationale: Desmopressin (DDAVP) is a synthetic analog of ADH and is commonly administered
intranasally for the treatment of central diabetes insipidus. It can also be given orally or
parenterally, but intranasal is the most common route.
,5. A nurse is assessing a client with Cushing's syndrome. Which finding is most consistent with
this condition?
A) Weight loss and hypotension
B) Moon facies and buffalo hump
C) Hyperpigmentation and hyponatremia
D) Hypoglycemia and hyperkalemia
Correct Answer: Moon facies and buffalo hump
Rationale: Cushing's syndrome is caused by excess cortisol, leading to characteristic features
such as moon facies (round face), buffalo hump (fat deposition on the back), weight gain,
hypertension, hyperglycemia, and thin skin with easy bruising. Hyperpigmentation and
hyponatremia are associated with Addison's disease (adrenal insufficiency).
6. A client with Cushing's syndrome is at risk for which complication?
A) Hypoglycemia
B) Hypotension
C) Infection
D) Hyperkalemia
Correct Answer: Infection
Rationale: Excess cortisol suppresses the immune system, increasing the risk of infection.
Hyperglycemia (not hypoglycemia) is common, and hypertension (not hypotension) is typical.
Hyperkalemia is associated with Addison's disease.
7. A client is diagnosed with Addison's disease (adrenal insufficiency). Which finding is most
consistent with this condition?
, A) Hypertension and hyperglycemia
B) Moon facies and buffalo hump
C) Hyperpigmentation and hyponatremia
D) Weight gain and hirsutism
Correct Answer: Hyperpigmentation and hyponatremia
Rationale: Addison's disease is caused by adrenal insufficiency, leading to decreased cortisol and
aldosterone. Manifestations include hyperpigmentation (due to increased ACTH), hyponatremia,
hyperkalemia, hypotension, and weight loss. Cushing's syndrome presents with moon facies and
buffalo hump.
8. A client with Addison's disease is admitted with severe hypotension, hyponatremia, and
hyperkalemia. The nurse recognizes this as:
A) Cushing's crisis
B) Thyroid storm
C) Addisonian crisis
D) Myxedema coma
Correct Answer: Addisonian crisis
Rationale: An Addisonian crisis is a life-threatening emergency characterized by severe
hypotension, hyponatremia, hyperkalemia, and shock. It is caused by acute adrenal insufficiency
and requires immediate treatment with IV corticosteroids and fluids.
9. A client with Addison's disease is prescribed hydrocortisone. The nurse should teach the
client to:
A) Take the medication on an empty stomach
