Galen NSG 4800 Transition to Professional Nursing Practice:
Practice Test 2 (Units 8-13) - Questions with Correct Answers
100 questions
1. A client after a craniotomy has urine output of 400 mL/hr with low urine specific gravity. The
nurse suspects:
A. SIADH
B. Acute kidney injury
C. Diabetes insipidus
D. Normal recovery
Correct Answer: C. Diabetes insipidus
Rationale: Injury to the pituitary or hypothalamus can impair ADH release. SIADH causes low urine
output, and AKI does not produce large volumes of very dilute urine after brain surgery.
2. A client with type 1 diabetes is ill and not eating. The nurse should teach to:
A. Stop insulin
B. Avoid fluids
C. Check glucose once a day
D. Continue insulin, monitor glucose and ketones frequently and drink fluids
Correct Answer: D. Continue insulin, monitor glucose and ketones frequently and drink fluids
Rationale: Illness raises glucose; stopping insulin can cause DKA. Stopping insulin is dangerous
because illness hormones raise glucose and ketones even without food.
3. Cushing's triad, a late sign of increased ICP, consists of:
A. Hypertension with widened pulse pressure, bradycardia and irregular respirations
B. Hypotension, tachycardia and tachypnea
C. Fever, rash and stiff neck
D. Hypoglycemia, tremor and sweating
Correct Answer: A. Hypertension with widened pulse pressure, bradycardia and irregular
respirations
Rationale: This triad indicates brainstem compression and impending herniation. It requires immediate
intervention. Hypotension with tachycardia suggests shock, and fever with rash and stiff neck suggests
meningitis.
,4. Hyperthyroidism (Graves' disease) signs include:
A. Cold intolerance and weight gain
B. Bradycardia
C. Constipation
D. Heat intolerance, weight loss, tachycardia and exophthalmos
Correct Answer: D. Heat intolerance, weight loss, tachycardia and exophthalmos
Rationale: Treatment includes antithyroid drugs, radioactive iodine or surgery. Cold intolerance, weight
gain and bradycardia are hypothyroid signs.
5. Clients taking levodopa should avoid large amounts of:
A. Protein at the same time as doses
B. Water
C. Fiber
D. Vitamin C
Correct Answer: A. Protein at the same time as doses
Rationale: Protein competes for absorption; spacing improves effect. Water, fiber and vitamin C do not
compete with levodopa absorption the way protein does.
6. A client with a cervical spinal cord injury at C3-C5 is at greatest risk for:
A. Bladder dysfunction only
B. Leg weakness only
C. Respiratory failure due to phrenic nerve involvement
D. Visual loss
Correct Answer: C. Respiratory failure due to phrenic nerve involvement
Rationale: 'C3, 4, 5 keeps the diaphragm alive.' Bladder dysfunction and leg weakness occur but are not
immediately life-threatening.
,7. Before tPA for ischemic stroke, the nurse must ensure:
A. The client ate recently
B. A CT scan has ruled out hemorrhage and the client is within the treatment window
C. Aspirin was given
D. BP is above 200/120
Correct Answer: B. A CT scan has ruled out hemorrhage and the client is within the treatment
window
Rationale: tPA is generally given within 3 to 4.5 hours of last known well. BP should be below 185/110
before administration to reduce bleeding risk. Recent food intake is not the concern, aspirin is held for 24
hours after tPA, and a BP above 185/110 must be lowered before tPA.
8. Clients receiving radioactive iodine should be taught to:
A. Hold infants closely
B. Share utensils
C. Limit close contact and follow radiation safety instructions for a few days
D. Ignore precautions
Correct Answer: C. Limit close contact and follow radiation safety instructions for a few days
Rationale: Radiation is excreted in body fluids. Close contact with infants and sharing utensils can
expose others to radiation.
9. Insulin pumps deliver:
A. Long-acting insulin only
B. Continuous basal rapid-acting insulin with bolus doses at meals
C. Oral medication
D. Glucagon only
Correct Answer: B. Continuous basal rapid-acting insulin with bolus doses at meals
Rationale: Pump failure can rapidly cause DKA because there is no long-acting insulin. Pumps use
rapid-acting insulin, not long-acting insulin, oral medication or glucagon.
, 10. Hyperparathyroidism causes:
A. Hypercalcemia, kidney stones and bone pain
B. Hypocalcemia
C. Tetany
D. Weight gain
Correct Answer: A. Hypercalcemia, kidney stones and bone pain
Rationale: Excess parathyroid hormone pulls calcium from bone, causing hypercalcemia, kidney stones,
bone pain, abdominal pain and mood changes ('stones, bones, groans and moans'). Hypocalcemia and
tetany occur with hypoparathyroidism.
11. The hemoglobin A1C reflects:
A. Average blood glucose over about 3 months
B. Glucose today
C. Insulin level
D. Kidney function
Correct Answer: A. Average blood glucose over about 3 months
Rationale: The general goal for most adults is below 7%. It does not reflect today's glucose, insulin levels
or kidney function.
12. A pheochromocytoma causes:
A. Hypotension
B. Weight gain
C. Paroxysmal severe hypertension, headache, palpitations and sweating
D. Bradycardia
Correct Answer: C. Paroxysmal severe hypertension, headache, palpitations and sweating
Rationale: Avoid palpating the abdomen, which may trigger a crisis. Excess catecholamines raise BP and
heart rate rather than lowering them.
Practice Test 2 (Units 8-13) - Questions with Correct Answers
100 questions
1. A client after a craniotomy has urine output of 400 mL/hr with low urine specific gravity. The
nurse suspects:
A. SIADH
B. Acute kidney injury
C. Diabetes insipidus
D. Normal recovery
Correct Answer: C. Diabetes insipidus
Rationale: Injury to the pituitary or hypothalamus can impair ADH release. SIADH causes low urine
output, and AKI does not produce large volumes of very dilute urine after brain surgery.
2. A client with type 1 diabetes is ill and not eating. The nurse should teach to:
A. Stop insulin
B. Avoid fluids
C. Check glucose once a day
D. Continue insulin, monitor glucose and ketones frequently and drink fluids
Correct Answer: D. Continue insulin, monitor glucose and ketones frequently and drink fluids
Rationale: Illness raises glucose; stopping insulin can cause DKA. Stopping insulin is dangerous
because illness hormones raise glucose and ketones even without food.
3. Cushing's triad, a late sign of increased ICP, consists of:
A. Hypertension with widened pulse pressure, bradycardia and irregular respirations
B. Hypotension, tachycardia and tachypnea
C. Fever, rash and stiff neck
D. Hypoglycemia, tremor and sweating
Correct Answer: A. Hypertension with widened pulse pressure, bradycardia and irregular
respirations
Rationale: This triad indicates brainstem compression and impending herniation. It requires immediate
intervention. Hypotension with tachycardia suggests shock, and fever with rash and stiff neck suggests
meningitis.
,4. Hyperthyroidism (Graves' disease) signs include:
A. Cold intolerance and weight gain
B. Bradycardia
C. Constipation
D. Heat intolerance, weight loss, tachycardia and exophthalmos
Correct Answer: D. Heat intolerance, weight loss, tachycardia and exophthalmos
Rationale: Treatment includes antithyroid drugs, radioactive iodine or surgery. Cold intolerance, weight
gain and bradycardia are hypothyroid signs.
5. Clients taking levodopa should avoid large amounts of:
A. Protein at the same time as doses
B. Water
C. Fiber
D. Vitamin C
Correct Answer: A. Protein at the same time as doses
Rationale: Protein competes for absorption; spacing improves effect. Water, fiber and vitamin C do not
compete with levodopa absorption the way protein does.
6. A client with a cervical spinal cord injury at C3-C5 is at greatest risk for:
A. Bladder dysfunction only
B. Leg weakness only
C. Respiratory failure due to phrenic nerve involvement
D. Visual loss
Correct Answer: C. Respiratory failure due to phrenic nerve involvement
Rationale: 'C3, 4, 5 keeps the diaphragm alive.' Bladder dysfunction and leg weakness occur but are not
immediately life-threatening.
,7. Before tPA for ischemic stroke, the nurse must ensure:
A. The client ate recently
B. A CT scan has ruled out hemorrhage and the client is within the treatment window
C. Aspirin was given
D. BP is above 200/120
Correct Answer: B. A CT scan has ruled out hemorrhage and the client is within the treatment
window
Rationale: tPA is generally given within 3 to 4.5 hours of last known well. BP should be below 185/110
before administration to reduce bleeding risk. Recent food intake is not the concern, aspirin is held for 24
hours after tPA, and a BP above 185/110 must be lowered before tPA.
8. Clients receiving radioactive iodine should be taught to:
A. Hold infants closely
B. Share utensils
C. Limit close contact and follow radiation safety instructions for a few days
D. Ignore precautions
Correct Answer: C. Limit close contact and follow radiation safety instructions for a few days
Rationale: Radiation is excreted in body fluids. Close contact with infants and sharing utensils can
expose others to radiation.
9. Insulin pumps deliver:
A. Long-acting insulin only
B. Continuous basal rapid-acting insulin with bolus doses at meals
C. Oral medication
D. Glucagon only
Correct Answer: B. Continuous basal rapid-acting insulin with bolus doses at meals
Rationale: Pump failure can rapidly cause DKA because there is no long-acting insulin. Pumps use
rapid-acting insulin, not long-acting insulin, oral medication or glucagon.
, 10. Hyperparathyroidism causes:
A. Hypercalcemia, kidney stones and bone pain
B. Hypocalcemia
C. Tetany
D. Weight gain
Correct Answer: A. Hypercalcemia, kidney stones and bone pain
Rationale: Excess parathyroid hormone pulls calcium from bone, causing hypercalcemia, kidney stones,
bone pain, abdominal pain and mood changes ('stones, bones, groans and moans'). Hypocalcemia and
tetany occur with hypoparathyroidism.
11. The hemoglobin A1C reflects:
A. Average blood glucose over about 3 months
B. Glucose today
C. Insulin level
D. Kidney function
Correct Answer: A. Average blood glucose over about 3 months
Rationale: The general goal for most adults is below 7%. It does not reflect today's glucose, insulin levels
or kidney function.
12. A pheochromocytoma causes:
A. Hypotension
B. Weight gain
C. Paroxysmal severe hypertension, headache, palpitations and sweating
D. Bradycardia
Correct Answer: C. Paroxysmal severe hypertension, headache, palpitations and sweating
Rationale: Avoid palpating the abdomen, which may trigger a crisis. Excess catecholamines raise BP and
heart rate rather than lowering them.
