Nursing Exam 3 Study Guide 2026: Free
Endocrine & Renal NCLEX Practice Q&A
Description:
Struggling to master the complex topics for your Nursing Exam 3? This targeted study guide is
specifically designed for nursing students reviewing Endocrine Disorders (like Thyroid,
Cushing's, and Addison's), Renal Function (AKI, CKD), and Acid-Base Balance. Our
resource provides updated 2026 practice questions with detailed rationales that mirror the style
and difficulty of the NCLEX-RN® and nursing school exams.
Inside, you'll find a focused review of critical content, including:
Thyroid Storm vs. Myxedema Coma: Differentiate key symptoms and emergency
interventions.
ABG Interpretation: Master Uncompensated, Partially, and Fully Compensated imbalances
with real-world scenarios.
Adrenal Gland Disorders: Confidently answer questions on Cushing's Syndrome and
Addisonian Crisis.
Acute & Chronic Kidney Injury: Identify stages, lab values, and priority nursing actions.
Stop searching through endless, unverified notes.
Download your free targeted practice test now and walk into your exam with confidence!
, Nursing Exam 3 Practice: Endocrine, Renal & Acid-Base NCLEX
Questions (2026)
1. A nurse is providing care for a client who presents with confusion and lethargy. The client was
discovered at home unresponsive, with an empty bottle of aspirin nearby. Vital signs include BP
100/58 mmHg, HR 122/min and regular, RR 36/min and deep. Which arterial blood gas (ABG)
result should the nurse anticipate?
A.) pH: 7.65, PaO2: 98 mmHg, PaCO2: 36 mmHg, HCO3: 30 mEq/L
B.) pH: 7.50, PaO2: 99 mmHg, PaCO2: 30 mmHg, HCO3: 24 mEq/L
C.) pH: 7.10, PaO2: 99 mmHg, PaCO2: 32 mmHg, HCO3: 16 mEq/L
D.) pH: 7.55, PaO2: 97 mmHg, PaCO2: 36 mmHg, HCO3: 30 mEq/L
Answer: C
Explanation: Aspirin toxicity initially causes respiratory alkalosis due to direct stimulation of
the respiratory center. However, as the toxicity progresses, it leads to a metabolic acidosis from
the accumulation of lactic acid and ketoacids, resulting in a low pH and low bicarbonate level, as
seen in option C.
2. A nurse is assessing a client involved in a motor vehicle collision who reports chest pain and
dyspnea. A chest x-ray confirms a pneumothorax. Which ABG finding is most likely?
A.) pH: 7.08, PaO2: 88 mmHg, PaCO2: 54 mmHg, HCO3: 25 mEq/L
B.) pH: 7.40, PaO2: 95 mmHg, PaCO2: 40 mmHg, HCO3: 24 mEq/L
C.) pH: 7.52, PaO2: 98 mmHg, PaCO2: 32 mmHg, HCO3: 22 mEq/L
D.) pH: 7.32, PaO2: 85 mmHg, PaCO2: 48 mmHg, HCO3: 26 mEq/L
Answer: A
Explanation: A pneumothorax impairs gas exchange and can lead to alveolar hypoventilation.
This causes carbon dioxide retention, resulting in respiratory acidosis, characterized by a low pH
and elevated PaCO2, as indicated in option A.
, 3. A nurse is reviewing arterial blood gas results for a client who has been vomiting for 24 hours.
Which acid-base imbalance is the most probable outcome?
A.) Respiratory Acidosis
B.) Metabolic Alkalosis
C.) Respiratory Alkalosis
D.) Metabolic Acidosis
Answer: B
Explanation: Prolonged vomiting leads to a loss of gastric acid (hydrogen ions), which causes a
relative increase in bicarbonate concentration in the blood, resulting in metabolic alkalosis.
4. A charge nurse is educating a group of nurses on conditions associated with metabolic acidosis.
Which statement by a nurse indicates a correct understanding?
a. "Metabolic acidosis can occur due to diabetic ketoacidosis (DKA)."
b. "Metabolic acidosis can occur in a client with myasthenia gravis."
c. "Metabolic acidosis can occur in a client with asthma."
d. "Metabolic acidosis can occur due to cancer."
Answer: A
Explanation: Metabolic acidosis results from an accumulation of acid or a loss of bicarbonate.
In DKA, an excess production of ketoacids leads to a high anion gap metabolic acidosis.
5. A nurse is caring for a client with pancreatitis whose ABG results show metabolic acidosis.
Which clinical findings should the nurse expect? (Select all that apply)
a. Tachycardia
b. Hypertension
c. Bounding pulses
d. Hyperreflexia
e. Dysrhythmia
f. Tachypnea
Answer: E, F
Explanation: In metabolic acidosis, the body attempts to compensate by increasing the rate and
Endocrine & Renal NCLEX Practice Q&A
Description:
Struggling to master the complex topics for your Nursing Exam 3? This targeted study guide is
specifically designed for nursing students reviewing Endocrine Disorders (like Thyroid,
Cushing's, and Addison's), Renal Function (AKI, CKD), and Acid-Base Balance. Our
resource provides updated 2026 practice questions with detailed rationales that mirror the style
and difficulty of the NCLEX-RN® and nursing school exams.
Inside, you'll find a focused review of critical content, including:
Thyroid Storm vs. Myxedema Coma: Differentiate key symptoms and emergency
interventions.
ABG Interpretation: Master Uncompensated, Partially, and Fully Compensated imbalances
with real-world scenarios.
Adrenal Gland Disorders: Confidently answer questions on Cushing's Syndrome and
Addisonian Crisis.
Acute & Chronic Kidney Injury: Identify stages, lab values, and priority nursing actions.
Stop searching through endless, unverified notes.
Download your free targeted practice test now and walk into your exam with confidence!
, Nursing Exam 3 Practice: Endocrine, Renal & Acid-Base NCLEX
Questions (2026)
1. A nurse is providing care for a client who presents with confusion and lethargy. The client was
discovered at home unresponsive, with an empty bottle of aspirin nearby. Vital signs include BP
100/58 mmHg, HR 122/min and regular, RR 36/min and deep. Which arterial blood gas (ABG)
result should the nurse anticipate?
A.) pH: 7.65, PaO2: 98 mmHg, PaCO2: 36 mmHg, HCO3: 30 mEq/L
B.) pH: 7.50, PaO2: 99 mmHg, PaCO2: 30 mmHg, HCO3: 24 mEq/L
C.) pH: 7.10, PaO2: 99 mmHg, PaCO2: 32 mmHg, HCO3: 16 mEq/L
D.) pH: 7.55, PaO2: 97 mmHg, PaCO2: 36 mmHg, HCO3: 30 mEq/L
Answer: C
Explanation: Aspirin toxicity initially causes respiratory alkalosis due to direct stimulation of
the respiratory center. However, as the toxicity progresses, it leads to a metabolic acidosis from
the accumulation of lactic acid and ketoacids, resulting in a low pH and low bicarbonate level, as
seen in option C.
2. A nurse is assessing a client involved in a motor vehicle collision who reports chest pain and
dyspnea. A chest x-ray confirms a pneumothorax. Which ABG finding is most likely?
A.) pH: 7.08, PaO2: 88 mmHg, PaCO2: 54 mmHg, HCO3: 25 mEq/L
B.) pH: 7.40, PaO2: 95 mmHg, PaCO2: 40 mmHg, HCO3: 24 mEq/L
C.) pH: 7.52, PaO2: 98 mmHg, PaCO2: 32 mmHg, HCO3: 22 mEq/L
D.) pH: 7.32, PaO2: 85 mmHg, PaCO2: 48 mmHg, HCO3: 26 mEq/L
Answer: A
Explanation: A pneumothorax impairs gas exchange and can lead to alveolar hypoventilation.
This causes carbon dioxide retention, resulting in respiratory acidosis, characterized by a low pH
and elevated PaCO2, as indicated in option A.
, 3. A nurse is reviewing arterial blood gas results for a client who has been vomiting for 24 hours.
Which acid-base imbalance is the most probable outcome?
A.) Respiratory Acidosis
B.) Metabolic Alkalosis
C.) Respiratory Alkalosis
D.) Metabolic Acidosis
Answer: B
Explanation: Prolonged vomiting leads to a loss of gastric acid (hydrogen ions), which causes a
relative increase in bicarbonate concentration in the blood, resulting in metabolic alkalosis.
4. A charge nurse is educating a group of nurses on conditions associated with metabolic acidosis.
Which statement by a nurse indicates a correct understanding?
a. "Metabolic acidosis can occur due to diabetic ketoacidosis (DKA)."
b. "Metabolic acidosis can occur in a client with myasthenia gravis."
c. "Metabolic acidosis can occur in a client with asthma."
d. "Metabolic acidosis can occur due to cancer."
Answer: A
Explanation: Metabolic acidosis results from an accumulation of acid or a loss of bicarbonate.
In DKA, an excess production of ketoacids leads to a high anion gap metabolic acidosis.
5. A nurse is caring for a client with pancreatitis whose ABG results show metabolic acidosis.
Which clinical findings should the nurse expect? (Select all that apply)
a. Tachycardia
b. Hypertension
c. Bounding pulses
d. Hyperreflexia
e. Dysrhythmia
f. Tachypnea
Answer: E, F
Explanation: In metabolic acidosis, the body attempts to compensate by increasing the rate and
