NSG 4100 Exam 2 Actual Updated 2026 With Detailed Answers
,
,SECTION 1: CUSHING'S SYNDROME - PATHOPHYSIOLOGY &
ASSESSMENT (Questions 1-30)
Question 1:
The nurse is caring for someone with adrenal hyperfunction who
screams at her spouse, bursts into tears, and screams at the wall. The
client tells the nurse "I feel like I'm going crazy." Which of the following
is the appropriate response for the nurse to make?
A) "You feel like this because of your hormone levels"
B) "I will close the door to your room and restrict visitors"
C) "I will bring you information about support groups"
D) "I will ask your doctor about ordering a psychiatric consult"
Answer: A) "You feel like this because of your hormone levels"
Rationale: Cushing's syndrome causes emotional lability, irritability,
depression, and even psychosis due to excess cortisol affecting the
central nervous system. The most therapeutic response is to provide
reassurance and education that these feelings are related to the
disease process, not a psychiatric illness. This validates the client's
experience while reducing anxiety and potential stigma. Closing the
door or restricting visitors may increase isolation. Support groups are
helpful but not the immediate priority. A psychiatric consult may
eventually be needed but the first response should be education and
reassurance.
, Question 2:
The nurse is caring for a client who is taking high doses of
corticosteroids therapy and asks the nurse, "Why do I need to keep
taking the steroids when I no longer feel bad?" Which of the following is
an appropriate response for the nurse to make?
A) "You must decrease the steroids so that way your hormones work
again"
B) "Once you start steroids you have to get weaned off of them"
C) "It is possible for the inflammation to reoccur if you stopped the
drug"
D) "The drug suppresses your immune system that needs to be built
back up"
Answer: B) "Once you start steroids you have to get weaned off of
them"
Rationale: Corticosteroids suppress the hypothalamic-pituitary-
adrenal (HPA) axis, leading to adrenal atrophy. Abrupt cessation can
cause acute adrenal insufficiency (addisonian crisis). The medications
must be tapered gradually to allow the adrenal glands to resume
normal function. While inflammation recurrence (C) is a concern, the
primary reason for tapering is to prevent adrenal crisis. The other
options are incorrect or incomplete explanations.
Question 3:
The nurse is caring for a client who has Cushing's syndrome. Which of
,
,SECTION 1: CUSHING'S SYNDROME - PATHOPHYSIOLOGY &
ASSESSMENT (Questions 1-30)
Question 1:
The nurse is caring for someone with adrenal hyperfunction who
screams at her spouse, bursts into tears, and screams at the wall. The
client tells the nurse "I feel like I'm going crazy." Which of the following
is the appropriate response for the nurse to make?
A) "You feel like this because of your hormone levels"
B) "I will close the door to your room and restrict visitors"
C) "I will bring you information about support groups"
D) "I will ask your doctor about ordering a psychiatric consult"
Answer: A) "You feel like this because of your hormone levels"
Rationale: Cushing's syndrome causes emotional lability, irritability,
depression, and even psychosis due to excess cortisol affecting the
central nervous system. The most therapeutic response is to provide
reassurance and education that these feelings are related to the
disease process, not a psychiatric illness. This validates the client's
experience while reducing anxiety and potential stigma. Closing the
door or restricting visitors may increase isolation. Support groups are
helpful but not the immediate priority. A psychiatric consult may
eventually be needed but the first response should be education and
reassurance.
, Question 2:
The nurse is caring for a client who is taking high doses of
corticosteroids therapy and asks the nurse, "Why do I need to keep
taking the steroids when I no longer feel bad?" Which of the following is
an appropriate response for the nurse to make?
A) "You must decrease the steroids so that way your hormones work
again"
B) "Once you start steroids you have to get weaned off of them"
C) "It is possible for the inflammation to reoccur if you stopped the
drug"
D) "The drug suppresses your immune system that needs to be built
back up"
Answer: B) "Once you start steroids you have to get weaned off of
them"
Rationale: Corticosteroids suppress the hypothalamic-pituitary-
adrenal (HPA) axis, leading to adrenal atrophy. Abrupt cessation can
cause acute adrenal insufficiency (addisonian crisis). The medications
must be tapered gradually to allow the adrenal glands to resume
normal function. While inflammation recurrence (C) is a concern, the
primary reason for tapering is to prevent adrenal crisis. The other
options are incorrect or incomplete explanations.
Question 3:
The nurse is caring for a client who has Cushing's syndrome. Which of
