NR 324 Adult Health II - Exam 6 Practice 2026 |Chamberlain College
1. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood
glucose of 650 mg/dL and positive ketones in the urine. Which condition is the
patient most likely experiencing?
A. Hyperglycemic Hyperosmolar State (HHS)
B. Dawn Phenomenon
C. Somogyi Effect
D. Diabetic Ketoacidosis (DKA)
Answer: D
Rationale: DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis,
commonly seen in Type 1 diabetics. HHS typically occurs in Type 2 and lacks significant
ketosis.
2. Which nursing intervention is a priority for a patient diagnosed with SIADH?
A. Encouraging increased fluid intake
B. Administering IV bolus of 0.45% Normal Saline
C. Monitoring for polyuria
D. Implementing fluid restriction
Answer: D
Rationale: SIADH involves excessive ADH, leading to water retention and dilutional
hyponatremia. Fluid restriction is the primary treatment to prevent further dilution of
sodium.
,3. A patient with Diabetes Insipidus (DI) is receiving Desmopressin. Which
finding indicates the medication is effective?
A. Increased urine output
B. Decreased urine specific gravity
C. Increased urine specific gravity
D. Decreased serum sodium levels below normal
Answer: C
Rationale: Desmopressin (synthetic ADH) helps the kidneys reabsorb water, which
decreases urine output and increases urine concentration (specific gravity).
4. A nurse is caring for a patient with Graves’ disease. Which clinical
manifestation should the nurse expect?
A. Exophthalmos
B. Weight gain
C. Bradycardia
D. Cold intolerance
Answer: A
Rationale: Graves’ disease is a form of hyperthyroidism. Symptoms include tachycardia,
weight loss, heat intolerance, and exophthalmos (bulging eyes).
5. Which electrolyte imbalance is a patient at risk for after a total thyroidectomy
due to accidental parathyroid removal?
A. Hypocalcemia
B. Hypercalcemia
C. Hyperkalemia
D. Hyponatremia
Answer: A
Rationale: The parathyroid glands regulate calcium. Their removal or damage during
thyroid surgery leads to hypocalcemia, evidenced by tetany or positive Trousseau’s sign.
, 6. A patient with Cushing’s Syndrome is being monitored. Which finding is
consistent with this diagnosis?
A. Postural hypotension
B. Purple striae on the abdomen
C. Hyperpigmentation of the skin
D. Decreased serum glucose
Answer: B
Rationale: Cushing’s Syndrome (excess cortisol) causes central obesity, ‘moon face’,
‘buffalo hump’, hyperglycemia, and purple striae on the skin.
7. A patient with Addison’s disease is admitted with an Addisonian Crisis. What
is the priority nursing action?
A. Administering oral glucose
B. Limiting sodium intake
C. Administering potassium supplements
D. Rapid IV fluid replacement with Normal Saline
Answer: D
Rationale: Addisonian crisis involves severe hypotension and dehydration. Immediate
fluid replacement and corticosteroid administration are vital to prevent circulatory
collapse.
8. What is the peak action time for NPH insulin?
A. 30 to 60 minutes
B. 2 to 4 hours
C. 4 to 12 hours
D. 18 to 24 hours
Answer: C
Rationale: NPH is an intermediate-acting insulin. Its onset is 1-2 hours, and its peak is
typically 4 to 12 hours after administration.
1. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood
glucose of 650 mg/dL and positive ketones in the urine. Which condition is the
patient most likely experiencing?
A. Hyperglycemic Hyperosmolar State (HHS)
B. Dawn Phenomenon
C. Somogyi Effect
D. Diabetic Ketoacidosis (DKA)
Answer: D
Rationale: DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis,
commonly seen in Type 1 diabetics. HHS typically occurs in Type 2 and lacks significant
ketosis.
2. Which nursing intervention is a priority for a patient diagnosed with SIADH?
A. Encouraging increased fluid intake
B. Administering IV bolus of 0.45% Normal Saline
C. Monitoring for polyuria
D. Implementing fluid restriction
Answer: D
Rationale: SIADH involves excessive ADH, leading to water retention and dilutional
hyponatremia. Fluid restriction is the primary treatment to prevent further dilution of
sodium.
,3. A patient with Diabetes Insipidus (DI) is receiving Desmopressin. Which
finding indicates the medication is effective?
A. Increased urine output
B. Decreased urine specific gravity
C. Increased urine specific gravity
D. Decreased serum sodium levels below normal
Answer: C
Rationale: Desmopressin (synthetic ADH) helps the kidneys reabsorb water, which
decreases urine output and increases urine concentration (specific gravity).
4. A nurse is caring for a patient with Graves’ disease. Which clinical
manifestation should the nurse expect?
A. Exophthalmos
B. Weight gain
C. Bradycardia
D. Cold intolerance
Answer: A
Rationale: Graves’ disease is a form of hyperthyroidism. Symptoms include tachycardia,
weight loss, heat intolerance, and exophthalmos (bulging eyes).
5. Which electrolyte imbalance is a patient at risk for after a total thyroidectomy
due to accidental parathyroid removal?
A. Hypocalcemia
B. Hypercalcemia
C. Hyperkalemia
D. Hyponatremia
Answer: A
Rationale: The parathyroid glands regulate calcium. Their removal or damage during
thyroid surgery leads to hypocalcemia, evidenced by tetany or positive Trousseau’s sign.
, 6. A patient with Cushing’s Syndrome is being monitored. Which finding is
consistent with this diagnosis?
A. Postural hypotension
B. Purple striae on the abdomen
C. Hyperpigmentation of the skin
D. Decreased serum glucose
Answer: B
Rationale: Cushing’s Syndrome (excess cortisol) causes central obesity, ‘moon face’,
‘buffalo hump’, hyperglycemia, and purple striae on the skin.
7. A patient with Addison’s disease is admitted with an Addisonian Crisis. What
is the priority nursing action?
A. Administering oral glucose
B. Limiting sodium intake
C. Administering potassium supplements
D. Rapid IV fluid replacement with Normal Saline
Answer: D
Rationale: Addisonian crisis involves severe hypotension and dehydration. Immediate
fluid replacement and corticosteroid administration are vital to prevent circulatory
collapse.
8. What is the peak action time for NPH insulin?
A. 30 to 60 minutes
B. 2 to 4 hours
C. 4 to 12 hours
D. 18 to 24 hours
Answer: C
Rationale: NPH is an intermediate-acting insulin. Its onset is 1-2 hours, and its peak is
typically 4 to 12 hours after administration.
