NR 324 Adult Health II Practice Final Exam 2026 |Chamberlain College
1. A patient with Diabetic Ketoacidosis (DKA) has a serum glucose level of 600
mg/dL and a potassium level of 3.2 mEq/L. Which provider order should the
nurse implement first?
A. Administer 20 units of regular insulin IV push
B. Administer potassium chloride 40 mEq IVPB
C. Infuse 0.9% Normal Saline at 1000 mL/hr
D. Check urine for ketones every 4 hours
Answer: C
Rationale: Fluid resuscitation is the immediate priority in DKA to restore circulatory
volume and stabilize blood pressure before correcting electrolyte imbalances or high
glucose.
2. Which clinical manifestation is a hallmark sign of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Excessive thirst and polydipsia
B. Hypernatremia and high urine output
C. Dilutional hyponatremia and low urine output
D. Dehydration and weight loss
Answer: C
Rationale: SIADH involves excessive ADH, leading to water retention, concentrated urine,
and dilutional hyponatremia.
,3. A client with Diabetes Insipidus (DI) is prescribed Desmopressin (DDAVP).
Which finding indicates the medication is effective?
A. Decreased urine specific gravity
B. Increased serum sodium levels
C. Decreased urinary output and increased specific gravity
D. Rapid weight loss and hypotension
Answer: C
Rationale: DDAVP acts as synthetic ADH, which helps the kidneys reabsorb water, thereby
decreasing urine volume and increasing urine concentration (specific gravity).
4. A patient in a thyroid storm is most likely to exhibit which of the following
vital sign patterns?
A. Hypotension, bradycardia, and hypothermia
B. Hypertension, tachycardia, and hyperpyrexia
C. Normotension, bradypnea, and normal temperature
D. Hypertension, bradycardia, and Cheyne-Stokes respirations
Answer: B
Rationale: Thyroid storm is an extreme state of hyperthyroidism characterized by a
hypermetabolic state, causing high fever, rapid heart rate, and high blood pressure.
5. When assessing a patient with Cushing’s Syndrome, which physical
characteristic does the nurse expect to observe?
A. Bronze skin pigmentation and weight loss
B. Thin, frail body frame and hypotension
C. Exophthalmos and pretibial myxedema
D. Moon face, buffalo hump, and truncal obesity
Answer: D
Rationale: Excessive cortisol in Cushing’s Syndrome leads to fat redistribution to the face
and upper back, along with central obesity.
, 6. A nurse identifies ‘failure to capture’ on a patient’s cardiac monitor. What is
the appropriate interpretation of this finding?
A. The pacemaker is sensing extra electrical activity in the room
B. The heart is firing but the pacemaker is not sensing it
C. The pacemaker battery has completely failed
D. The pacemaker is firing but the heart muscle is not responding
Answer: D
Rationale: Failure to capture occurs when the electrical spike is present on the ECG, but it
is not followed by a QRS complex, meaning the myocardium did not depolarize.
7. Which intervention is a priority for a patient in Ventricular Fibrillation (V-fib)?
A. Administering IV Amiodarone
B. Performing a synchronized cardioversion
C. Intubation and mechanical ventilation
D. Immediate defibrillation
Answer: D
Rationale: V-fib is a lethal rhythm where the ventricles quiver without effective
contraction; the only way to restore a rhythm is immediate defibrillation.
8. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.8
mEq/L. Which medication should the nurse anticipate administering to quickly
shift potassium into the cells?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Regular insulin and 50% Dextrose IV
D. Spironolactone (Aldactone)
Answer: C
Rationale: Regular insulin shifts potassium from the extracellular fluid into the
intracellular fluid, while dextrose prevents hypoglycemia during the process.
1. A patient with Diabetic Ketoacidosis (DKA) has a serum glucose level of 600
mg/dL and a potassium level of 3.2 mEq/L. Which provider order should the
nurse implement first?
A. Administer 20 units of regular insulin IV push
B. Administer potassium chloride 40 mEq IVPB
C. Infuse 0.9% Normal Saline at 1000 mL/hr
D. Check urine for ketones every 4 hours
Answer: C
Rationale: Fluid resuscitation is the immediate priority in DKA to restore circulatory
volume and stabilize blood pressure before correcting electrolyte imbalances or high
glucose.
2. Which clinical manifestation is a hallmark sign of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Excessive thirst and polydipsia
B. Hypernatremia and high urine output
C. Dilutional hyponatremia and low urine output
D. Dehydration and weight loss
Answer: C
Rationale: SIADH involves excessive ADH, leading to water retention, concentrated urine,
and dilutional hyponatremia.
,3. A client with Diabetes Insipidus (DI) is prescribed Desmopressin (DDAVP).
Which finding indicates the medication is effective?
A. Decreased urine specific gravity
B. Increased serum sodium levels
C. Decreased urinary output and increased specific gravity
D. Rapid weight loss and hypotension
Answer: C
Rationale: DDAVP acts as synthetic ADH, which helps the kidneys reabsorb water, thereby
decreasing urine volume and increasing urine concentration (specific gravity).
4. A patient in a thyroid storm is most likely to exhibit which of the following
vital sign patterns?
A. Hypotension, bradycardia, and hypothermia
B. Hypertension, tachycardia, and hyperpyrexia
C. Normotension, bradypnea, and normal temperature
D. Hypertension, bradycardia, and Cheyne-Stokes respirations
Answer: B
Rationale: Thyroid storm is an extreme state of hyperthyroidism characterized by a
hypermetabolic state, causing high fever, rapid heart rate, and high blood pressure.
5. When assessing a patient with Cushing’s Syndrome, which physical
characteristic does the nurse expect to observe?
A. Bronze skin pigmentation and weight loss
B. Thin, frail body frame and hypotension
C. Exophthalmos and pretibial myxedema
D. Moon face, buffalo hump, and truncal obesity
Answer: D
Rationale: Excessive cortisol in Cushing’s Syndrome leads to fat redistribution to the face
and upper back, along with central obesity.
, 6. A nurse identifies ‘failure to capture’ on a patient’s cardiac monitor. What is
the appropriate interpretation of this finding?
A. The pacemaker is sensing extra electrical activity in the room
B. The heart is firing but the pacemaker is not sensing it
C. The pacemaker battery has completely failed
D. The pacemaker is firing but the heart muscle is not responding
Answer: D
Rationale: Failure to capture occurs when the electrical spike is present on the ECG, but it
is not followed by a QRS complex, meaning the myocardium did not depolarize.
7. Which intervention is a priority for a patient in Ventricular Fibrillation (V-fib)?
A. Administering IV Amiodarone
B. Performing a synchronized cardioversion
C. Intubation and mechanical ventilation
D. Immediate defibrillation
Answer: D
Rationale: V-fib is a lethal rhythm where the ventricles quiver without effective
contraction; the only way to restore a rhythm is immediate defibrillation.
8. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.8
mEq/L. Which medication should the nurse anticipate administering to quickly
shift potassium into the cells?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Regular insulin and 50% Dextrose IV
D. Spironolactone (Aldactone)
Answer: C
Rationale: Regular insulin shifts potassium from the extracellular fluid into the
intracellular fluid, while dextrose prevents hypoglycemia during the process.
