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NSG 4100 Exam 2 NCLEX Practice (PDF) 2026
Metabolic Disorders
Galen College of Nursing • NCLEX-style • Units 3 & 4
Instructions: Choose the best answer for each question. For SATA questions, select all that apply.
UNIT 3 — Complex Metabolic Problems (1–25)
1. Addison’s Disease
A client with Addison’s disease reports fatigue and dizziness when standing. Which finding should the nurse
expect?
A. Hypertension
B. Orthostatic hypotension
C. Weight gain
D. Hyperglycemia
2. Addisonian Crisis
A client with Addison’s disease suddenly develops severe hypotension, confusion, and vomiting. What is the
nurse’s priority action?
A. Give oral glucocorticoids
B. Start IV fluids and administer IV corticosteroids
C. Restrict fluids
D. Administer potassium chloride
3. Addison’s Labs
Which lab results support the diagnosis of Addison’s disease?
A. Sodium 148, potassium 3.1
B. Sodium 129, potassium 5.8
C. Sodium 146, potassium 5.9
D. Sodium 132, potassium 3.0
4. Cushing’s Syndrome
A client has truncal obesity, thin skin, and easy bruising. Which complication is the nurse most concerned
about?
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A. Infection
B. Hypoglycemia
C. Dehydration
D. Bradycardia
5. Cushing’s Diagnostics
Which diagnostic finding supports Cushing’s syndrome?
A. Increased daily variation in cortisol
B. Low 24-hour urinary cortisol
C. Elevated 24-hour urinary cortisol
D. Decreased blood glucose
6. Cushing’s Electrolytes
The nurse anticipates which electrolyte pattern in Cushing’s syndrome?
A. Hypernatremia and hypokalemia
B. Hyponatremia and hyperkalemia
C. Hypernatremia and hyperkalemia
D. Hyponatremia and hypokalemia
7. Hyperaldosteronism
A client is diagnosed with hyperaldosteronism. Which finding is most expected?
A. Hyperkalemia
B. Hypotension
C. Hyponatremia
D. Hypokalemia
8. Hypoaldosteronism
A client has low aldosterone production. Which assessment finding is most expected?
A. Hypertension
B. Hyperkalemia
C. Hypokalemia
D. Hypernatremia
9. Diabetes Insipidus
A client with head trauma is producing 700 mL/hr of urine. Which order should the nurse anticipate?
A. Desmopressin
B. Fluid restriction
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C. Hypertonic saline
D. Mannitol
10. DI Expected Findings
Which finding is most consistent with diabetes insipidus?
A. Concentrated urine
B. Decreased urine output
C. Dilute urine and high urine output
D. Hyponatremia with fluid overload
11. SIADH
A client has SIADH. Which assessment finding should the nurse expect?
A. Increased serum osmolality
B. Decreased urine osmolality
C. Hyponatremia
D. Excessive thirst and dehydration
12. SIADH Priority
A client with SIADH has sodium 117 mEq/L and is confused. What is the nurse’s priority intervention?
A. Encourage oral fluids
B. Initiate seizure precautions
C. Give hypotonic IV fluids
D. Administer loop diuretics without monitoring
13. SIADH vs DI
Which finding best differentiates SIADH from DI?
A. Increased urine output
B. Low serum osmolality
C. Hyperglycemia
D. Hypokalemia
14. Pheochromocytoma
A client reports sudden episodes of headache, palpitations, and sweating. Which additional finding supports
pheochromocytoma?
A. Bradycardia
B. Episodic hypertension
C. Low temperature
NSG 4100 Exam 2 NCLEX Practice (PDF) 2026
Metabolic Disorders
Galen College of Nursing • NCLEX-style • Units 3 & 4
Instructions: Choose the best answer for each question. For SATA questions, select all that apply.
UNIT 3 — Complex Metabolic Problems (1–25)
1. Addison’s Disease
A client with Addison’s disease reports fatigue and dizziness when standing. Which finding should the nurse
expect?
A. Hypertension
B. Orthostatic hypotension
C. Weight gain
D. Hyperglycemia
2. Addisonian Crisis
A client with Addison’s disease suddenly develops severe hypotension, confusion, and vomiting. What is the
nurse’s priority action?
A. Give oral glucocorticoids
B. Start IV fluids and administer IV corticosteroids
C. Restrict fluids
D. Administer potassium chloride
3. Addison’s Labs
Which lab results support the diagnosis of Addison’s disease?
A. Sodium 148, potassium 3.1
B. Sodium 129, potassium 5.8
C. Sodium 146, potassium 5.9
D. Sodium 132, potassium 3.0
4. Cushing’s Syndrome
A client has truncal obesity, thin skin, and easy bruising. Which complication is the nurse most concerned
about?
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A. Infection
B. Hypoglycemia
C. Dehydration
D. Bradycardia
5. Cushing’s Diagnostics
Which diagnostic finding supports Cushing’s syndrome?
A. Increased daily variation in cortisol
B. Low 24-hour urinary cortisol
C. Elevated 24-hour urinary cortisol
D. Decreased blood glucose
6. Cushing’s Electrolytes
The nurse anticipates which electrolyte pattern in Cushing’s syndrome?
A. Hypernatremia and hypokalemia
B. Hyponatremia and hyperkalemia
C. Hypernatremia and hyperkalemia
D. Hyponatremia and hypokalemia
7. Hyperaldosteronism
A client is diagnosed with hyperaldosteronism. Which finding is most expected?
A. Hyperkalemia
B. Hypotension
C. Hyponatremia
D. Hypokalemia
8. Hypoaldosteronism
A client has low aldosterone production. Which assessment finding is most expected?
A. Hypertension
B. Hyperkalemia
C. Hypokalemia
D. Hypernatremia
9. Diabetes Insipidus
A client with head trauma is producing 700 mL/hr of urine. Which order should the nurse anticipate?
A. Desmopressin
B. Fluid restriction
, lOMoAR cPSD| 65448581
C. Hypertonic saline
D. Mannitol
10. DI Expected Findings
Which finding is most consistent with diabetes insipidus?
A. Concentrated urine
B. Decreased urine output
C. Dilute urine and high urine output
D. Hyponatremia with fluid overload
11. SIADH
A client has SIADH. Which assessment finding should the nurse expect?
A. Increased serum osmolality
B. Decreased urine osmolality
C. Hyponatremia
D. Excessive thirst and dehydration
12. SIADH Priority
A client with SIADH has sodium 117 mEq/L and is confused. What is the nurse’s priority intervention?
A. Encourage oral fluids
B. Initiate seizure precautions
C. Give hypotonic IV fluids
D. Administer loop diuretics without monitoring
13. SIADH vs DI
Which finding best differentiates SIADH from DI?
A. Increased urine output
B. Low serum osmolality
C. Hyperglycemia
D. Hypokalemia
14. Pheochromocytoma
A client reports sudden episodes of headache, palpitations, and sweating. Which additional finding supports
pheochromocytoma?
A. Bradycardia
B. Episodic hypertension
C. Low temperature
