NSG-320 Exam 1: (Latest 2026/2027 Update) Cystic Fibrosis, Diabetes,
Thyroid Disorders, Electrolyte Imbalances, ABGs, Respiratory Diagnostics,
Trauma & Surgery | Q&A | Grade A | 100% Correct (Verified Answers) –
Nursing Program
Subject: Medical-Surgical Nursing – Cystic Fibrosis Interventions; Prediabetes & Metabolic Syndrome; Diabetes Mellitus
(Diagnostics, Insulin Types, Complications, SICK Day Management); Thyroid Disorders (Hypothyroidism/Hyperthyroidism,
Graves', Medications); Trauma Center Levels (1-4); Surgery Classifications; Anesthesia Types; Malignant Hyperthermia; Fluid &
Electrolyte Imbalances (Na, K, Ca, Mg, Phos, FVD/FVE); ABG Interpretation; Respiratory Diagnostics (CXR, CT, MRI, V/Q, PET,
Bronchoscopy, PFTs, Thoracentesis); Asthma Medications; COPD (Chronic Bronchitis, Emphysema); Pneumonia & TB
Interventions
Source: NSG-320 Exam 1 Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
Total Questions: 100+ (All processed – no omissions)
1. What are nursing interventions for cystic fibrosis?
Correct Answer: Pulmonary: aerosol/nebulizer treatments, CPT (postural drainage with percussion/vibration),
PEP devices (Flutter), O2 therapy in severe disease, antibiotics (long course, implanted ports). Pancreatic
insufficiency: enzyme replacement (Pancreaze, Creon, Ultresa) before each meal/snack, vitamin supplements (A,
D, E, K), diet high in fat/calories/protein/vitamins, added salt with excessive sweating. Diabetes: administer
insulin.
1. Mucus plugging is primary problem; CPT and nebulizers help clear secretions.
2. Pancreatic enzymes must be taken with ALL meals and snacks.
2. What is meconium ileus?
Correct Answer: A bowel obstruction that occurs when meconium is thicker and stickier than normal, creating
a blockage in the ileum. Most infants with meconium ileus have cystic fibrosis.
1. May be first sign of CF in newborns.
2. Presents with abdominal distension, failure to pass meconium, vomiting.
3. What is prediabetes?
Correct Answer: A condition in which blood sugar is higher than normal but not high enough to be classified
as type 2 diabetes. Includes impaired glucose tolerance (2-hour plasma glucose 140-199 mg/dL) and/or
impaired fasting glucose (fasting blood glucose 100-125 mg/dL).
1. Education vital to prevent progression to type 2 DM.
2. Screening and risk factor management essential.
4. What are the features of metabolic syndrome (syndrome X)?
Correct Answer: Abdominal obesity; hyperglycemia fasting >100; hypertension >130/85; hyperlipidemia
(triglycerides >150, HDL <40-50); abnormal A1C 5.5%-6.5%.
1. Associated with type 2 diabetes and cardiovascular disease.
2. Lifestyle modifications reduce risk.
5. What are diabetes diagnostic criteria?
Correct Answer: A1C ≥6.5%; FPG ≥126 mg/dL; 2-hour OGTT ≥200 mg/dL; classic hyperglycemia symptoms
with random glucose ≥200 mg/dL.
1. Normal blood sugar: 74-106 mg/dL.
2. Confirmation requires repeat testing unless symptomatic.
, 6. What are microvascular and macrovascular diabetic complications?
Correct Answer: Microvascular: eye/vision changes (retinopathy), diabetic peripheral neuropathy, diabetic
nephropathy (microalbuminuria), male ED, cognitive dysfunction. Macrovascular: cardiovascular disease, stroke,
heart attack, sudden death.
1. Strict glucose control reduces microvascular complications.
2. BP and lipid management reduce macrovascular risk.
7. What are signs/symptoms of hyperglycemia and hypoglycemia?
Correct Answer: Hyperglycemia (>200): "Hot and dry – sugar is high" – warm moist skin, dehydration, positive
urine ketones/glucose. Hypoglycemia (<70): "Cold and clammy – need some candy" – cool clammy sweaty skin,
hungry, anxious, shaky, irritable, confusion, seizures, coma.
1. Rule of 15 for hypoglycemia: 15g carbs, recheck in 15 minutes.
2. Sliding scale insulin if BS >250.
8. What are the types of insulin?
Correct Answer: Rapid-acting (lispro, aspart, glulisine): onset 10-30 min, peak 30 min-3 hr, duration 3-5 hr –
inject within 15 min of meal. Short-acting (Regular): onset 30-60 min, peak 2-5 hr, duration 5-8 hr – 30-45 min
before meal. Intermediate (NPH): onset 1.5-4 hr, peak 4-12 hr, duration 12-18 hr – cloudy, can mix. Long-acting
(glargine, detemir, degludec): onset 0.8-4 hr, peak none, duration 16-24 hr – do NOT mix.
1. Basal-bolus regimen mimics normal pancreas.
2. Mealtime insulin provides additional coverage for meals.
9. What are the Somogyi effect and dawn phenomenon?
Correct Answer: Somogyi: insulin overdose causes nocturnal hypoglycemia → counterregulatory hormones →
rebound hyperglycemia (check 2-4am). Dawn phenomenon: morning hyperglycemia from growth hormone and
cortisol release; more common in adolescence. Treatment: Somogyi – reduce insulin or bedtime snack; dawn –
increase insulin or adjust timing.
1. Check blood glucose between 2-4am to differentiate.
2. Somogyi may cause headaches, night sweats, nightmares.
10. What is SICK day management for diabetes?
Correct Answer: S: Sugar – check BS every 2-3 hours. I: Insulin – ALWAYS take insulin. C: Carbs – drink lots of
fluids; sugar-free if high, carb-containing if low. K: Ketones – check urine ketones every 4 hours (if BS >240);
take rapid-acting insulin if ketones present. Danger signals: persistent N/V, moderate/large ketones, elevated
BS after two supplement doses, high fever >24 hours.
1. Never omit insulin during illness – risk of DKA.
2. Encourage hydration to prevent dehydration.
11. What is hypothyroidism?
Correct Answer: Deficiency of thyroid hormone causing general slowing of metabolic rate. Primary: destruction
of thyroid tissue or defective hormone synthesis (Hashimoto's). Secondary: pituitary disease or hypothalamic
dysfunction. Manifestations: fatigue, weight gain, cold intolerance, constipation, decreased cardiac output,
increased cholesterol, anemia. TSH elevated (>4.5), normal T4.
1. Treatment: levothyroxine (Synthroid) lifelong.
2. Monitor HR – report pulse >100 or irregular; report chest pain, weight loss, nervousness, tremors, insomnia (over-replacement).
12. What is hyperthyroidism?
Correct Answer: Sustained increase in thyroid hormone synthesis/release. Causes: Graves' disease, toxic
nodular goiter, thyroiditis, excess iodine, pituitary tumors. Manifestations: goiter, exophthalmos (usually not
reversible), weight loss, nervousness, tachycardia, systolic hypertension, heat intolerance, tremors, insomnia.
TSH low/undetectable, T4 elevated.
1. Anti-thyroid drugs (PTU, methimazole) – initial treatment, inhibit iodine binding.
2. Propranolol (beta-blocker) – supportive therapy for palpitations/tachycardia.
Thyroid Disorders, Electrolyte Imbalances, ABGs, Respiratory Diagnostics,
Trauma & Surgery | Q&A | Grade A | 100% Correct (Verified Answers) –
Nursing Program
Subject: Medical-Surgical Nursing – Cystic Fibrosis Interventions; Prediabetes & Metabolic Syndrome; Diabetes Mellitus
(Diagnostics, Insulin Types, Complications, SICK Day Management); Thyroid Disorders (Hypothyroidism/Hyperthyroidism,
Graves', Medications); Trauma Center Levels (1-4); Surgery Classifications; Anesthesia Types; Malignant Hyperthermia; Fluid &
Electrolyte Imbalances (Na, K, Ca, Mg, Phos, FVD/FVE); ABG Interpretation; Respiratory Diagnostics (CXR, CT, MRI, V/Q, PET,
Bronchoscopy, PFTs, Thoracentesis); Asthma Medications; COPD (Chronic Bronchitis, Emphysema); Pneumonia & TB
Interventions
Source: NSG-320 Exam 1 Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
Total Questions: 100+ (All processed – no omissions)
1. What are nursing interventions for cystic fibrosis?
Correct Answer: Pulmonary: aerosol/nebulizer treatments, CPT (postural drainage with percussion/vibration),
PEP devices (Flutter), O2 therapy in severe disease, antibiotics (long course, implanted ports). Pancreatic
insufficiency: enzyme replacement (Pancreaze, Creon, Ultresa) before each meal/snack, vitamin supplements (A,
D, E, K), diet high in fat/calories/protein/vitamins, added salt with excessive sweating. Diabetes: administer
insulin.
1. Mucus plugging is primary problem; CPT and nebulizers help clear secretions.
2. Pancreatic enzymes must be taken with ALL meals and snacks.
2. What is meconium ileus?
Correct Answer: A bowel obstruction that occurs when meconium is thicker and stickier than normal, creating
a blockage in the ileum. Most infants with meconium ileus have cystic fibrosis.
1. May be first sign of CF in newborns.
2. Presents with abdominal distension, failure to pass meconium, vomiting.
3. What is prediabetes?
Correct Answer: A condition in which blood sugar is higher than normal but not high enough to be classified
as type 2 diabetes. Includes impaired glucose tolerance (2-hour plasma glucose 140-199 mg/dL) and/or
impaired fasting glucose (fasting blood glucose 100-125 mg/dL).
1. Education vital to prevent progression to type 2 DM.
2. Screening and risk factor management essential.
4. What are the features of metabolic syndrome (syndrome X)?
Correct Answer: Abdominal obesity; hyperglycemia fasting >100; hypertension >130/85; hyperlipidemia
(triglycerides >150, HDL <40-50); abnormal A1C 5.5%-6.5%.
1. Associated with type 2 diabetes and cardiovascular disease.
2. Lifestyle modifications reduce risk.
5. What are diabetes diagnostic criteria?
Correct Answer: A1C ≥6.5%; FPG ≥126 mg/dL; 2-hour OGTT ≥200 mg/dL; classic hyperglycemia symptoms
with random glucose ≥200 mg/dL.
1. Normal blood sugar: 74-106 mg/dL.
2. Confirmation requires repeat testing unless symptomatic.
, 6. What are microvascular and macrovascular diabetic complications?
Correct Answer: Microvascular: eye/vision changes (retinopathy), diabetic peripheral neuropathy, diabetic
nephropathy (microalbuminuria), male ED, cognitive dysfunction. Macrovascular: cardiovascular disease, stroke,
heart attack, sudden death.
1. Strict glucose control reduces microvascular complications.
2. BP and lipid management reduce macrovascular risk.
7. What are signs/symptoms of hyperglycemia and hypoglycemia?
Correct Answer: Hyperglycemia (>200): "Hot and dry – sugar is high" – warm moist skin, dehydration, positive
urine ketones/glucose. Hypoglycemia (<70): "Cold and clammy – need some candy" – cool clammy sweaty skin,
hungry, anxious, shaky, irritable, confusion, seizures, coma.
1. Rule of 15 for hypoglycemia: 15g carbs, recheck in 15 minutes.
2. Sliding scale insulin if BS >250.
8. What are the types of insulin?
Correct Answer: Rapid-acting (lispro, aspart, glulisine): onset 10-30 min, peak 30 min-3 hr, duration 3-5 hr –
inject within 15 min of meal. Short-acting (Regular): onset 30-60 min, peak 2-5 hr, duration 5-8 hr – 30-45 min
before meal. Intermediate (NPH): onset 1.5-4 hr, peak 4-12 hr, duration 12-18 hr – cloudy, can mix. Long-acting
(glargine, detemir, degludec): onset 0.8-4 hr, peak none, duration 16-24 hr – do NOT mix.
1. Basal-bolus regimen mimics normal pancreas.
2. Mealtime insulin provides additional coverage for meals.
9. What are the Somogyi effect and dawn phenomenon?
Correct Answer: Somogyi: insulin overdose causes nocturnal hypoglycemia → counterregulatory hormones →
rebound hyperglycemia (check 2-4am). Dawn phenomenon: morning hyperglycemia from growth hormone and
cortisol release; more common in adolescence. Treatment: Somogyi – reduce insulin or bedtime snack; dawn –
increase insulin or adjust timing.
1. Check blood glucose between 2-4am to differentiate.
2. Somogyi may cause headaches, night sweats, nightmares.
10. What is SICK day management for diabetes?
Correct Answer: S: Sugar – check BS every 2-3 hours. I: Insulin – ALWAYS take insulin. C: Carbs – drink lots of
fluids; sugar-free if high, carb-containing if low. K: Ketones – check urine ketones every 4 hours (if BS >240);
take rapid-acting insulin if ketones present. Danger signals: persistent N/V, moderate/large ketones, elevated
BS after two supplement doses, high fever >24 hours.
1. Never omit insulin during illness – risk of DKA.
2. Encourage hydration to prevent dehydration.
11. What is hypothyroidism?
Correct Answer: Deficiency of thyroid hormone causing general slowing of metabolic rate. Primary: destruction
of thyroid tissue or defective hormone synthesis (Hashimoto's). Secondary: pituitary disease or hypothalamic
dysfunction. Manifestations: fatigue, weight gain, cold intolerance, constipation, decreased cardiac output,
increased cholesterol, anemia. TSH elevated (>4.5), normal T4.
1. Treatment: levothyroxine (Synthroid) lifelong.
2. Monitor HR – report pulse >100 or irregular; report chest pain, weight loss, nervousness, tremors, insomnia (over-replacement).
12. What is hyperthyroidism?
Correct Answer: Sustained increase in thyroid hormone synthesis/release. Causes: Graves' disease, toxic
nodular goiter, thyroiditis, excess iodine, pituitary tumors. Manifestations: goiter, exophthalmos (usually not
reversible), weight loss, nervousness, tachycardia, systolic hypertension, heat intolerance, tremors, insomnia.
TSH low/undetectable, T4 elevated.
1. Anti-thyroid drugs (PTU, methimazole) – initial treatment, inhibit iodine binding.
2. Propranolol (beta-blocker) – supportive therapy for palpitations/tachycardia.
