NSG-320 Final Exam: (Latest 2026/2027 Update) Endocrine Disorders,
Electrolyte Imbalances, Cardiac & Respiratory, Hematology, Neurology, Renal,
Orthopedics | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: Medical-Surgical Nursing – Endocrine (Somogyi, Dawn, Diabetes, Thyroid); Electrolytes (Na, K,
Ca, Mg, Phos); Cardiac (CAD, Angina, Dysrhythmias, HF, PAD, VTE); Respiratory (Pneumonia, TB, CF,
COPD); Hematology (Anemias, Thalassemia, Sickle Cell, Hemophilia, Thrombocytopenia); Hepatitis,
Cirrhosis, Pancreatitis, Cholecystitis; Renal (UTI, BPH, CKD, Dialysis); Orthopedics (Sprains, Fractures,
Compartment Syndrome, Osteoporosis, Gout); Autoimmune (SLE, Fibromyalgia); Neuro (Headaches, MS,
Parkinson's, Myasthenia Gravis, Seizures, Stroke); Eye Disorders (Cataracts, Glaucoma, AMD, Retinal
Detachment); Meniere's Disease; Anaphylaxis; HIV
Source: NSG-320 Final Exam Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. What is the Somogyi effect and its intervention?
Correct Answer: Rebound morning hyperglycemia following a nighttime episode of hypoglycemia.
Treatment: lower nighttime insulin dose, snack before bedtime.
1. Check blood glucose between 2-4 AM to differentiate from dawn phenomenon.
2. Symptoms may include nightmares, night sweats, headache on awakening.
2. What is the dawn phenomenon and its intervention?
Correct Answer: Morning hyperglycemia due to surge of growth hormone and cortisol. Treatment: late
evening dose of intermediate-acting insulin or adjustment in timing of insulin.
1. No hypoglycemia overnight; blood glucose rises in early morning hours.
2. Insulin pump or adjusting injection time can help.
3. What is hypoglycemia emergency care?
Correct Answer: 15 grams of carbohydrates. Retest in 15 minutes, repeat if necessary. At home, clients
can administer glucagon if Rule of 15 doesn't work. If unconscious: IV Dextrose 50% immediately.
1. Examples of 15g carbs: 4 oz juice/soda, 3-4 glucose tablets, 1 tbsp sugar/honey.
2. Glucagon is for severe hypoglycemia when patient cannot swallow.
4. What is diabetic foot care teaching?
Correct Answer: Inspect daily, avoid going barefoot, proper footwear, treat cuts, avoid hot water,
cotton stockings, nail trimming (straight across), dry between toes.
1. Neuropathy causes decreased sensation; wounds may go unnoticed.
2. Poor circulation impairs healing; amputations are common complications.
, 5. What are hyperthyroidism clinical manifestations?
Correct Answer: Increased metabolic processes, heat intolerance, tachycardia, weight loss.
1. Thyroid hormone excess increases basal metabolic rate.
2. Other symptoms: nervousness, diaphoresis, tremors, goiter.
6. What are Graves' disease symptoms and interventions?
Correct Answer: Symptoms: enlarged thyroid gland (goiter), exophthalmos (protruding eyes).
Interventions: eye care (artificial tears, gel/ointment, taping at night, HOB elevated for puffiness,
sunglasses when outside), education, smoking cessation.
1. Exophthalmos is usually not reversible; protect cornea from drying.
2. Cigarette smoking worsens eye disease.
7. What are hypothyroidism clinical manifestations and Hashimoto's interventions?
Correct Answer: Manifestations: decreased metabolic processes, weakness, lethargy, cold intolerance,
weight gain, bradycardia. Interventions: levothyroxine lifelong, take thyroid hormone in morning
BEFORE food, comfortable warm environment.
1. Levothyroxine must be taken consistently; do not switch brands.
2. Monitor for chest pain, palpitations (over-replacement).
8. What are hypernatremia and hyponatremia manifestations?
Correct Answer: Hypernatremia: thirst, changes in mental status, seizures, coma, fluid volume deficit.
Hyponatremia: headache, irritability, difficulty concentrating, confusion, vomiting, seizures, coma.
1. Hypernatremia = water deficit; treat with hypotonic fluids.
2. Hyponatremia = water excess; treat with fluid restriction or hypertonic saline if severe.
9. What are hyperkalemia and hypokalemia manifestations?
Correct Answer: Hyperkalemia: life-threatening arrhythmias (peaked T waves), fatigue/confusion,
tetany/muscle cramps, weak/paralyzed skeletal muscles, abdominal cramping/diarrhea. Hypokalemia:
cardiac (depressed T wave), skeletal muscle weakness/paresthesia, weakness of respiratory muscles,
decreased GI motility, hyperglycemia.
1. Hyperkalemia is cardiac emergency; treat with calcium gluconate, insulin+glucose, kayexalate,
dialysis.
2. Hypokalemia: never give IV potassium >20 mEq/hr; never IV push.
10. What are hypercalcemia and hypocalcemia manifestations and interventions?
Correct Answer: Hypercalcemia: hyperparathyroidism, fatigue/lethargy/weakness/confusion,
hallucinations/seizures/coma, dysrhythmias, bone pain/fractures/nephrolithiasis, polyuria/dehydration.
Interventions: increase fluid intake 3000-4000 mL, cranberry/prune juice. Hypocalcemia: positive
Trousseau's or Chvostek's sign, laryngeal stridor, dysphagia, tingling around mouth/extremities, cardiac
dysrhythmias, rebreathe into paper bag.
1. Chvostek sign: facial twitching when tapping over facial nerve.
2. Trousseau sign: carpal spasm with BP cuff inflation.
Electrolyte Imbalances, Cardiac & Respiratory, Hematology, Neurology, Renal,
Orthopedics | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: Medical-Surgical Nursing – Endocrine (Somogyi, Dawn, Diabetes, Thyroid); Electrolytes (Na, K,
Ca, Mg, Phos); Cardiac (CAD, Angina, Dysrhythmias, HF, PAD, VTE); Respiratory (Pneumonia, TB, CF,
COPD); Hematology (Anemias, Thalassemia, Sickle Cell, Hemophilia, Thrombocytopenia); Hepatitis,
Cirrhosis, Pancreatitis, Cholecystitis; Renal (UTI, BPH, CKD, Dialysis); Orthopedics (Sprains, Fractures,
Compartment Syndrome, Osteoporosis, Gout); Autoimmune (SLE, Fibromyalgia); Neuro (Headaches, MS,
Parkinson's, Myasthenia Gravis, Seizures, Stroke); Eye Disorders (Cataracts, Glaucoma, AMD, Retinal
Detachment); Meniere's Disease; Anaphylaxis; HIV
Source: NSG-320 Final Exam Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. What is the Somogyi effect and its intervention?
Correct Answer: Rebound morning hyperglycemia following a nighttime episode of hypoglycemia.
Treatment: lower nighttime insulin dose, snack before bedtime.
1. Check blood glucose between 2-4 AM to differentiate from dawn phenomenon.
2. Symptoms may include nightmares, night sweats, headache on awakening.
2. What is the dawn phenomenon and its intervention?
Correct Answer: Morning hyperglycemia due to surge of growth hormone and cortisol. Treatment: late
evening dose of intermediate-acting insulin or adjustment in timing of insulin.
1. No hypoglycemia overnight; blood glucose rises in early morning hours.
2. Insulin pump or adjusting injection time can help.
3. What is hypoglycemia emergency care?
Correct Answer: 15 grams of carbohydrates. Retest in 15 minutes, repeat if necessary. At home, clients
can administer glucagon if Rule of 15 doesn't work. If unconscious: IV Dextrose 50% immediately.
1. Examples of 15g carbs: 4 oz juice/soda, 3-4 glucose tablets, 1 tbsp sugar/honey.
2. Glucagon is for severe hypoglycemia when patient cannot swallow.
4. What is diabetic foot care teaching?
Correct Answer: Inspect daily, avoid going barefoot, proper footwear, treat cuts, avoid hot water,
cotton stockings, nail trimming (straight across), dry between toes.
1. Neuropathy causes decreased sensation; wounds may go unnoticed.
2. Poor circulation impairs healing; amputations are common complications.
, 5. What are hyperthyroidism clinical manifestations?
Correct Answer: Increased metabolic processes, heat intolerance, tachycardia, weight loss.
1. Thyroid hormone excess increases basal metabolic rate.
2. Other symptoms: nervousness, diaphoresis, tremors, goiter.
6. What are Graves' disease symptoms and interventions?
Correct Answer: Symptoms: enlarged thyroid gland (goiter), exophthalmos (protruding eyes).
Interventions: eye care (artificial tears, gel/ointment, taping at night, HOB elevated for puffiness,
sunglasses when outside), education, smoking cessation.
1. Exophthalmos is usually not reversible; protect cornea from drying.
2. Cigarette smoking worsens eye disease.
7. What are hypothyroidism clinical manifestations and Hashimoto's interventions?
Correct Answer: Manifestations: decreased metabolic processes, weakness, lethargy, cold intolerance,
weight gain, bradycardia. Interventions: levothyroxine lifelong, take thyroid hormone in morning
BEFORE food, comfortable warm environment.
1. Levothyroxine must be taken consistently; do not switch brands.
2. Monitor for chest pain, palpitations (over-replacement).
8. What are hypernatremia and hyponatremia manifestations?
Correct Answer: Hypernatremia: thirst, changes in mental status, seizures, coma, fluid volume deficit.
Hyponatremia: headache, irritability, difficulty concentrating, confusion, vomiting, seizures, coma.
1. Hypernatremia = water deficit; treat with hypotonic fluids.
2. Hyponatremia = water excess; treat with fluid restriction or hypertonic saline if severe.
9. What are hyperkalemia and hypokalemia manifestations?
Correct Answer: Hyperkalemia: life-threatening arrhythmias (peaked T waves), fatigue/confusion,
tetany/muscle cramps, weak/paralyzed skeletal muscles, abdominal cramping/diarrhea. Hypokalemia:
cardiac (depressed T wave), skeletal muscle weakness/paresthesia, weakness of respiratory muscles,
decreased GI motility, hyperglycemia.
1. Hyperkalemia is cardiac emergency; treat with calcium gluconate, insulin+glucose, kayexalate,
dialysis.
2. Hypokalemia: never give IV potassium >20 mEq/hr; never IV push.
10. What are hypercalcemia and hypocalcemia manifestations and interventions?
Correct Answer: Hypercalcemia: hyperparathyroidism, fatigue/lethargy/weakness/confusion,
hallucinations/seizures/coma, dysrhythmias, bone pain/fractures/nephrolithiasis, polyuria/dehydration.
Interventions: increase fluid intake 3000-4000 mL, cranberry/prune juice. Hypocalcemia: positive
Trousseau's or Chvostek's sign, laryngeal stridor, dysphagia, tingling around mouth/extremities, cardiac
dysrhythmias, rebreathe into paper bag.
1. Chvostek sign: facial twitching when tapping over facial nerve.
2. Trousseau sign: carpal spasm with BP cuff inflation.
