NURS 497 MIDTERM 2 EXAM
QUESTIONS AND ANSWERS GRADED A+
2026
Which of the following are important nursing intervention(s) when caring for a client with
Cushing's syndrome? - ANS - Monitoring blood glucose levels
- Protecting the client from exposure to infection
What would be the result of the removal of the adrenal cortex? - ANS Hyperkalemia
Which statement would be correct for a client with type 2 diabetes mellitus who is admitted to
the hospital with pneumonia? - ANS The client may have sufficient endogenous insulin to
prevent ketosis but is at risk for the development of a hyperosmolar hyperglycemic state.
Analyze the following diagnostic findings for a client with type 2 diabetes. Which of the
following results will need further assessment? - ANS A1c 9.0%
A newly diagnosed diabetic patient will exhibit which of the following symptoms? (3) -
ANS Polyphagia, polydipsia, weight loss
Patients with uncontrolled type 2 diabetes are likely to experience which of the following
complications? (Select all that apply.) - ANS - Peripheral vascular disease
- Orthostatic hypotension
- Visual difficulties
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 1
,- Thickened capillary membranes
Risk factors for insulin resistance include which of the following? (Select all that apply.) -
ANS Obesity, medications, age, inactivity
A nurse checks laboratory results as both Cushing's disease and Addison's disease can manifest
with elevated levels of: - ANS adrenocorticotropic hormone (ACTH)
What is the most common cause of Addison's disease? - ANS - An autoimmune reaction
- Addison's disease is caused by autoimmune mechanisms that destroy adrenal cortical cells and
is more common in women.
What is the earliest manifestation of diabetes-induced kidney dysfunction? -
ANS Microalbuminuria
What causes the chronic microvascular and macrovascular complications of DM? - ANS The
underlying cause of microvascular and macrovascular diseases is related to hyperglycemia
Which physical feature supports the diagnosis of Cushing's syndrome? - ANS - Truncal obesity
and moon face
- Weight gain is the most common feature and results from the accumulation of adipose tissue
in the trunk, facial, and cervical areas. These characteristic patterns of fat deposition have been
described as "truncal obesity," "moon face," and "buffalo hump."
A 65-year-old patient has been taking prednisone to manage symptoms of Crohn's disease for
the past several years. When following up with her gastroenterologist, she was diagnosed with
Cushing syndrome. What are some manifestations of Cushing's syndrome? (4) - ANS - Excess
bruising on arms and legs
- Hypokalemia
- Muscle weakness in legs and arms
- Increased facial hair
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 2
, A patient is admitted to the medical unit for complications of long-term, poorly controlled type
2 DM. Which of the following would the nurse expect to find in addition to elevated glucose? -
ANS - Atherosclerosis
- Macrovascular disease (lesions in large- and medium-sized arteries) increases morbidity and
mortality and increases the risk for accelerated atherosclerosis. Acidosis would occur in this
patient.
What is the cause of the hyperpigmentation seen in people with Cushing's syndrome? - ANS -
Elevated levels of ACTH
- Bronze or brownish hyperpigmentation of the skin, mucous membranes, and hair occur when
there are very high levels of ACTH.
Which of the following alterations would the nurse expect to find in a patient with untreated
Cushing's disease or syndrome? - ANS - Hypertension
- With elevated cortisol levels, vascular sensitivity to catecholamines increases significantly,
leading to vasoconstriction and hypertension.
What is the purpose of the glycosylated hemoglobin (hemoglobin A1c) test? - ANS -
Monitoring long-term serum glucose control
- Glycosylated hemoglobin refers to the permanent attachment of glucose to hemoglobin
molecules and reflects the average plasma glucose exposure over the life of a red blood cell
(approximately 120 days).
A nurse has taken report for the evening shift on an adolescent inpatient unit. Which client
should the nurse address first? - ANS A client diagnosed with conduct disorder who is
verbally abusing a peer in the milieu
A military veteran is being assessed for outpatient therapy after he reports having problems at
home and at work. Which of the symptoms that he describes are commonly associated with
PTSD? Select all that apply. - ANS - "I slapped my wife when she was trying to hug me."
- "I've been drinking and smoking pot daily."
- "I've been having trouble sleeping and I think I've been having nightmares but I can't
remember them."
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 3
QUESTIONS AND ANSWERS GRADED A+
2026
Which of the following are important nursing intervention(s) when caring for a client with
Cushing's syndrome? - ANS - Monitoring blood glucose levels
- Protecting the client from exposure to infection
What would be the result of the removal of the adrenal cortex? - ANS Hyperkalemia
Which statement would be correct for a client with type 2 diabetes mellitus who is admitted to
the hospital with pneumonia? - ANS The client may have sufficient endogenous insulin to
prevent ketosis but is at risk for the development of a hyperosmolar hyperglycemic state.
Analyze the following diagnostic findings for a client with type 2 diabetes. Which of the
following results will need further assessment? - ANS A1c 9.0%
A newly diagnosed diabetic patient will exhibit which of the following symptoms? (3) -
ANS Polyphagia, polydipsia, weight loss
Patients with uncontrolled type 2 diabetes are likely to experience which of the following
complications? (Select all that apply.) - ANS - Peripheral vascular disease
- Orthostatic hypotension
- Visual difficulties
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 1
,- Thickened capillary membranes
Risk factors for insulin resistance include which of the following? (Select all that apply.) -
ANS Obesity, medications, age, inactivity
A nurse checks laboratory results as both Cushing's disease and Addison's disease can manifest
with elevated levels of: - ANS adrenocorticotropic hormone (ACTH)
What is the most common cause of Addison's disease? - ANS - An autoimmune reaction
- Addison's disease is caused by autoimmune mechanisms that destroy adrenal cortical cells and
is more common in women.
What is the earliest manifestation of diabetes-induced kidney dysfunction? -
ANS Microalbuminuria
What causes the chronic microvascular and macrovascular complications of DM? - ANS The
underlying cause of microvascular and macrovascular diseases is related to hyperglycemia
Which physical feature supports the diagnosis of Cushing's syndrome? - ANS - Truncal obesity
and moon face
- Weight gain is the most common feature and results from the accumulation of adipose tissue
in the trunk, facial, and cervical areas. These characteristic patterns of fat deposition have been
described as "truncal obesity," "moon face," and "buffalo hump."
A 65-year-old patient has been taking prednisone to manage symptoms of Crohn's disease for
the past several years. When following up with her gastroenterologist, she was diagnosed with
Cushing syndrome. What are some manifestations of Cushing's syndrome? (4) - ANS - Excess
bruising on arms and legs
- Hypokalemia
- Muscle weakness in legs and arms
- Increased facial hair
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 2
, A patient is admitted to the medical unit for complications of long-term, poorly controlled type
2 DM. Which of the following would the nurse expect to find in addition to elevated glucose? -
ANS - Atherosclerosis
- Macrovascular disease (lesions in large- and medium-sized arteries) increases morbidity and
mortality and increases the risk for accelerated atherosclerosis. Acidosis would occur in this
patient.
What is the cause of the hyperpigmentation seen in people with Cushing's syndrome? - ANS -
Elevated levels of ACTH
- Bronze or brownish hyperpigmentation of the skin, mucous membranes, and hair occur when
there are very high levels of ACTH.
Which of the following alterations would the nurse expect to find in a patient with untreated
Cushing's disease or syndrome? - ANS - Hypertension
- With elevated cortisol levels, vascular sensitivity to catecholamines increases significantly,
leading to vasoconstriction and hypertension.
What is the purpose of the glycosylated hemoglobin (hemoglobin A1c) test? - ANS -
Monitoring long-term serum glucose control
- Glycosylated hemoglobin refers to the permanent attachment of glucose to hemoglobin
molecules and reflects the average plasma glucose exposure over the life of a red blood cell
(approximately 120 days).
A nurse has taken report for the evening shift on an adolescent inpatient unit. Which client
should the nurse address first? - ANS A client diagnosed with conduct disorder who is
verbally abusing a peer in the milieu
A military veteran is being assessed for outpatient therapy after he reports having problems at
home and at work. Which of the symptoms that he describes are commonly associated with
PTSD? Select all that apply. - ANS - "I slapped my wife when she was trying to hug me."
- "I've been drinking and smoking pot daily."
- "I've been having trouble sleeping and I think I've been having nightmares but I can't
remember them."
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 3
