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A client presents with tachycardia, weight loss,
heat intolerance, diarrhea, and exophthalmos.
Which hormone is primarily responsible for these
manifestations?
A. Thyroid-stimulating hormone (TSH)
B. Triiodothyronine (T3)
C. Calcitonin
D. Parathyroid hormone (PTH)
Correct Answer: B
Rationale: Hyperthyroidism is caused by excess
thyroid hormones, especially T3 and T4, which
increase basal metabolic rate. T3 is the most active
thyroid hormone and directly causes symptoms such
as tachycardia, weight loss, heat intolerance,
diarrhea, and nervous system stimulation. TSH is
typically suppressed in primary hyperthyroidism due
,to negative feedback. Calcitonin regulates calcium
levels, and PTH regulates calcium and phosphate
balance, not metabolism.
A nurse is reviewing lab results for a client with
suspected diabetes insipidus (DI). Which findings
support the diagnosis?
A. Low serum sodium and low osmolality
B. High urine specific gravity and hypernatremia
C. Hypernatremia and increased serum osmolality
D. Hypokalemia and metabolic alkalosis
Correct Answer: C
Rationale: Diabetes insipidus is caused by
deficiency of ADH or renal resistance to ADH,
leading to inability to concentrate urine. This results
in water loss, causing hypernatremia and increased
serum osmolality. Urine is dilute with low specific
gravity. Options A and B are inconsistent because
DI causes diluted urine, not concentrated urine.
,A client receiving methimazole for
hyperthyroidism reports sore throat and fever.
What is the nurse’s priority action?
A. Reassure the client this is expected
B. Encourage increased fluid intake
C. Instruct the client to take medication with food
D. Notify the healthcare provider immediately
Correct Answer: D
Rationale: Methimazole can cause agranulocytosis,
a life-threatening drop in white blood cells. Fever
and sore throat are early signs of infection and
require immediate discontinuation of the drug and
urgent lab evaluation. This is a priority safety issue.
A client with Cushing’s syndrome is most likely
to exhibit which assessment finding?
A. Weight loss and hypotension
B. Truncal obesity and hyperglycemia
C. Hypoglycemia and dehydration
D. Bradycardia and hypothermia
Correct Answer: B
, Rationale: Cushing’s syndrome results from excess
cortisol, which causes fat redistribution (truncal
obesity, “moon face,” “buffalo hump”),
hyperglycemia due to gluconeogenesis, and protein
breakdown. It also causes hypertension, not
hypotension.
A nurse is caring for a client with diabetic
ketoacidosis (DKA). Which intervention is the
priority?
A. Administer sodium bicarbonate
B. Start IV 0.9% normal saline
C. Give long-acting insulin
D. Restrict potassium intake
Correct Answer: B
Rationale: The priority in DKA is fluid
resuscitation because severe dehydration occurs due
to osmotic diuresis. Normal saline restores
circulating volume and perfusion. Insulin is
important but comes after fluids. Potassium must be
monitored but is not the first intervention.