MDC 2 Exam 1 (NUR 2392) Study Guide
Rasmussen College
Endocrine, Gastrointestinal, and Renal/Urinary Systems
2026
Verified Correct Answers (A+ Graded)
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Section 1: Endocrine System (Diabetes, Thyroid, Adrenal)
1. A patient with Type 1 Diabetes Mellitus presents to the emergency department with
Kussmaul respirations, fruity breath, and abdominal pain. The nurse anticipates which arterial
blood gas (ABG) finding?
A. pH 7.50, PaCO2 30, HCO3 24
B. pH 7.25, PaCO2 30, HCO3 18
C. pH 7.35, PaCO2 45, HCO3 22
D. pH 7.30, PaCO2 50, HCO3 28
Answer: B
Rationale: These are signs of Diabetic Ketoacidosis (DKA). DKA causes metabolic acidosis (low
pH < 7.35 and low HCO3). Kussmaul respirations are the body's compensatory mechanism to
blow off CO2 (low PaCO2).
2. The nurse is educating a patient about the Somogyi effect. Which statement by the patient
indicates understanding?
A. "This happens when I take too much insulin at night."
, B. "This is when my blood sugar drops low at night, causing my body to release hormones that
raise my sugar by morning."
C. "This occurs because my body doesn't produce any insulin."
D. "This is caused by eating a snack right before bed."
Answer: B
Rationale: The Somogyi effect (rebound hyperglycemia) is caused by nocturnal hypoglycemia.
The body releases counterregulatory hormones (glucagon, epinephrine) in response to the low
blood sugar, resulting in hyperglycemia by morning.
3. A patient with Type 2 Diabetes is prescribed Metformin. What is the mechanism of action of
this medication?
A. Stimulates the beta cells to release more insulin.
B. Delays carbohydrate absorption in the intestines.
C. Decreases hepatic glucose production and increases insulin sensitivity.
D. Replaces insulin at the cellular level.
Answer: C
Rationale: Metformin is a biguanide. It primarily works by reducing the amount of glucose the
liver produces and making the body's cells more sensitive to insulin.
4. A patient with hypothyroidism is prescribed levothyroxine (Synthroid). Which instruction is
most important for the nurse to include?
A. "Take the medication with food to prevent nausea."
B. "Take the medication at the same time daily, preferably in the morning before breakfast."
C. "Expect immediate relief of symptoms within 24 hours."
D. "Double the dose if you miss a day to catch up."
Answer: B
Rasmussen College
Endocrine, Gastrointestinal, and Renal/Urinary Systems
2026
Verified Correct Answers (A+ Graded)
---
Section 1: Endocrine System (Diabetes, Thyroid, Adrenal)
1. A patient with Type 1 Diabetes Mellitus presents to the emergency department with
Kussmaul respirations, fruity breath, and abdominal pain. The nurse anticipates which arterial
blood gas (ABG) finding?
A. pH 7.50, PaCO2 30, HCO3 24
B. pH 7.25, PaCO2 30, HCO3 18
C. pH 7.35, PaCO2 45, HCO3 22
D. pH 7.30, PaCO2 50, HCO3 28
Answer: B
Rationale: These are signs of Diabetic Ketoacidosis (DKA). DKA causes metabolic acidosis (low
pH < 7.35 and low HCO3). Kussmaul respirations are the body's compensatory mechanism to
blow off CO2 (low PaCO2).
2. The nurse is educating a patient about the Somogyi effect. Which statement by the patient
indicates understanding?
A. "This happens when I take too much insulin at night."
, B. "This is when my blood sugar drops low at night, causing my body to release hormones that
raise my sugar by morning."
C. "This occurs because my body doesn't produce any insulin."
D. "This is caused by eating a snack right before bed."
Answer: B
Rationale: The Somogyi effect (rebound hyperglycemia) is caused by nocturnal hypoglycemia.
The body releases counterregulatory hormones (glucagon, epinephrine) in response to the low
blood sugar, resulting in hyperglycemia by morning.
3. A patient with Type 2 Diabetes is prescribed Metformin. What is the mechanism of action of
this medication?
A. Stimulates the beta cells to release more insulin.
B. Delays carbohydrate absorption in the intestines.
C. Decreases hepatic glucose production and increases insulin sensitivity.
D. Replaces insulin at the cellular level.
Answer: C
Rationale: Metformin is a biguanide. It primarily works by reducing the amount of glucose the
liver produces and making the body's cells more sensitive to insulin.
4. A patient with hypothyroidism is prescribed levothyroxine (Synthroid). Which instruction is
most important for the nurse to include?
A. "Take the medication with food to prevent nausea."
B. "Take the medication at the same time daily, preferably in the morning before breakfast."
C. "Expect immediate relief of symptoms within 24 hours."
D. "Double the dose if you miss a day to catch up."
Answer: B
