ACTUAL EXAM Endocrine NCLEX questions Latest 2023
Endocrine NCLEX questions Latest
- An agitated, confused female client arrives in the emergency department. Her
history includes type 1 diabetes mellitus, hypertension, and angina pectoris.
Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood
glucose sample measures 42 mg/dl, and the client is treated for an acute
hypoglycemic reaction. After recovery, nurse Lily teaches the client to treat
hypoglycemia by ingesting:
a. 2 to 5 g of a simple carbohydrate.
b. 10 to 15 g of a simple carbohydrate.
c. 18 to 20 g of a simple carbohydrate.
d. 25 to 30 g of a simple carbohydrate.
B.
To reverse hypoglycemia, the American Diabetes Association recommends ingesting
10 to 15 g of a simple carbohydrate, such as three to five pieces of hard candy, two
to three packets of sugar (4 to 6 tsp), or 4 oz of fruit juice. If necessary, this
treatment can be repeated in 15 minutes. Ingesting only 2 to 5 g of a simple
carbohydrate may not raise the blood glucose level sufficiently. Ingesting more than
15 g may raise it above normal, causing hyperglycemia. - A female adult client with a history of chronic hyperparathyroidism admits to
being noncompliant. Based on initial assessment findings, nurse Julia formulates the
nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for
this client, which “related-to” phrase should the nurse add?
a. Related to bone demineralization resulting in pathologic fractures
b. Related to exhaustion secondary to an accelerated metabolic rate
c. Related to edema and dry skin secondary to fluid infiltration into the interstitial
spaces
d. Related to tetany secondary to a decreased serum calcium level
A.
Poorly controlled hyperparathyroidism may cause an elevated serum calcium level.
This, in turn, may diminish calcium stores in the bone, causing bone demineralization
and setting the stage for pathologic fractures and a risk for injury.
Hyperparathyroidism doesn’t accelerate the metabolic rate. A decreased thyroid
hormone level, not an increased parathyroid hormone level, may cause edema and
dry skin secondary to fluid infiltration into the interstitial spaces.
Hyperparathyroidism causes hypercalcemia, not hypocalcemia; therefore, it isn’t
associated with tetany.
- Nurse John is assigned to care for a postoperative male client who has diabetes
mellitus. During the assessment interview, the client reports that he’s impotent and
says he’s concerned about its effect on his marriage. In planning this client’s care, the
most appropriate intervention would be to:
a. Encourage the client to ask questions about personal sexuality.
b. Provide time for privacy.
c. Provide support for the spouse or significant other.
d. Suggest referral to a sex counselor or other appropriate professional.
D.
The nurse should refer this client to a sex counselor or other professional. Making
appropriate referrals is a valid part of planning the client’s care. The nurse doesn’t
normally provide sex counseling. - During a class on exercise for diabetic clients, a female client asks the nurse
educator how often to exercise. The nurse educator advises the clients to exercise
how often to meet the goals of planned exercise?
a. At least once a week
b. At least three times a week
c. At least five times a week
d. Every day
B.
Diabetic clients must exercise at least three times a week to meet the goals of
planned exercise — lowering the blood glucose level, reducing or maintaining the
proper weight, increasing the serum high-density lipoprotein level, decreasing serum
triglyceride levels, reducing blood pressure, and minimizing stress. Exercising once a
week wouldn’t achieve these goals. Exercising more than three times a week,
although beneficial, would exceed the minimum requirement.
- Nurse Oliver should expect a client with hypothyroidism to report which health
concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
c. Nervousness and tremors
d. Thyroid gland swelling
B.
Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight
gain. Signs and symptoms of hyperthyroidism (Graves’ disease) include an increased
appetite, weight loss, nervousness, tremors, and thyroid gland enlargement (goiter). - A female client with hypothyroidism (myxedema) is receiving levothyroxine
(Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an
adverse drug effect?
a. Dysuria
b. Leg cramps
c. Tachycardia
d. Blurred vision
C.
Levothyroxine, a synthetic thyroid hormone, is given to a client with hypothyroidism
to simulate the effects of thyroxine. Adverse effects of this agent include
tachycardia. The other options aren’t associated with levothyroxine. - A 67-year-old male client has been complaining of sleeping more, increased
urination, anorexia, weakness, irritability, depression, and bone pain that interferes
with her going outdoors. Based on these assessment findings, nurse Richard would
suspect which of the following disorders?
a. Diabetes mellitus
b. Diabetes insipidus
c. Hypoparathyroidism
d. Hyperparathyroidism
D.
Hyperparathyroidism is most common in older women and is characterized by bone
pain and weakness from excess parathyroid hormone (PTH). Clients also exhibit
hypercaliuria-causing polyuria. While clients with diabetes mellitus and diabetes
insipidus also have polyuria, they don’t have bone pain and increased sleeping.
Hypoparathyroidism is characterized by urinary frequency rather than polyuria. - When caring for a male client with diabetes insipidus, nurse Juliet expects to
administer:
a. vasopressin (Pitressin Synthetic).
b. furosemide (Lasix).
c. regular insulin.
d. 10% dextrose.
A.
Because diabetes insipidus results from decreased antidiuretic hormone
(vasopressin) production, the nurse should expect to administer synthetic
vasopressin for hormone replacement therapy. Furosemide, a diuretic, is
contraindicated because a client with diabetes insipidus experiences polyuria. Insulin
and dextrose are used to treat diabetes mellitus and its complications, not diabetes
insipidus.
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