NSG 5003: Endocrine and Metabolic Disorders – Multiple
Choice Review Questions with Answers and Explanations
1. Most common cause of hypothyroidism in the U.S.:
A) Autoimmune destruction (Hashimoto’s thyroiditis)
B) Thyroid cancer
C) Thyroid nodules
D) Ectopic hormone production
Answer: A) Autoimmune destruction (Hashimoto’s thyroiditis)
Hashimoto’s thyroiditis is an autoimmune disorder in which the immune system attacks
thyroid tissue, reducing hormone production and leading to hypothyroidism.
2. Postpartum woman with fatigue, constipation, and cold intolerance likely has:
A) Low TSH
B) High TSH
C) Negative anti-thyroperoxidase antibodies
D) High T3/T4
Answer: B) High TSH
High TSH indicates hypothyroidism, which is consistent with fatigue, constipation, and
cold intolerance, often seen in postpartum thyroiditis.
3. Incoherent patient with hypothyroidism presents with hypothermia, bradycardia,
hypotension, and nonpitting edema. The complication to prevent is:
A) Hashimoto’s thyroiditis
B) Cushing syndrome
C) Myxedema coma
D) Thyroid storm
Answer: C) Myxedema coma
Severe hypothyroidism can progress to life-threatening myxedema coma, requiring rapid
hormone replacement and supportive care.
4. A 50-year-old woman with type 2 diabetes on insulin shows fasting glucose 90–100
mg/dl, postprandial <200 mg/dl, HbA1c 5.5%. Interpretation:
A) Signs of insulin resistance
B) Good control of blood glucose
C) Risk for ketoacidosis
D) Risk for hyperglycemia
Answer: B) Good control of blood glucose
Her labs indicate effective glycemic management, suggesting adherence to insulin
therapy and lifestyle measures.
5. Pathological fracture patient with high calcium and low phosphate: likely cause?
A) Hypoparathyroidism
B) Hyperparathyroidism
C) Hyperaldosteronism
D) Hypoaldosteronism
, Answer: B) Hyperparathyroidism
Excess parathyroid hormone increases calcium and decreases phosphate levels,
weakening bones and predisposing to fractures.
6. Pheochromocytoma is characterized by:
A) Catecholamine suppression
B) Inadequate mineralocorticoid secretion
C) Hyperfunctioning adrenal medulla
D) Hypofunctioning adrenal medulla
Answer: C) Hyperfunctioning adrenal medulla
Excess catecholamines cause hypertension, palpitations, sweating, and headaches in
pheochromocytoma.
7. Manifestation of Cushing syndrome includes:
A) Truncal obesity with thin extremities
B) Enlargement of face, hands, feet
C) Cachexia
D) Thick scalp hair
Answer: A) Truncal obesity with thin extremities
Excess cortisol redistributes fat to the trunk and face, while muscles in extremities
atrophy, producing this classic appearance.
8. Signs of thyroid crisis (thyroid storm) from Graves’ disease include:
A) Constipation with gastric distension
B) Bradycardia and bradypnea
C) Hyperthermia and tachycardia
D) Constipation and lethargy
Answer: C) Hyperthermia and tachycardia
Thyroid storm causes severe hypermetabolism with fever, rapid heart rate, agitation, and
potential multi-organ dysfunction.
9. 51-year-old woman with thin hair, exophthalmos, hyperreflexia, and pretibial edema:
consistent with:
A) Subacute thyroiditis
B) Autoimmune thyroiditis
C) Graves’ disease
D) Hashimoto’s disease
Answer: C) Graves’ disease
Graves’ disease is an autoimmune hyperthyroid condition causing eye and skin findings
such as exophthalmos and pretibial myxedema.
10. A 30-year-old patient on long-term prednisone (10 mg/day) abruptly stops therapy. Risk:
A) Adrenal crisis
B) Hypercortisolism
C) ACTH stimulation
D) Thyroid crisis
Answer: A) Adrenal crisis
Long-term steroid therapy suppresses adrenal function, so abrupt withdrawal may cause
hypotension, electrolyte imbalance, and shock.
11. Which hormone primarily regulates sodium and water balance in the body?
A) Cortisol
, B) Aldosterone
C) Thyroxine
D) Insulin
Answer: B) Aldosterone
Aldosterone, secreted by the adrenal cortex, promotes sodium reabsorption and potassium
excretion in the kidneys, maintaining fluid balance and blood pressure.
12. What is the primary function of parathyroid hormone (PTH)?
A) Increase phosphate levels
B) Decrease calcium levels
C) Increase blood calcium levels
D) Stimulate insulin secretion
Answer: C) Increase blood calcium levels
PTH raises serum calcium by stimulating bone resorption, enhancing intestinal calcium
absorption via vitamin D, and increasing renal calcium reabsorption.
13. Which of the following is a common symptom of hyperthyroidism?
A) Weight gain
B) Cold intolerance
C) Heat intolerance
D) Bradycardia
Answer: C) Heat intolerance
Hyperthyroidism increases metabolic rate, leading to heat intolerance, sweating, and
weight loss despite increased appetite.
14. Addison’s disease results from:
A) Hypersecretion of adrenal cortex hormones
B) Hyposecretion of adrenal cortex hormones
C) Hypersecretion of adrenal medulla hormones
D) Hyposecretion of pituitary hormones
Answer: B) Hyposecretion of adrenal cortex hormones
Addison’s disease involves insufficient cortisol and aldosterone, causing hypotension,
fatigue, hyperpigmentation, and electrolyte imbalances.
15. Which of the following hormones is released in response to stress?
A) Insulin
B) Glucagon
C) Cortisol
D) Aldosterone
Answer: C) Cortisol
Cortisol is a glucocorticoid released during stress, increasing glucose availability,
suppressing inflammation, and supporting cardiovascular function.
16. A 45-year-old patient with moon face, buffalo hump, and central obesity most likely has:
A) Addison’s disease
B) Cushing’s syndrome
C) Acromegaly
D) Hyperthyroidism
Answer: B) Cushing’s syndrome
Excess cortisol leads to characteristic fat redistribution, muscle weakness, hyperglycemia,
and skin changes.
Choice Review Questions with Answers and Explanations
1. Most common cause of hypothyroidism in the U.S.:
A) Autoimmune destruction (Hashimoto’s thyroiditis)
B) Thyroid cancer
C) Thyroid nodules
D) Ectopic hormone production
Answer: A) Autoimmune destruction (Hashimoto’s thyroiditis)
Hashimoto’s thyroiditis is an autoimmune disorder in which the immune system attacks
thyroid tissue, reducing hormone production and leading to hypothyroidism.
2. Postpartum woman with fatigue, constipation, and cold intolerance likely has:
A) Low TSH
B) High TSH
C) Negative anti-thyroperoxidase antibodies
D) High T3/T4
Answer: B) High TSH
High TSH indicates hypothyroidism, which is consistent with fatigue, constipation, and
cold intolerance, often seen in postpartum thyroiditis.
3. Incoherent patient with hypothyroidism presents with hypothermia, bradycardia,
hypotension, and nonpitting edema. The complication to prevent is:
A) Hashimoto’s thyroiditis
B) Cushing syndrome
C) Myxedema coma
D) Thyroid storm
Answer: C) Myxedema coma
Severe hypothyroidism can progress to life-threatening myxedema coma, requiring rapid
hormone replacement and supportive care.
4. A 50-year-old woman with type 2 diabetes on insulin shows fasting glucose 90–100
mg/dl, postprandial <200 mg/dl, HbA1c 5.5%. Interpretation:
A) Signs of insulin resistance
B) Good control of blood glucose
C) Risk for ketoacidosis
D) Risk for hyperglycemia
Answer: B) Good control of blood glucose
Her labs indicate effective glycemic management, suggesting adherence to insulin
therapy and lifestyle measures.
5. Pathological fracture patient with high calcium and low phosphate: likely cause?
A) Hypoparathyroidism
B) Hyperparathyroidism
C) Hyperaldosteronism
D) Hypoaldosteronism
, Answer: B) Hyperparathyroidism
Excess parathyroid hormone increases calcium and decreases phosphate levels,
weakening bones and predisposing to fractures.
6. Pheochromocytoma is characterized by:
A) Catecholamine suppression
B) Inadequate mineralocorticoid secretion
C) Hyperfunctioning adrenal medulla
D) Hypofunctioning adrenal medulla
Answer: C) Hyperfunctioning adrenal medulla
Excess catecholamines cause hypertension, palpitations, sweating, and headaches in
pheochromocytoma.
7. Manifestation of Cushing syndrome includes:
A) Truncal obesity with thin extremities
B) Enlargement of face, hands, feet
C) Cachexia
D) Thick scalp hair
Answer: A) Truncal obesity with thin extremities
Excess cortisol redistributes fat to the trunk and face, while muscles in extremities
atrophy, producing this classic appearance.
8. Signs of thyroid crisis (thyroid storm) from Graves’ disease include:
A) Constipation with gastric distension
B) Bradycardia and bradypnea
C) Hyperthermia and tachycardia
D) Constipation and lethargy
Answer: C) Hyperthermia and tachycardia
Thyroid storm causes severe hypermetabolism with fever, rapid heart rate, agitation, and
potential multi-organ dysfunction.
9. 51-year-old woman with thin hair, exophthalmos, hyperreflexia, and pretibial edema:
consistent with:
A) Subacute thyroiditis
B) Autoimmune thyroiditis
C) Graves’ disease
D) Hashimoto’s disease
Answer: C) Graves’ disease
Graves’ disease is an autoimmune hyperthyroid condition causing eye and skin findings
such as exophthalmos and pretibial myxedema.
10. A 30-year-old patient on long-term prednisone (10 mg/day) abruptly stops therapy. Risk:
A) Adrenal crisis
B) Hypercortisolism
C) ACTH stimulation
D) Thyroid crisis
Answer: A) Adrenal crisis
Long-term steroid therapy suppresses adrenal function, so abrupt withdrawal may cause
hypotension, electrolyte imbalance, and shock.
11. Which hormone primarily regulates sodium and water balance in the body?
A) Cortisol
, B) Aldosterone
C) Thyroxine
D) Insulin
Answer: B) Aldosterone
Aldosterone, secreted by the adrenal cortex, promotes sodium reabsorption and potassium
excretion in the kidneys, maintaining fluid balance and blood pressure.
12. What is the primary function of parathyroid hormone (PTH)?
A) Increase phosphate levels
B) Decrease calcium levels
C) Increase blood calcium levels
D) Stimulate insulin secretion
Answer: C) Increase blood calcium levels
PTH raises serum calcium by stimulating bone resorption, enhancing intestinal calcium
absorption via vitamin D, and increasing renal calcium reabsorption.
13. Which of the following is a common symptom of hyperthyroidism?
A) Weight gain
B) Cold intolerance
C) Heat intolerance
D) Bradycardia
Answer: C) Heat intolerance
Hyperthyroidism increases metabolic rate, leading to heat intolerance, sweating, and
weight loss despite increased appetite.
14. Addison’s disease results from:
A) Hypersecretion of adrenal cortex hormones
B) Hyposecretion of adrenal cortex hormones
C) Hypersecretion of adrenal medulla hormones
D) Hyposecretion of pituitary hormones
Answer: B) Hyposecretion of adrenal cortex hormones
Addison’s disease involves insufficient cortisol and aldosterone, causing hypotension,
fatigue, hyperpigmentation, and electrolyte imbalances.
15. Which of the following hormones is released in response to stress?
A) Insulin
B) Glucagon
C) Cortisol
D) Aldosterone
Answer: C) Cortisol
Cortisol is a glucocorticoid released during stress, increasing glucose availability,
suppressing inflammation, and supporting cardiovascular function.
16. A 45-year-old patient with moon face, buffalo hump, and central obesity most likely has:
A) Addison’s disease
B) Cushing’s syndrome
C) Acromegaly
D) Hyperthyroidism
Answer: B) Cushing’s syndrome
Excess cortisol leads to characteristic fat redistribution, muscle weakness, hyperglycemia,
and skin changes.
