WGU D446 ADULT HEALTH 2: ENDOCRINE SYSTEM
WGU D446 Adult Health 2: Endocrine System
Final Test
GRADED A+
Total Questions: 50
Format: Multiple Choice, Select-All-That-Apply, and Prioritization
Time Limit: 75 minutes
Grading: A+ (90–100%)
SECTION 1: Endocrine System Fundamentals
Question 1
A nurse is teaching a patient about the function of the endocrine system. Which statement by
the patient indicates correct understanding?
A. "The endocrine system uses neurotransmitters to send messages between cells."
B. "Endocrine glands secrete hormones directly into the bloodstream."
C. "The endocrine system responds more quickly than the nervous system."
D. "Exocrine glands produce hormones that regulate metabolism."
Answer: B. Endocrine glands secrete hormones directly into the bloodstream.
Rationale: Endocrine glands are ductless and release hormones directly into the bloodstream
for transport to target cells. The nervous system uses neurotransmitters and responds quickly;
the endocrine system is slower but has prolonged effects. Exocrine glands secrete substances
through ducts, not hormones.
Question 2
Which of the following are classified as major endocrine glands? (Select all that apply)
A. Hypothalamus
B. Pituitary gland
C. Pancreas
D. Liver
E. Adrenal glands
Answer: A, B, C, E
Rationale: The major endocrine glands include the hypothalamus, pituitary, thyroid,
parathyroid, adrenal glands, pancreas, pineal, and gonads. The liver has metabolic functions
but is not primarily an endocrine gland.
Question 3
A patient asks the nurse how hormones reach their target cells. What is the nurse's best
response?
, WGU D446 ADULT HEALTH 2: ENDOCRINE SYSTEM
A. "Hormones travel through the lymphatic system to reach target cells."
B. "Most hormones travel dissolved in blood plasma, while some are bound to transport
proteins."
C. "Hormones are released into ducts that lead directly to target organs."
D. "Hormones only affect cells within the same tissue where they are produced."
Answer: B. Most hormones travel dissolved in blood plasma, while some are bound to
transport proteins.
Rationale: Water-soluble hormones travel freely in blood; lipid-soluble hormones (e.g.,
steroids) bind to carrier proteins. Endocrine glands are ductless. Paracrine/autocrine hormones
act locally, but most travel via bloodstream.
Question 4
A nurse is reviewing feedback mechanisms. Which of the following is an example of positive
feedback?
A. Regulation of blood glucose by insulin and glucagon
B. Release of oxytocin during childbirth
C. Control of thyroid hormone by TSH
D. Maintenance of body temperature
Answer: B. Release of oxytocin during childbirth
Rationale: Positive feedback amplifies the original stimulus. Oxytocin release increases uterine
contractions, which stimulates more oxytocin release. Negative feedback maintains
homeostasis by reducing the initial stimulus.
SECTION 2: Diabetes Mellitus
Question 5
A patient with type 1 diabetes mellitus asks why they must take insulin. What is the nurse's
best response?
A. "Your body produces insulin, but your cells are resistant to it."
B. "Your pancreas does not produce insulin, so it must be replaced."
C. "Insulin helps your liver release stored glucose for energy."
D. "You need insulin to prevent your blood sugar from dropping too low."
Answer: B. Your pancreas does not produce insulin, so it must be replaced.
Rationale: Type 1 diabetes is caused by autoimmune destruction of pancreatic beta cells,
resulting in absolute insulin deficiency. Insulin replacement is required for survival. Insulin
lowers blood glucose; it does not prevent hypoglycemia.
Question 6
A nurse is teaching a patient with type 2 diabetes about metformin. Which statement indicates
understanding?
A. "Metformin increases insulin production from my pancreas."
B. "I should take metformin when my blood sugar is too high."
C. "Metformin helps my body use insulin more effectively."
D. "Metformin can cause weight gain and high blood pressure."
Answer: C. Metformin helps my body use insulin more effectively.
, WGU D446 ADULT HEALTH 2: ENDOCRINE SYSTEM
Rationale: Metformin is a biguanide that improves insulin sensitivity, decreases hepatic
glucose production, and lowers blood glucose. It does not increase insulin secretion, is taken
regularly (not as needed), and is weight-neutral.
Question 7
A patient with type 1 diabetes reports feeling shaky, sweaty, and confused. What is the priority
action?
A. Administer 15 g of carbohydrates.
B. Check the patient's blood glucose level.
C. Give a glucagon injection.
D. Notify the healthcare provider.
Answer: B. Check the patient's blood glucose level.
Rationale: Symptoms suggest hypoglycemia. Blood glucose must be confirmed (usually <70
mg/dL) before treatment. If the patient is conscious, treat with 15 g carbohydrates. Glucagon is
for unconscious patients.
Question 8
A patient with type 2 diabetes has a hemoglobin A1c of 8.5%. What does this indicate?
A. Excellent blood glucose control over the past 3 months
B. Poor blood glucose control requiring intervention
C. The patient has been hypoglycemic frequently
D. The test is not valid for type 2 diabetes
Answer: B. Poor blood glucose control requiring intervention
Rationale: Hemoglobin A1c reflects average blood glucose over 2–3 months. Goal for most
adults is <7%. An A1c of 8.5% indicates elevated average glucose and increased risk for
complications.
Question 9
A nurse is caring for a patient in diabetic ketoacidosis (DKA). Which of the following findings
are expected? (Select all that apply)
A. Blood glucose 350 mg/dL
B. Metabolic alkalosis
C. Serum ketones positive
D. Potassium 5.5 mEq/L
E. Deep, rapid breathing (Kussmaul)
Answer: A, C, D, E
Rationale: DKA presents with hyperglycemia, ketosis, metabolic acidosis (low pH, low HCO₃⁻),
hyperkalemia (initially due to acidosis), and Kussmaul respirations. Potassium may drop after
insulin therapy.
Question 10
A patient with type 2 diabetes is admitted with hyperosmolar hyperglycemic state (HHS).
Which finding distinguishes HHS from DKA?
A. Blood glucose >250 mg/dL
WGU D446 Adult Health 2: Endocrine System
Final Test
GRADED A+
Total Questions: 50
Format: Multiple Choice, Select-All-That-Apply, and Prioritization
Time Limit: 75 minutes
Grading: A+ (90–100%)
SECTION 1: Endocrine System Fundamentals
Question 1
A nurse is teaching a patient about the function of the endocrine system. Which statement by
the patient indicates correct understanding?
A. "The endocrine system uses neurotransmitters to send messages between cells."
B. "Endocrine glands secrete hormones directly into the bloodstream."
C. "The endocrine system responds more quickly than the nervous system."
D. "Exocrine glands produce hormones that regulate metabolism."
Answer: B. Endocrine glands secrete hormones directly into the bloodstream.
Rationale: Endocrine glands are ductless and release hormones directly into the bloodstream
for transport to target cells. The nervous system uses neurotransmitters and responds quickly;
the endocrine system is slower but has prolonged effects. Exocrine glands secrete substances
through ducts, not hormones.
Question 2
Which of the following are classified as major endocrine glands? (Select all that apply)
A. Hypothalamus
B. Pituitary gland
C. Pancreas
D. Liver
E. Adrenal glands
Answer: A, B, C, E
Rationale: The major endocrine glands include the hypothalamus, pituitary, thyroid,
parathyroid, adrenal glands, pancreas, pineal, and gonads. The liver has metabolic functions
but is not primarily an endocrine gland.
Question 3
A patient asks the nurse how hormones reach their target cells. What is the nurse's best
response?
, WGU D446 ADULT HEALTH 2: ENDOCRINE SYSTEM
A. "Hormones travel through the lymphatic system to reach target cells."
B. "Most hormones travel dissolved in blood plasma, while some are bound to transport
proteins."
C. "Hormones are released into ducts that lead directly to target organs."
D. "Hormones only affect cells within the same tissue where they are produced."
Answer: B. Most hormones travel dissolved in blood plasma, while some are bound to
transport proteins.
Rationale: Water-soluble hormones travel freely in blood; lipid-soluble hormones (e.g.,
steroids) bind to carrier proteins. Endocrine glands are ductless. Paracrine/autocrine hormones
act locally, but most travel via bloodstream.
Question 4
A nurse is reviewing feedback mechanisms. Which of the following is an example of positive
feedback?
A. Regulation of blood glucose by insulin and glucagon
B. Release of oxytocin during childbirth
C. Control of thyroid hormone by TSH
D. Maintenance of body temperature
Answer: B. Release of oxytocin during childbirth
Rationale: Positive feedback amplifies the original stimulus. Oxytocin release increases uterine
contractions, which stimulates more oxytocin release. Negative feedback maintains
homeostasis by reducing the initial stimulus.
SECTION 2: Diabetes Mellitus
Question 5
A patient with type 1 diabetes mellitus asks why they must take insulin. What is the nurse's
best response?
A. "Your body produces insulin, but your cells are resistant to it."
B. "Your pancreas does not produce insulin, so it must be replaced."
C. "Insulin helps your liver release stored glucose for energy."
D. "You need insulin to prevent your blood sugar from dropping too low."
Answer: B. Your pancreas does not produce insulin, so it must be replaced.
Rationale: Type 1 diabetes is caused by autoimmune destruction of pancreatic beta cells,
resulting in absolute insulin deficiency. Insulin replacement is required for survival. Insulin
lowers blood glucose; it does not prevent hypoglycemia.
Question 6
A nurse is teaching a patient with type 2 diabetes about metformin. Which statement indicates
understanding?
A. "Metformin increases insulin production from my pancreas."
B. "I should take metformin when my blood sugar is too high."
C. "Metformin helps my body use insulin more effectively."
D. "Metformin can cause weight gain and high blood pressure."
Answer: C. Metformin helps my body use insulin more effectively.
, WGU D446 ADULT HEALTH 2: ENDOCRINE SYSTEM
Rationale: Metformin is a biguanide that improves insulin sensitivity, decreases hepatic
glucose production, and lowers blood glucose. It does not increase insulin secretion, is taken
regularly (not as needed), and is weight-neutral.
Question 7
A patient with type 1 diabetes reports feeling shaky, sweaty, and confused. What is the priority
action?
A. Administer 15 g of carbohydrates.
B. Check the patient's blood glucose level.
C. Give a glucagon injection.
D. Notify the healthcare provider.
Answer: B. Check the patient's blood glucose level.
Rationale: Symptoms suggest hypoglycemia. Blood glucose must be confirmed (usually <70
mg/dL) before treatment. If the patient is conscious, treat with 15 g carbohydrates. Glucagon is
for unconscious patients.
Question 8
A patient with type 2 diabetes has a hemoglobin A1c of 8.5%. What does this indicate?
A. Excellent blood glucose control over the past 3 months
B. Poor blood glucose control requiring intervention
C. The patient has been hypoglycemic frequently
D. The test is not valid for type 2 diabetes
Answer: B. Poor blood glucose control requiring intervention
Rationale: Hemoglobin A1c reflects average blood glucose over 2–3 months. Goal for most
adults is <7%. An A1c of 8.5% indicates elevated average glucose and increased risk for
complications.
Question 9
A nurse is caring for a patient in diabetic ketoacidosis (DKA). Which of the following findings
are expected? (Select all that apply)
A. Blood glucose 350 mg/dL
B. Metabolic alkalosis
C. Serum ketones positive
D. Potassium 5.5 mEq/L
E. Deep, rapid breathing (Kussmaul)
Answer: A, C, D, E
Rationale: DKA presents with hyperglycemia, ketosis, metabolic acidosis (low pH, low HCO₃⁻),
hyperkalemia (initially due to acidosis), and Kussmaul respirations. Potassium may drop after
insulin therapy.
Question 10
A patient with type 2 diabetes is admitted with hyperosmolar hyperglycemic state (HHS).
Which finding distinguishes HHS from DKA?
A. Blood glucose >250 mg/dL
