NCLEX-RN Endocrine System Pharmacology Practice
Questions |
20 Original NGN & ATI-Style MCQs with Detailed
Rationales |
Diabetes, Thyroid, Insulin, Adrenal & Pituitary
Medications |
Nursing Exam Study Guide 2026
Question 1
Clinical Scenario
A 52-year-old woman with newly diagnosed hypothyroidism
is prescribed levothyroxine 75 mcg orally daily. During
discharge teaching, the nurse reviews how to take the
medication. The client also takes calcium carbonate, ferrous
sulfate, and a multivitamin each morning.
Question Stem
Which statement by the client indicates an understanding of
levothyroxine administration?
A. "I will take levothyroxine with breakfast and my vitamins."
B. "I will take levothyroxine at bedtime with a snack."
,C. "I will take levothyroxine on an empty stomach and
separate it from calcium supplements."
D. "I will stop taking levothyroxine once my symptoms
improve."
Correct Answer
Correct Answer: C. "I will take levothyroxine on an empty
stomach and separate it from calcium supplements."
Detailed Rationale
Levothyroxine is best absorbed when taken on an empty
stomach, typically 30–60 minutes before breakfast. Calcium
supplements, iron products, antacids, and some
multivitamins can significantly decrease levothyroxine
absorption, reducing therapeutic effectiveness. Separating
these medications by at least 4 hours promotes optimal
thyroid hormone absorption and therapeutic response.
Option A is incorrect because taking levothyroxine with food
and vitamins may decrease absorption. Option B is incorrect
because although bedtime administration may be
acceptable in some cases, it should be consistently taken
on an empty stomach rather than with a snack. Option D is
incorrect because hypothyroidism generally requires lifelong
therapy, and abrupt discontinuation may result in recurrence
of symptoms and abnormal thyroid hormone levels.
,Nurses should emphasize adherence, regular laboratory
monitoring of TSH and free T4 levels, and recognition that
symptom improvement may take several weeks. Medication
safety includes educating patients about interactions that
reduce absorption and avoiding unauthorized dosage
changes.
Learning Objective
After completing this question, the learner should be able
to:
• Identify proper administration techniques for
levothyroxine.
• Recognize medications that interfere with thyroid
hormone absorption.
• Educate patients about lifelong thyroid replacement
therapy.
• Monitor therapeutic effectiveness through laboratory
values.
Medication Safety Focus
Patient education
Question 2
Clinical Scenario
, A 68-year-old man with type 2 diabetes mellitus receives
insulin glargine and insulin lispro. Before lunch, his blood
glucose is 72 mg/dL. He reports feeling shaky and
diaphoretic.
Question Stem
Which action should the nurse take first?
A. Administer insulin lispro as prescribed.
B. Provide 15 g of rapid-acting carbohydrates.
C. Notify the provider immediately.
D. Recheck blood glucose in 2 hours.
Correct Answer
Correct Answer: B. Provide 15 g of rapid-acting
carbohydrates.
Detailed Rationale
The client is experiencing symptomatic hypoglycemia.
Immediate treatment with 15 g of rapid-acting
carbohydrates, such as glucose tablets or juice, is the
priority intervention. The "15-15 rule" recommends
administering 15 g of carbohydrate and rechecking glucose
in approximately 15 minutes.
Option A is unsafe because insulin administration would
worsen hypoglycemia. Option C may become appropriate if
Questions |
20 Original NGN & ATI-Style MCQs with Detailed
Rationales |
Diabetes, Thyroid, Insulin, Adrenal & Pituitary
Medications |
Nursing Exam Study Guide 2026
Question 1
Clinical Scenario
A 52-year-old woman with newly diagnosed hypothyroidism
is prescribed levothyroxine 75 mcg orally daily. During
discharge teaching, the nurse reviews how to take the
medication. The client also takes calcium carbonate, ferrous
sulfate, and a multivitamin each morning.
Question Stem
Which statement by the client indicates an understanding of
levothyroxine administration?
A. "I will take levothyroxine with breakfast and my vitamins."
B. "I will take levothyroxine at bedtime with a snack."
,C. "I will take levothyroxine on an empty stomach and
separate it from calcium supplements."
D. "I will stop taking levothyroxine once my symptoms
improve."
Correct Answer
Correct Answer: C. "I will take levothyroxine on an empty
stomach and separate it from calcium supplements."
Detailed Rationale
Levothyroxine is best absorbed when taken on an empty
stomach, typically 30–60 minutes before breakfast. Calcium
supplements, iron products, antacids, and some
multivitamins can significantly decrease levothyroxine
absorption, reducing therapeutic effectiveness. Separating
these medications by at least 4 hours promotes optimal
thyroid hormone absorption and therapeutic response.
Option A is incorrect because taking levothyroxine with food
and vitamins may decrease absorption. Option B is incorrect
because although bedtime administration may be
acceptable in some cases, it should be consistently taken
on an empty stomach rather than with a snack. Option D is
incorrect because hypothyroidism generally requires lifelong
therapy, and abrupt discontinuation may result in recurrence
of symptoms and abnormal thyroid hormone levels.
,Nurses should emphasize adherence, regular laboratory
monitoring of TSH and free T4 levels, and recognition that
symptom improvement may take several weeks. Medication
safety includes educating patients about interactions that
reduce absorption and avoiding unauthorized dosage
changes.
Learning Objective
After completing this question, the learner should be able
to:
• Identify proper administration techniques for
levothyroxine.
• Recognize medications that interfere with thyroid
hormone absorption.
• Educate patients about lifelong thyroid replacement
therapy.
• Monitor therapeutic effectiveness through laboratory
values.
Medication Safety Focus
Patient education
Question 2
Clinical Scenario
, A 68-year-old man with type 2 diabetes mellitus receives
insulin glargine and insulin lispro. Before lunch, his blood
glucose is 72 mg/dL. He reports feeling shaky and
diaphoretic.
Question Stem
Which action should the nurse take first?
A. Administer insulin lispro as prescribed.
B. Provide 15 g of rapid-acting carbohydrates.
C. Notify the provider immediately.
D. Recheck blood glucose in 2 hours.
Correct Answer
Correct Answer: B. Provide 15 g of rapid-acting
carbohydrates.
Detailed Rationale
The client is experiencing symptomatic hypoglycemia.
Immediate treatment with 15 g of rapid-acting
carbohydrates, such as glucose tablets or juice, is the
priority intervention. The "15-15 rule" recommends
administering 15 g of carbohydrate and rechecking glucose
in approximately 15 minutes.
Option A is unsafe because insulin administration would
worsen hypoglycemia. Option C may become appropriate if
