1. A patient with Type 2 diabetes is scheduled for a CT scan with intravenous contrast. Which
medication should be held for 48 hours after the procedure?
A. Glipizide
B. Sitagliptin
C. Pioglitazone
D. Metformin
Answer: D
Rationale: Metformin must be held before and for 48 hours after contrast media
administration to prevent lactic acidosis and acute renal failure.
2. Which clinical manifestation is a hallmark sign of Diabetic Ketoacidosis (DKA) but not
Hyperosmolar Hyperglycemic Syndrome (HHS)?
A. Polyuria
B. Kussmaul respirations
C. Profound dehydration
D. Altered mental status
Answer: B
,Rationale: Kussmaul respirations are deep, rapid breaths occurring in DKA as the body
attempts to compensate for metabolic acidosis; HHS typically does not involve
ketoacidosis.
3. A nurse is caring for a patient who underwent a total thyroidectomy. The patient reports
tingling in their fingers and around the mouth. Which action should the nurse take first?
A. Assess for Chvostek’s sign
B. Check the patient’s blood pressure
C. Administer a sedative as ordered
D. Monitor for laryngeal nerve damage
Answer: A
Rationale: Tingling indicates hypocalcemia, often caused by accidental parathyroid
damage during thyroidectomy. Assessing for Chvostek’s sign is the priority to evaluate
neuromuscular irritability.
4. Which instruction should be included for a patient newly prescribed Levothyroxine for
hypothyroidism?
A. Take the medication in the morning on an empty stomach
B. Take the medication at bedtime with a snack
C. Take the medication with a full meal to avoid GI upset
D. Monitor for weight gain as a common side effect
, Answer: A
Rationale: Levothyroxine is best absorbed when taken on an empty stomach, usually 30-
60 minutes before breakfast.
5. A patient with Addison’s disease is being discharged. Which statement by the patient
indicates a need for further teaching?
A. ‘I should wear a medical alert bracelet at all times.’
B. ‘I will need to take steroid replacements for the rest of my life.’
C. ‘I can skip my medication if I have the stomach flu and cannot eat.’
D. ‘I should increase my salt intake during hot weather.’
Answer: C
Rationale: Patients with Addison’s must never skip doses, especially during illness, as it
can trigger an Addisonian crisis. They may need higher doses during stress.
6. Which assessment finding is most characteristic of Cushing’s Syndrome?
A. Hyperpigmentation of the skin
B. Exophthalmos
C. Weight loss and hypotension
D. Trunkal obesity and moon face
Answer: D