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ATI RN–STYLE MEDICAL-SURGICAL
ENDOCRINE PRACTICE EXAM 2026–
2027 [QUESTION 1-100] AND ANSWERS
UPDATED 2026/2027 | DETAILED
RATIONALES – A+ GRADED | INSTANT
DOWNLOAD
INTRODUCTION
The ATI RN–Style Medical-Surgical Endocrine Practice Exam 2026–2027 is designed to help
nursing students strengthen clinical judgment and decision-making related to endocrine
disorders. The practice exam focuses on high-risk conditions involving the thyroid, adrenal
glands, pituitary gland, pancreas, and disorders of glucose, fluid, and electrolyte regulation. It is
appropriate for RN students preparing for medical-surgical examinations, ATI-style assessments,
NCLEX-RN preparation, and comprehensive clinical review.
The questions emphasize application rather than simple recall. Students must interpret
assessment findings, laboratory values, medication effects, diagnostic results, complications, and
changes in patient condition. Several scenarios require prioritization, recognition of emergencies,
delegation, patient teaching, and evaluation of treatment effectiveness.
This 100-question practice bank provides four answer choices for every item, one best answer,
and detailed rationales explaining both the correct response and why the alternatives are
inappropriate. The goal is to strengthen clinical reasoning, identify knowledge gaps, and help
students recognize endocrine emergencies before they become life-threatening.
CONTENT AREA OVERVIEW
Approx.
Content Area Questions Key Topics
Weight
Diabetes Mellitus & Type 1/2 DM, insulin, oral agents, glucose
1–25 25%
Glycemic Management monitoring, complications
DKA, HHS, hypoglycemia, potassium
Diabetic Emergencies 26–38 13%
shifts, fluid replacement
Hypothyroidism, hyperthyroidism, thyroid
Thyroid Disorders 39–52 14%
storm, myxedema coma
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Approx.
Content Area Questions Key Topics
Weight
Addison disease, Cushing syndrome,
Adrenal Disorders 53–65 13%
adrenal crisis, corticosteroids
Pituitary & ADH DI, SIADH, vasopressin, fluid/electrolyte
66–74 9%
Disorders imbalance
Parathyroid & Calcium Hyperparathyroidism, hypoparathyroidism,
75–82 8%
Disorders calcium abnormalities
Endocrine Clinical Prioritization, medications, labs,
83–100 18%
Judgment & Safety complications, patient safety
Integrated endocrine nursing
TOTAL 100 100%
management
QUESTIONS 1–100
DIABETES MELLITUS & GLYCEMIC MANAGEMENT
Q1:
A nurse is caring for a client with type 1 diabetes mellitus who reports nausea and abdominal
discomfort after missing several insulin doses. The client's respiratory rate is 30/min and deep,
blood pressure is 96/58 mm Hg, and blood glucose is 398 mg/dL (22.1 mmol/L). Which action
should the nurse take first?
A) Administer the client's prescribed rapid-acting insulin
B) Assess the client's serum potassium and initiate prescribed IV fluid therapy
C) Encourage the client to drink a carbohydrate-containing beverage
D) Administer sodium bicarbonate immediately
Rationale: The findings suggest diabetic ketoacidosis (DKA), in which severe dehydration and
electrolyte abnormalities can occur. Initial management includes isotonic IV fluid replacement
and assessment of potassium before insulin administration because insulin drives potassium into
cells and can precipitate dangerous hypokalemia. Option A is incomplete because potassium
status must be evaluated. Option C would worsen hyperglycemia. Option D is not routinely
indicated and is generally reserved for severe metabolic acidosis under specific criteria.
Q2:
A client with type 2 diabetes mellitus is prescribed metformin. Which finding requires the nurse
to notify the provider before administering the medication?
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A) Hemoglobin A1C of 7.8%
B) Estimated glomerular filtration rate of 28 mL/min/1.73 m²
C) Fasting glucose of 156 mg/dL
D) Mild abdominal bloating after meals
Rationale: Significantly impaired renal function increases the risk associated with metformin,
particularly lactic acidosis. An eGFR of 28 mL/min/1.73 m² requires provider evaluation before
administration. Elevated A1C and fasting glucose indicate inadequate glycemic control but do
not independently contraindicate metformin. Mild gastrointestinal symptoms are common with
metformin and may improve with continued use.
Q3:
A client with type 1 diabetes receives insulin lispro before breakfast. The meal tray is delayed by
45 minutes. Which action is most appropriate?
A) Administer another dose of insulin
B) Encourage the client to ambulate until the tray arrives
C) Obtain a rapid source of carbohydrate if the meal will remain delayed and monitor
glucose
D) Give the client's long-acting insulin instead
Rationale: Rapid-acting insulin begins working quickly, so delaying food increases the risk of
hypoglycemia. The nurse should ensure carbohydrate availability and monitor the client's
glucose. A second insulin dose could cause severe hypoglycemia. Exercise can further lower
glucose. Long-acting insulin is not a substitute for the scheduled meal-related insulin.
Q4:
A client with diabetes is unconscious, has a blood glucose of 42 mg/dL (2.3 mmol/L), and has no
IV access. Which intervention should the nurse anticipate?
A) Give oral glucose gel
B) Administer regular insulin
C) Administer glucagon intramuscularly
D) Give the client water containing sugar
Rationale: An unconscious client cannot safely swallow, so oral glucose or sugar-containing
fluids can cause aspiration. When IV access is unavailable, glucagon is an appropriate
emergency treatment for severe hypoglycemia. Insulin would further lower glucose and is
contraindicated.
Q5:
A nurse evaluates a client newly prescribed insulin glargine. Which statement by the client
demonstrates correct understanding?
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A) “I will mix it with regular insulin in the same syringe.”
B) “I will take it at the same time each day as prescribed.”
C) “I will use it whenever my glucose is above 250 mg/dL.”
D) “I should expect a strong peak shortly after administration.”
Rationale: Insulin glargine is a long-acting basal insulin that is administered consistently and is
not intended for correction of acute hyperglycemia. It should not be mixed with other insulins
because this can alter its action. It has a relatively flat, prolonged action rather than a
pronounced peak.
Q6:
A client with type 2 diabetes takes a sulfonylurea and reports sweating, tremors, palpitations, and
confusion. The blood glucose is 54 mg/dL (3.0 mmol/L). Which intervention is appropriate if the
client is awake and able to swallow?
A) Administer the scheduled diabetes medication
B) Give approximately 15 g of rapid-acting carbohydrate
C) Encourage the client to skip all carbohydrates for the rest of the day
D) Administer long-acting insulin
Rationale: The manifestations are classic hypoglycemia. An alert client who can swallow should
receive approximately 15 g of rapid carbohydrate, followed by reassessment. Antidiabetic
medications and insulin can worsen hypoglycemia. Completely eliminating carbohydrates is
inappropriate.
Q7:
A client with diabetes asks why foot inspection is necessary every day. Which response by the
nurse is most appropriate?
A) “It prevents all diabetic complications.”
B) “It eliminates the need for professional foot examinations.”
C) “Neuropathy can reduce your ability to feel injuries before they become infected.”
D) “Diabetes causes everyone to develop foot ulcers.”
Rationale: Peripheral neuropathy may decrease sensation, allowing small wounds, burns, or
pressure injuries to go unnoticed. Early identification reduces the risk of complications. Daily
inspection does not prevent every complication or replace professional assessment, and not
every client develops ulcers.
Q8:
A client with diabetes reports blurry vision that began after insulin therapy was intensified.
Which explanation is most appropriate?
ATI RN–STYLE MEDICAL-SURGICAL
ENDOCRINE PRACTICE EXAM 2026–
2027 [QUESTION 1-100] AND ANSWERS
UPDATED 2026/2027 | DETAILED
RATIONALES – A+ GRADED | INSTANT
DOWNLOAD
INTRODUCTION
The ATI RN–Style Medical-Surgical Endocrine Practice Exam 2026–2027 is designed to help
nursing students strengthen clinical judgment and decision-making related to endocrine
disorders. The practice exam focuses on high-risk conditions involving the thyroid, adrenal
glands, pituitary gland, pancreas, and disorders of glucose, fluid, and electrolyte regulation. It is
appropriate for RN students preparing for medical-surgical examinations, ATI-style assessments,
NCLEX-RN preparation, and comprehensive clinical review.
The questions emphasize application rather than simple recall. Students must interpret
assessment findings, laboratory values, medication effects, diagnostic results, complications, and
changes in patient condition. Several scenarios require prioritization, recognition of emergencies,
delegation, patient teaching, and evaluation of treatment effectiveness.
This 100-question practice bank provides four answer choices for every item, one best answer,
and detailed rationales explaining both the correct response and why the alternatives are
inappropriate. The goal is to strengthen clinical reasoning, identify knowledge gaps, and help
students recognize endocrine emergencies before they become life-threatening.
CONTENT AREA OVERVIEW
Approx.
Content Area Questions Key Topics
Weight
Diabetes Mellitus & Type 1/2 DM, insulin, oral agents, glucose
1–25 25%
Glycemic Management monitoring, complications
DKA, HHS, hypoglycemia, potassium
Diabetic Emergencies 26–38 13%
shifts, fluid replacement
Hypothyroidism, hyperthyroidism, thyroid
Thyroid Disorders 39–52 14%
storm, myxedema coma
,2|Page
Approx.
Content Area Questions Key Topics
Weight
Addison disease, Cushing syndrome,
Adrenal Disorders 53–65 13%
adrenal crisis, corticosteroids
Pituitary & ADH DI, SIADH, vasopressin, fluid/electrolyte
66–74 9%
Disorders imbalance
Parathyroid & Calcium Hyperparathyroidism, hypoparathyroidism,
75–82 8%
Disorders calcium abnormalities
Endocrine Clinical Prioritization, medications, labs,
83–100 18%
Judgment & Safety complications, patient safety
Integrated endocrine nursing
TOTAL 100 100%
management
QUESTIONS 1–100
DIABETES MELLITUS & GLYCEMIC MANAGEMENT
Q1:
A nurse is caring for a client with type 1 diabetes mellitus who reports nausea and abdominal
discomfort after missing several insulin doses. The client's respiratory rate is 30/min and deep,
blood pressure is 96/58 mm Hg, and blood glucose is 398 mg/dL (22.1 mmol/L). Which action
should the nurse take first?
A) Administer the client's prescribed rapid-acting insulin
B) Assess the client's serum potassium and initiate prescribed IV fluid therapy
C) Encourage the client to drink a carbohydrate-containing beverage
D) Administer sodium bicarbonate immediately
Rationale: The findings suggest diabetic ketoacidosis (DKA), in which severe dehydration and
electrolyte abnormalities can occur. Initial management includes isotonic IV fluid replacement
and assessment of potassium before insulin administration because insulin drives potassium into
cells and can precipitate dangerous hypokalemia. Option A is incomplete because potassium
status must be evaluated. Option C would worsen hyperglycemia. Option D is not routinely
indicated and is generally reserved for severe metabolic acidosis under specific criteria.
Q2:
A client with type 2 diabetes mellitus is prescribed metformin. Which finding requires the nurse
to notify the provider before administering the medication?
,3|Page
A) Hemoglobin A1C of 7.8%
B) Estimated glomerular filtration rate of 28 mL/min/1.73 m²
C) Fasting glucose of 156 mg/dL
D) Mild abdominal bloating after meals
Rationale: Significantly impaired renal function increases the risk associated with metformin,
particularly lactic acidosis. An eGFR of 28 mL/min/1.73 m² requires provider evaluation before
administration. Elevated A1C and fasting glucose indicate inadequate glycemic control but do
not independently contraindicate metformin. Mild gastrointestinal symptoms are common with
metformin and may improve with continued use.
Q3:
A client with type 1 diabetes receives insulin lispro before breakfast. The meal tray is delayed by
45 minutes. Which action is most appropriate?
A) Administer another dose of insulin
B) Encourage the client to ambulate until the tray arrives
C) Obtain a rapid source of carbohydrate if the meal will remain delayed and monitor
glucose
D) Give the client's long-acting insulin instead
Rationale: Rapid-acting insulin begins working quickly, so delaying food increases the risk of
hypoglycemia. The nurse should ensure carbohydrate availability and monitor the client's
glucose. A second insulin dose could cause severe hypoglycemia. Exercise can further lower
glucose. Long-acting insulin is not a substitute for the scheduled meal-related insulin.
Q4:
A client with diabetes is unconscious, has a blood glucose of 42 mg/dL (2.3 mmol/L), and has no
IV access. Which intervention should the nurse anticipate?
A) Give oral glucose gel
B) Administer regular insulin
C) Administer glucagon intramuscularly
D) Give the client water containing sugar
Rationale: An unconscious client cannot safely swallow, so oral glucose or sugar-containing
fluids can cause aspiration. When IV access is unavailable, glucagon is an appropriate
emergency treatment for severe hypoglycemia. Insulin would further lower glucose and is
contraindicated.
Q5:
A nurse evaluates a client newly prescribed insulin glargine. Which statement by the client
demonstrates correct understanding?
, 4|Page
A) “I will mix it with regular insulin in the same syringe.”
B) “I will take it at the same time each day as prescribed.”
C) “I will use it whenever my glucose is above 250 mg/dL.”
D) “I should expect a strong peak shortly after administration.”
Rationale: Insulin glargine is a long-acting basal insulin that is administered consistently and is
not intended for correction of acute hyperglycemia. It should not be mixed with other insulins
because this can alter its action. It has a relatively flat, prolonged action rather than a
pronounced peak.
Q6:
A client with type 2 diabetes takes a sulfonylurea and reports sweating, tremors, palpitations, and
confusion. The blood glucose is 54 mg/dL (3.0 mmol/L). Which intervention is appropriate if the
client is awake and able to swallow?
A) Administer the scheduled diabetes medication
B) Give approximately 15 g of rapid-acting carbohydrate
C) Encourage the client to skip all carbohydrates for the rest of the day
D) Administer long-acting insulin
Rationale: The manifestations are classic hypoglycemia. An alert client who can swallow should
receive approximately 15 g of rapid carbohydrate, followed by reassessment. Antidiabetic
medications and insulin can worsen hypoglycemia. Completely eliminating carbohydrates is
inappropriate.
Q7:
A client with diabetes asks why foot inspection is necessary every day. Which response by the
nurse is most appropriate?
A) “It prevents all diabetic complications.”
B) “It eliminates the need for professional foot examinations.”
C) “Neuropathy can reduce your ability to feel injuries before they become infected.”
D) “Diabetes causes everyone to develop foot ulcers.”
Rationale: Peripheral neuropathy may decrease sensation, allowing small wounds, burns, or
pressure injuries to go unnoticed. Early identification reduces the risk of complications. Daily
inspection does not prevent every complication or replace professional assessment, and not
every client develops ulcers.
Q8:
A client with diabetes reports blurry vision that began after insulin therapy was intensified.
Which explanation is most appropriate?
