MOSBY'S NCLEX STYLE QUESTIONS W/ RATIONALE:
ENDOCRINE SYSTEM QUESTIONS WITH ACCURATE ANSWERS
A 34-year-old client is 3 days postoperative from the removal of the thyroid gland
(thyroidectomy). She had blood drawn for serum chemistries in the morning,
which showed calcium of 3.2 mg/dL, potassium of 3.9 mEq/L, and phosphorus of
4.0 mg/dL. The nurse would interpret these findings to indicate:
1. hypocalcemia
2. hypercalcemia
3. hyperkalemia
4. hypophosphatemia correct answer Correct: 1
Rationale: Hypocalcemia is a low serum calcium level. Surgical removal of the
thyroid gland may also include removal of the parathyroid gland. This causes a
deficiency of parathyroid hormones, which control serum calcium by regulating
the absorption of calcium from the GI tract, mobilizing calcium in bones, and
excreting calcium in breast milk, feces, sweat, and urine.
Normal serum calcium levels are 9.0-11.5 mg/dL; potassium is within normal
limits (3.5-5 mEq/L), and phosphors are also within normal limits (2.8 to 4.5
mg/dL)
A 45-year-old client is newly diagnosed with type 2 (non-insulin dependent) DM.
Which symptoms would indicated to a nurse that this client is experiencing
hyperglycemia?
1. polydipsia, polyuria, and poluphagia
2. weight gain, fatigue, and bradycardia
3. irritability, diaphoresis, and tachycardia
4. loss of appetite, abdominal pain, and oliguria correct answer Correct: 1
Rationale: symptoms of hyperglycemia, as seen in both forms of DM, include
polydipsia, polyuria, polyphagia, and weight loss. Clients with hyperglycemia due
, to DM do not manifest weight gain, loss of appetite or oliguria, or bradycardia,
but they may exhibit fatigue, tachycardia, and abdominal pain. Irritability and
diaphoresis are manifestations of hypoglycemia (low blood sugar).
A client has received diet instructions as part of the treatment plan for type 1 DM.
Which statement by the client would indicate to the nurse that additional
instruction is needed?
1. "I will need a bedtime snack because I take an evening dose of NPH insulin."
2. "If I go over my calories, I can just increase my insulin."
3. "I can have an occasional low-calorie dessert as longs I include it in my meal
plan."
4. "I should eat meals at the scheduled times, even if I am not hungry, to prevent
hypoglycemia." correct answer Correct: 2
Rationale: the goal of diet therapy for clients with DM is to attain and maintain
ideal body weight and a stable blood glucose level. Each client should be
prescbied a specific caloric intake and insulin regimen to support reaching the
goal. Insulin dose should not be regulated based on increasing caloric intake. The
statements in the other answer options are correct regarding diabetes
management.
A client is learning how to mix regular insulin and NPH insulin in the same syringe.
Which action, if performed by the client, indicates the need for further teaching?
1. Withdrawal of the NPH insulin first
2. Injection of air into the NPH insulin bottle first
3. Removal of air bubbles after drawing up the first insulin
4. Injection of an amount of air equal to the desired dose of insulin correct answer
Correct: 1
ENDOCRINE SYSTEM QUESTIONS WITH ACCURATE ANSWERS
A 34-year-old client is 3 days postoperative from the removal of the thyroid gland
(thyroidectomy). She had blood drawn for serum chemistries in the morning,
which showed calcium of 3.2 mg/dL, potassium of 3.9 mEq/L, and phosphorus of
4.0 mg/dL. The nurse would interpret these findings to indicate:
1. hypocalcemia
2. hypercalcemia
3. hyperkalemia
4. hypophosphatemia correct answer Correct: 1
Rationale: Hypocalcemia is a low serum calcium level. Surgical removal of the
thyroid gland may also include removal of the parathyroid gland. This causes a
deficiency of parathyroid hormones, which control serum calcium by regulating
the absorption of calcium from the GI tract, mobilizing calcium in bones, and
excreting calcium in breast milk, feces, sweat, and urine.
Normal serum calcium levels are 9.0-11.5 mg/dL; potassium is within normal
limits (3.5-5 mEq/L), and phosphors are also within normal limits (2.8 to 4.5
mg/dL)
A 45-year-old client is newly diagnosed with type 2 (non-insulin dependent) DM.
Which symptoms would indicated to a nurse that this client is experiencing
hyperglycemia?
1. polydipsia, polyuria, and poluphagia
2. weight gain, fatigue, and bradycardia
3. irritability, diaphoresis, and tachycardia
4. loss of appetite, abdominal pain, and oliguria correct answer Correct: 1
Rationale: symptoms of hyperglycemia, as seen in both forms of DM, include
polydipsia, polyuria, polyphagia, and weight loss. Clients with hyperglycemia due
, to DM do not manifest weight gain, loss of appetite or oliguria, or bradycardia,
but they may exhibit fatigue, tachycardia, and abdominal pain. Irritability and
diaphoresis are manifestations of hypoglycemia (low blood sugar).
A client has received diet instructions as part of the treatment plan for type 1 DM.
Which statement by the client would indicate to the nurse that additional
instruction is needed?
1. "I will need a bedtime snack because I take an evening dose of NPH insulin."
2. "If I go over my calories, I can just increase my insulin."
3. "I can have an occasional low-calorie dessert as longs I include it in my meal
plan."
4. "I should eat meals at the scheduled times, even if I am not hungry, to prevent
hypoglycemia." correct answer Correct: 2
Rationale: the goal of diet therapy for clients with DM is to attain and maintain
ideal body weight and a stable blood glucose level. Each client should be
prescbied a specific caloric intake and insulin regimen to support reaching the
goal. Insulin dose should not be regulated based on increasing caloric intake. The
statements in the other answer options are correct regarding diabetes
management.
A client is learning how to mix regular insulin and NPH insulin in the same syringe.
Which action, if performed by the client, indicates the need for further teaching?
1. Withdrawal of the NPH insulin first
2. Injection of air into the NPH insulin bottle first
3. Removal of air bubbles after drawing up the first insulin
4. Injection of an amount of air equal to the desired dose of insulin correct answer
Correct: 1
