Endocrine NCLEX PN Practice Questions II

Endocrine NCLEX PN Practice Questions II Q&A Ana Corona, MSN, FNP­C Nursing Instructor July 2007 Question 1 □ A thirty five year old male has been an insulin­dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect? A: Atherosclerosis B: Diabetic nephropathy C: Autonomic neuropathy D: Somatic neuropathy 1 □ Answer C is correct. Autonomic neuropathy can cause inability to urinate. Question 2 □ A patient’s chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute? A: Decreased HR B: Paresthesias C: Muscle weakness of the extremities D: Migraines 2 □ Answer D is correct. Answer choices A­C were symptoms of acute hyperkalemia Question 3 □ A patient’s chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute? A: Vomiting B: Extreme Thirst C: Weight gain D: Acetone breath smell 3 □ Answer C is correct. Weight loss would be expected Question 4 □ A 84 year­old male has been loosing mobility and gaining weight over the last 2 months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed? A: CBC (complete blood count) B: ECG (electrocardiogram) C: Thyroid function tests D: CT scan 4 □ Answer C is correct. Weight gain and poor temperature tolerance indicate something may be wrong with the thyroid function. Question 5 □ A 28 year old male has been found wandering around in a confused pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first? A: Blood sugar check B: CT scan C: Blood cultures D: Arterial blood gases 5 □ Answer A is correct. With a history of diabetes, the first response should be to check blood sugar levels. Question 6 □ The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is: A. Measure the urinary output B. Check the vital signs C. Encourage increased fluid intake D. Weigh the client 6 □ Answer B is correct. The large amount of fluid loss can cause fluid and electrolyte imbalance that should be corrected. The loss of electrolytes would be reflected in the vital signs. Measuring the urinary output is important, but the stem already says that the client has polyuria, so answer A is incorrect. Encouraging fluid intake will not correct the problem, making answer C incorrect. Answer D is incorrect because weighing the client is not necessary at this time. Question 7 □ A client has had a unilateral adrenalectomy to remove a tumor. To prevent complications, the most important measurement in the immediate post­operative period for the nurse to take is: A. Blood pressure B. Temperature C. Output D. Specific gravity 7 □ Answer A is correct. Blood pressure is the best indicator of cardiovascular collapse in the client who has had an adrenal gland removed. The remaining gland might have been suppressed due to the tumor activity. Temperature would be an indicator of infection, decreased output would be a clinical manifestation but would take longer to occur than blood pressure changes, and specific gravity changes occur with other disorders; therefore, answers B, C, and D are incorrect. Question 8 □ A client with Addison's disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids (Solu­Medrol). Which of the following interventions would the nurse implement? A. Glucometer readings as ordered B. Intake/output measurements C. Sodium and potassium levels monitored D. Daily weights 8 □ Answer A is correct. IV glucocorticoids raise the glucose levels and often require coverage with insulin. Answer B is not necessary at this time, sodium and potassium levels would be monitored when the client is receiving mineral corticoids, and daily weights is unnecessary; therefore, answers B, C, and D are incorrect. Question 9 □ A client had a total thyroidectomy yesterday. The client is complaining of tingling around the mouth and in the fingers and toes. What would the nurses' next action be? A. Obtain a crash cart B. Check the calcium level C. Assess the dressing for drainage D. Assess the blood pressure for hypertension 9 □ Answer B is correct. The parathyroid glands are responsible for calcium production and can be damaged during a thyroidectomy. The tingling is due to low calcium levels. The crash cart would be needed in respiratory distress but would not be the next action to take; thus, answer A is incorrect. Hypertension occurs in thyroid storm and the drainage would occur in hemorrhage, so answers C and D are incorrect. Question 10 □ A 32­year­old mother of three is brought to the clinic. Her pulse is 52, there is a weight gain of 30 pounds in 4 months, and the client is wearing two sweaters. The client is diagnosed with hypothyroidism. Which of the following nursing diagnoses is of highest priority? A. Impaired physical mobility related to decreased endurance B. Hypothermia r/t decreased metabolic rate C. Disturbed thought processes r/t interstitial edema D. Decreased cardiac output r/t bradycardia 10 □ Answer D is correct. The decrease in pulse can affect the cardiac output and lead to shock, which would take precedence over the other choices; therefore, answers A, B, and C are incorrect.