Endocrine NCLEX questions AND ANSWER GRADE A+ SOLUTIONS

Endocrine NCLEX questions AND
ANSWER GRADE A+ SOLUTIONS

1. An agitated, confused female client arrives in the emergency
department. Her history includes type 1 diabetes mellitus,
hypertension, and angina pectoris. Assessment reveals pallor,
diaphoresis, headache, and intense hunger. A stat blood glucose
sample measures 42 mg/dl, and the client is treated for an acute
hypoglycemic reaction. After recovery, nurse Lily teaches the client
to treat hypoglycemia by ingesting:
a. 2 to 5 g of a simple carbohydrate.
b. 10 to 15 g of a simple carbohydrate.
c. 18 to 20 g of a simple carbohydrate.
d. 25 to 30 g of a simple carbohydrate.
B.
To reverse hypoglycemia, the American Diabetes Association recommends
ingesting 10 to 15 g of a simple carbohydrate, such as three to five
pieces of hard candy, two to three packets of sugar (4 to 6 tsp), or
4 oz of fruit juice. If necessary, this treatment can be repeated in
15 minutes. Ingesting only 2 to 5 g of a simple carbohydrate may not
raise the blood glucose level sufficiently. Ingesting more than 15 g
may raise it above normal, causing hyperglycemia.


2. A female adult client with a history of chronic
hyperparathyroidism admits to being noncompliant. Based on initial
assessment findings, nurse Julia formulates the nursing diagnosis of
Risk for injury. To complete the nursing diagnosis statement for this
client, which "related-to" phrase should the nurse add?
a. Related to bone demineralization resulting in pathologic fractures
b. Related to exhaustion secondary to an accelerated metabolic rate
c. Related to edema and dry skin secondary to fluid infiltration into
the interstitial spaces
d. Related to tetany secondary to a decreased serum calcium level
A.
Poorly controlled hyperparathyroidism may cause an elevated serum
calcium level. This, in turn, may diminish calcium stores in the bone,
causing bone demineralization and setting the stage for pathologic

,fractures and a risk for injury. Hyperparathyroidism doesn't
accelerate the metabolic rate. A decreased thyroid hormone level, not
an increased parathyroid hormone level, may cause edema and dry skin
secondary to fluid infiltration into the interstitial spaces.
Hyperparathyroidism causes hypercalcemia, not hypocalcemia; therefore,
it isn't associated with tetany.
3. Nurse John is assigned to care for a postoperative male client who
has diabetes mellitus. During the assessment interview, the client
reports that he's impotent and says he's concerned about its effect
on his marriage. In planning this client's care, the most appropriate
intervention would be to:
a. Encourage the client to ask questions about personal sexuality.
b. Provide time for privacy.
c. Provide support for the spouse or significant other.
d. Suggest referral to a sex counselor or other appropriate
professional.
D.
The nurse should refer this client to a sex counselor or other
professional. Making appropriate referrals is a valid part of
planning the client's care. The nurse doesn't normally provide sex
counseling.
4. During a class on exercise for diabetic clients, a female client
asks the nurse educator how often to exercise. The nurse educator
advises the clients to exercise how often to meet the goals of
planned exercise?
a. At least once a week
b. At least three times a week
c. At least five times a week
d. Every day
B.
Diabetic clients must exercise at least three times a week to meet
the goals of planned exercise — lowering the blood glucose level,
reducing or maintaining the proper weight, increasing the serum high-
density lipoprotein level, decreasing serum triglyceride levels,
reducing blood pressure, and minimizing stress. Exercising once a
week wouldn't achieve these goals. Exercising more than three times a
week, although beneficial, would exceed the minimum requirement.
5. Nurse Oliver should expect a client with hypothyroidism to report
which health concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
c. Nervousness and tremors
d. Thyroid gland swelling

,B.
Hypothyroidism (myxedema) causes facial puffiness, extremity edema,
and weight gain. Signs and symptoms of hyperthyroidism (Graves'
disease) include an increased appetite, weight loss, nervousness,
tremors, and thyroid gland enlargement (goiter).



6. A female client with hypothyroidism (myxedema) is receiving
levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should
nurse Hans recognize as an adverse drug effect?
a. Dysuria
b. Leg cramps
c. Tachycardia
d. Blurred vision
C.
Levothyroxine, a synthetic thyroid hormone, is given to a client with
hypothyroidism to simulate the effects of thyroxine. Adverse effects
of this agent include tachycardia. The other options aren't
associated with levothyroxine.


7. A 67-year-old male client has been complaining of sleeping more,
increased urination, anorexia, weakness, irritability, depression,
and bone pain that interferes with her going outdoors. Based on these
assessment findings, nurse Richard would suspect which of the
following disorders?
a. Diabetes mellitus
b. Diabetes insipidus
c. Hypoparathyroidism
d. Hyperparathyroidism
D.
Hyperparathyroidism is most common in older women and is
characterized by bone pain and weakness from excess parathyroid
hormone (PTH). Clients also exhibit hypercaliuria-causing polyuria.
While clients with diabetes mellitus and diabetes insipidus also have
polyuria, they don't have bone pain and increased sleeping.
Hypoparathyroidism is characterized by urinary frequency rather than
polyuria.
8. When caring for a male client with diabetes insipidus, nurse
Juliet expects to administer:
a. vasopressin (Pitressin Synthetic).
b. furosemide (Lasix).
c. regular insulin.
d. 10% dextrose.

, A.
Because diabetes insipidus results from decreased antidiuretic
hormone (vasopressin) production, the nurse should expect to
administer synthetic vasopressin for hormone replacement therapy.
Furosemide, a diuretic, is contraindicated because a client with
diabetes insipidus experiences polyuria. Insulin and dextrose are
used to treat diabetes mellitus and its complications, not diabetes
insipidus.
9. The nurse is aware that the following is the most common cause of
hyperaldosteronism?
a. Excessive sodium intake
b. A pituitary adenoma
c. Deficient potassium intake
d. An adrenal adenoma
D.
An autonomous aldosterone-producing adenoma is the most common cause
of hyperaldosteronism. Hyperplasia is the second most frequent cause.
Aldosterone secretion is independent of sodium and potassium intake
as well as of pituitary stimulation.
10. A male client with type 1 diabetes mellitus has a highly elevated
glycosylated hemoglobin (Hb) test result. In discussing the result
with the client, nurse Sharmaine would be most accurate in stating:
a. "The test needs to be repeated following a 12-hour fast."
b. "It looks like you aren't following the prescribed diabetic diet."
c. "It tells us about your sugar control for the last 3 months."
d. "Your insulin regimen needs to be altered significantly."
C.
The glycosylated Hb test provides an objective measure of glycemic
control over a 3-month period. The test helps identify trends or
practices that impair glycemic control, and it doesn't require a
fasting period before blood is drawn. The nurse can't conclude that
the result occurs from poor dietary management or inadequate insulin
coverage.
11. Following a unilateral adrenalectomy, nurse Betty would assess
for hyperkalemia shown by which of the following?
a. Muscle weakness
b. Tremors
c. Diaphoresis
d. Constipation
A.
Muscle weakness, bradycardia, nausea, diarrhea, and paresthesia of
the hands, feet, tongue, and face are findings associated with
hyperkalemia, which is transient and occurs from transient