UWorld Endocrine [ACTUAL EXAM] LATEST VERSION
[QUESTIONS AND ANSWERS] WITH PRACTICE EXAM
DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A
A client is admitted to the intensive care unit with suspected pheochromocytoma. The
client's vital signs are temperature of 99.6 F (37.5 C), blood pressure (BP) of 200/110
mm Hg, heart rate of 110/min, and respirations of 20/min. The client is sweating
profusely and reports a severe headache. Which prescription should the nurse
implement first?
1. Draw labs to assess electrolyte panel
2. Give acetaminophen 650 mg by mouth as needed for headache
3. Place a fan in the client's room
4. Start nitroprusside infusion at 0.5 mcg/kg/min - CORRECT ANSWER 4
Pheochromocytoma is a condition caused by a tumor in the adrenal medulla. This
results in excess release of catecholamines such as epinephrine and norepinephrine,
leading to paroxysmal hypertensive crisis.
Important points to note when caring for these clients include the following:
1. Hypertension is difficult to treat and is often resistant to multiple drugs.
2. The client should avoid activities that can precipitate a hypertensive crisis (eg,
bending, lifting, Valsalva maneuver).
3. Abdominal palpation should be avoided as manipulation of the adrenal gland and
release of catecholamines can precipitate a hypertensive crisis.
Hypertensive crisis puts the client at risk for stroke and so has the highest priority for
treatment. Nitroprusside (Nitropress, Nipride) is a vasodilator given via infusion and can
be titrated to keep the BP within a desired parameter.
(Options 1, 2, and 3) Administration of acetaminophen and use of a fan may help relieve
symptoms. Drawing an electrolyte panel is appropriate. However, these are not life-
saving interventions and so are not the highest priority.
Educational objective: Pheochromocytoma is a condition caused by a tumor in the
adrenal medulla that causes release of catecholamines such as epinephrine and
norepinephrine, resulting in paroxysmal hypertensive crisis. Hypertensive crisis puts the
client at risk for stroke and should be treated promptly with intravenous nitroprusside or
another vasodilator (eg, phentolamine, nicardipine). Abdominal palpation should be
avoided in these clients.
The nurse in the emergency department is caring for a client recently diagnosed with
Graves' disease who was admitted following a motor vehicle accident. The nurse notes
,the vital signs shown in the exhibit. The nurse alerts the primary health care provider
that the client may be experiencing which condition? Click on the exhibit button for
additional information.
Vital Signs: increasing temp, BP, HR, and RR
1. Hypertensive crisis
2. Malignant hyperthermia
3. Serotonin syndrome
4. Thyroid storm - CORRECT ANSWER 4
Thyroid storm is a life-threatening condition that can occur in uncontrolled
hyperthyroidism or Graves' disease when a stressful incident, such as this client's motor
vehicle accident, triggers a sudden surge of thyroid hormone. Manifestations of thyroid
storm include a rapid onset of fever, tachycardia, and elevated blood pressure. The
client often feels anxious, tremulous, or restless. Confusion and psychosis can occur, as
can seizures and coma. Rapid treatment is necessary.
(Option 1) Hypertensive crisis alone would not cause fever.
(Option 2) Malignant hyperthermia would occur in the perioperative setting in response
to anesthesia. This client has no risk factors for malignant hyperthermia.
(Option 3) Serotonin syndrome would occur in the client taking more than one or an
overdose of antidepressant medication that increases serotonin levels.
Educational objective: Thyroid storm is a life-threatening complication of Graves'
disease (hyperthyroidism). Assessment findings include a rapid increase in
temperature, heart rate, and blood pressure in response to stress.
The nurse cares for a client with type 1 diabetes mellitus. Which laboratory result is
most important to report to the primary health care provider?
1. Fasting blood glucose 99 mg/dL (5.5 mmol/L)
2. Serum creatinine 2.0 mg/dL (177 µmol/L)
3. Serum potassium 3.9 mEq/L (3.9 mmol/L)
4. Serum sodium 140 mEq/L (140 mmol/L) - CORRECT ANSWER The normal
serum creatinine for an adult is 0.6-1.3 mg/dL (53-115 µmol/L). It provides an estimation
of the glomerular filtration rate and is an indicator of kidney function. A level of 2 mg/dL
(177 µmol/L) is clearly abnormal. The client with diabetes mellitus is at risk for diabetic
nephropathy, a complication associated with microvascular blood vessel damage in the
kidney. Early treatment and tight control of blood glucose levels are indicated to prevent
progressive renal injury in a client with diabetic nephropathy.
(Option 1) Normal serum fasting blood glucose is 70-99 mg/dL (3.9-5.5 mmol/L).
,(Option 3) Normal serum potassium is 3.5-5.0 mEq/L (3.5-5.0 mmol/L).
(Option 4) Normal serum sodium is 135-145 mEq/L (135-145 mmol/L).
Educational objective: The normal serum creatinine for an adult is 0.6-1.3 mg/dL (53-
115 µmol/L). Serum creatinine provides an estimation of the glomerular filtration rate
and is an indicator of kidney function.
The nurse is teaching a group of clients diagnosed with diabetes mellitus. Which lesson
regarding foot care should be included? Select all that apply.
1. Cut toenails straight across and file along the curves of the toes
2. Rub feet vigorously with a towel after bathing to ensure dryness
3. Use a mild foot powder on perspiring feet
4. Use cotton or lamb's wool to separate overlapping toes
5. Use an over-the-counter corn removal kit to remove corns or calluses - CORRECT
ANSWER 1, 3, 4
Individuals with type I or II diabetes mellitus are at increased risk for developing an
infection or ulcer on their feet. This is due to the chronic complication of peripheral
neuropathy, which results from nerve damage in the extremities.
Instructions for diabetic foot care include:
1. Wash feet daily with warm water and mild soap; test water temperature with
thermometer beforehand. Gently pat feet dry, particularly between the toes (Option 2).
Use lanolin to prevent dry and cracked skin, but do not apply between the toes.
2. Inspect for abrasions, cuts, or sores. Have others inspect the feet if eyesight is poor.
3. To prevent injury, use cotton or lamb's wool to separate overlapping toes. Cut
toenails straight across and use a nail file to file along the curves of the toes. Avoid
going barefoot and wear sturdy leather shoes. Use mild foot powder to absorb
perspiration and wear clean, absorbent socks with seams aligned (Options 1, 3, and 4).
4. Avoid using over-the-counter products (eg, iodine, alcohol, strong adhesives) on cuts
or abrasions (Option 5).
5. To improve circulation, do not sit with legs crossed or for extended periods, avoid
tight-fitting garments, and perform daily exercise.
6. Report other types of problems such as infections or athlete's foot immediately.
Educational objective: Individuals with type I or II diabetes mellitus are at increased risk
for developing an infection or ulcer on their feet due to the chronic complication of
peripheral neuropathy. Clients should keep feet clean, dry, and free from irritation.
The nurse cares for a client with type 2 diabetes mellitus and hemoglobin A1C results of
8% at an outpatient health clinic. Which statement by the nurse will best address these
results?
1. "It is important for us to review the signs and symptoms of a hypoglycemic reaction."
, 2. "Let's review your diet, exercise, and medication regimen over the past 2-3 months."
3. "Please describe what you have eaten in the last 24-48 hours."
4. "You should fast for at least 8 hours prior to your morning blood work." - CORRECT
ANSWER 2
Hemoglobin A1C is a diagnostic test used to measure the percentage of glycosylated
hemoglobin in the blood. A normal hemoglobin A1C is 4%-6% in clients without
diabetes; the goal is to keep the level <7% in clients with diabetes. The A1C test
measures blood glucose control over a period of 2-3 months; higher measurements
indicate higher glycemic levels. High levels may indicate poor adherence to the
recommended diet and exercise plan or ineffective antihyperglycemic medication
regimen. It is important for the nurse to review the diet, exercise, and medication plan
with the client who has a high hemoglobin A1C.
(Option 1) Although it is important to review signs and symptoms of hypoglycemia with
all clients with diabetes, this statement does not address the elevated hemoglobin A1C.
(Option 3) A diet recall of the last 24-48 hours will not give the nurse adequate
information on possible causes of an elevated hemoglobin A1C as this test measures
glycemic control over 2-3 months.
(Option 4) A hemoglobin A1C may be tested when the client is not fasting.
Educational objective: Hemoglobin A1C is a diagnostic test used to measure the
percentage of glycosylated hemoglobin in the blood over a period of 2-3 months. A
normal hemoglobin A1C is 4%-6% in clients without diabetes; the goal is to keep the
level <7% in clients with diabetes.
The nurse is caring for a client with suspected Graves disease. Which assessment
finding requires priority intervention?
1. Agitation and confusion
2. Heat intolerance
3. Pulse of 110/min, irregular rhythm
4. Red and bulging eyes - CORRECT ANSWER Thyroid storm is a serious and
potentially life-threatening emergency for clients with Graves disease. This condition
occurs when the thyroid gland releases large amounts of thyroid hormone in response
to stress (eg, trauma, surgery, infection). Characteristic features include tachycardia,
hypertension, cardiac arrhythmias (eg, atrial fibrillation), and fever up to 104-106 F (40-
41 C). Other findings include severe nausea, vomiting, anxiety, altered mentation, and
seizures.
(Option 2) Heat intolerance is an expected symptom in hyperthyroidism, including
Graves disease.
[QUESTIONS AND ANSWERS] WITH PRACTICE EXAM
DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A
A client is admitted to the intensive care unit with suspected pheochromocytoma. The
client's vital signs are temperature of 99.6 F (37.5 C), blood pressure (BP) of 200/110
mm Hg, heart rate of 110/min, and respirations of 20/min. The client is sweating
profusely and reports a severe headache. Which prescription should the nurse
implement first?
1. Draw labs to assess electrolyte panel
2. Give acetaminophen 650 mg by mouth as needed for headache
3. Place a fan in the client's room
4. Start nitroprusside infusion at 0.5 mcg/kg/min - CORRECT ANSWER 4
Pheochromocytoma is a condition caused by a tumor in the adrenal medulla. This
results in excess release of catecholamines such as epinephrine and norepinephrine,
leading to paroxysmal hypertensive crisis.
Important points to note when caring for these clients include the following:
1. Hypertension is difficult to treat and is often resistant to multiple drugs.
2. The client should avoid activities that can precipitate a hypertensive crisis (eg,
bending, lifting, Valsalva maneuver).
3. Abdominal palpation should be avoided as manipulation of the adrenal gland and
release of catecholamines can precipitate a hypertensive crisis.
Hypertensive crisis puts the client at risk for stroke and so has the highest priority for
treatment. Nitroprusside (Nitropress, Nipride) is a vasodilator given via infusion and can
be titrated to keep the BP within a desired parameter.
(Options 1, 2, and 3) Administration of acetaminophen and use of a fan may help relieve
symptoms. Drawing an electrolyte panel is appropriate. However, these are not life-
saving interventions and so are not the highest priority.
Educational objective: Pheochromocytoma is a condition caused by a tumor in the
adrenal medulla that causes release of catecholamines such as epinephrine and
norepinephrine, resulting in paroxysmal hypertensive crisis. Hypertensive crisis puts the
client at risk for stroke and should be treated promptly with intravenous nitroprusside or
another vasodilator (eg, phentolamine, nicardipine). Abdominal palpation should be
avoided in these clients.
The nurse in the emergency department is caring for a client recently diagnosed with
Graves' disease who was admitted following a motor vehicle accident. The nurse notes
,the vital signs shown in the exhibit. The nurse alerts the primary health care provider
that the client may be experiencing which condition? Click on the exhibit button for
additional information.
Vital Signs: increasing temp, BP, HR, and RR
1. Hypertensive crisis
2. Malignant hyperthermia
3. Serotonin syndrome
4. Thyroid storm - CORRECT ANSWER 4
Thyroid storm is a life-threatening condition that can occur in uncontrolled
hyperthyroidism or Graves' disease when a stressful incident, such as this client's motor
vehicle accident, triggers a sudden surge of thyroid hormone. Manifestations of thyroid
storm include a rapid onset of fever, tachycardia, and elevated blood pressure. The
client often feels anxious, tremulous, or restless. Confusion and psychosis can occur, as
can seizures and coma. Rapid treatment is necessary.
(Option 1) Hypertensive crisis alone would not cause fever.
(Option 2) Malignant hyperthermia would occur in the perioperative setting in response
to anesthesia. This client has no risk factors for malignant hyperthermia.
(Option 3) Serotonin syndrome would occur in the client taking more than one or an
overdose of antidepressant medication that increases serotonin levels.
Educational objective: Thyroid storm is a life-threatening complication of Graves'
disease (hyperthyroidism). Assessment findings include a rapid increase in
temperature, heart rate, and blood pressure in response to stress.
The nurse cares for a client with type 1 diabetes mellitus. Which laboratory result is
most important to report to the primary health care provider?
1. Fasting blood glucose 99 mg/dL (5.5 mmol/L)
2. Serum creatinine 2.0 mg/dL (177 µmol/L)
3. Serum potassium 3.9 mEq/L (3.9 mmol/L)
4. Serum sodium 140 mEq/L (140 mmol/L) - CORRECT ANSWER The normal
serum creatinine for an adult is 0.6-1.3 mg/dL (53-115 µmol/L). It provides an estimation
of the glomerular filtration rate and is an indicator of kidney function. A level of 2 mg/dL
(177 µmol/L) is clearly abnormal. The client with diabetes mellitus is at risk for diabetic
nephropathy, a complication associated with microvascular blood vessel damage in the
kidney. Early treatment and tight control of blood glucose levels are indicated to prevent
progressive renal injury in a client with diabetic nephropathy.
(Option 1) Normal serum fasting blood glucose is 70-99 mg/dL (3.9-5.5 mmol/L).
,(Option 3) Normal serum potassium is 3.5-5.0 mEq/L (3.5-5.0 mmol/L).
(Option 4) Normal serum sodium is 135-145 mEq/L (135-145 mmol/L).
Educational objective: The normal serum creatinine for an adult is 0.6-1.3 mg/dL (53-
115 µmol/L). Serum creatinine provides an estimation of the glomerular filtration rate
and is an indicator of kidney function.
The nurse is teaching a group of clients diagnosed with diabetes mellitus. Which lesson
regarding foot care should be included? Select all that apply.
1. Cut toenails straight across and file along the curves of the toes
2. Rub feet vigorously with a towel after bathing to ensure dryness
3. Use a mild foot powder on perspiring feet
4. Use cotton or lamb's wool to separate overlapping toes
5. Use an over-the-counter corn removal kit to remove corns or calluses - CORRECT
ANSWER 1, 3, 4
Individuals with type I or II diabetes mellitus are at increased risk for developing an
infection or ulcer on their feet. This is due to the chronic complication of peripheral
neuropathy, which results from nerve damage in the extremities.
Instructions for diabetic foot care include:
1. Wash feet daily with warm water and mild soap; test water temperature with
thermometer beforehand. Gently pat feet dry, particularly between the toes (Option 2).
Use lanolin to prevent dry and cracked skin, but do not apply between the toes.
2. Inspect for abrasions, cuts, or sores. Have others inspect the feet if eyesight is poor.
3. To prevent injury, use cotton or lamb's wool to separate overlapping toes. Cut
toenails straight across and use a nail file to file along the curves of the toes. Avoid
going barefoot and wear sturdy leather shoes. Use mild foot powder to absorb
perspiration and wear clean, absorbent socks with seams aligned (Options 1, 3, and 4).
4. Avoid using over-the-counter products (eg, iodine, alcohol, strong adhesives) on cuts
or abrasions (Option 5).
5. To improve circulation, do not sit with legs crossed or for extended periods, avoid
tight-fitting garments, and perform daily exercise.
6. Report other types of problems such as infections or athlete's foot immediately.
Educational objective: Individuals with type I or II diabetes mellitus are at increased risk
for developing an infection or ulcer on their feet due to the chronic complication of
peripheral neuropathy. Clients should keep feet clean, dry, and free from irritation.
The nurse cares for a client with type 2 diabetes mellitus and hemoglobin A1C results of
8% at an outpatient health clinic. Which statement by the nurse will best address these
results?
1. "It is important for us to review the signs and symptoms of a hypoglycemic reaction."
, 2. "Let's review your diet, exercise, and medication regimen over the past 2-3 months."
3. "Please describe what you have eaten in the last 24-48 hours."
4. "You should fast for at least 8 hours prior to your morning blood work." - CORRECT
ANSWER 2
Hemoglobin A1C is a diagnostic test used to measure the percentage of glycosylated
hemoglobin in the blood. A normal hemoglobin A1C is 4%-6% in clients without
diabetes; the goal is to keep the level <7% in clients with diabetes. The A1C test
measures blood glucose control over a period of 2-3 months; higher measurements
indicate higher glycemic levels. High levels may indicate poor adherence to the
recommended diet and exercise plan or ineffective antihyperglycemic medication
regimen. It is important for the nurse to review the diet, exercise, and medication plan
with the client who has a high hemoglobin A1C.
(Option 1) Although it is important to review signs and symptoms of hypoglycemia with
all clients with diabetes, this statement does not address the elevated hemoglobin A1C.
(Option 3) A diet recall of the last 24-48 hours will not give the nurse adequate
information on possible causes of an elevated hemoglobin A1C as this test measures
glycemic control over 2-3 months.
(Option 4) A hemoglobin A1C may be tested when the client is not fasting.
Educational objective: Hemoglobin A1C is a diagnostic test used to measure the
percentage of glycosylated hemoglobin in the blood over a period of 2-3 months. A
normal hemoglobin A1C is 4%-6% in clients without diabetes; the goal is to keep the
level <7% in clients with diabetes.
The nurse is caring for a client with suspected Graves disease. Which assessment
finding requires priority intervention?
1. Agitation and confusion
2. Heat intolerance
3. Pulse of 110/min, irregular rhythm
4. Red and bulging eyes - CORRECT ANSWER Thyroid storm is a serious and
potentially life-threatening emergency for clients with Graves disease. This condition
occurs when the thyroid gland releases large amounts of thyroid hormone in response
to stress (eg, trauma, surgery, infection). Characteristic features include tachycardia,
hypertension, cardiac arrhythmias (eg, atrial fibrillation), and fever up to 104-106 F (40-
41 C). Other findings include severe nausea, vomiting, anxiety, altered mentation, and
seizures.
(Option 2) Heat intolerance is an expected symptom in hyperthyroidism, including
Graves disease.
