Medical-Surgical Nursing II (MedSurg 2) –
Endocrine System NCLEX Practice Questions,
Nursing Exam Preparation Material
Introduction:
This document contains a comprehensive collection of NCLEX-
style practice questions with detailed answers and rationales
focused on endocrine disorders in Medical-Surgical Nursing II.
Topics include adrenal, pituitary, thyroid, and parathyroid
disorders such as Addison’s disease, Cushing syndrome, SIADH,
diabetes insipidus, Graves’ disease, hypothyroidism, and
acromegaly, making it ideal for exam review and clinical
reasoning practice. The questions are designed to reinforce
priority nursing assessments, interventions, and patient
education commonly tested in nursing exams.
Exam Questions and Detailed Answers with Rationale:
1. A pt is admitted to the hospital in addisonian crisis 1 month
after a diagnosis of Addison's disease. The nurse identifies the
nursing diagnosis of ineffective therapeutic regimen
management related to lack of knowledge of management of
condition when the patient says,
,a. "I double my dose of hydrocortisone on the days that I go for
a run."
b. "I had the stomach flu earlier this week and couldn't take
the hydrocortisone."
c. "I frequently eat at restaurants, and so my food has a lot of
added salt."
d. "I do yoga exercises almost every day to help me reduce
stress and relax." -Answer:-B
RATIONALE:-The need for hydrocortisone replacement is
increased with stressors such as illness, and the patient needs
to be taught to call the health care provider because
medication and IV fluids and electrolytes may need to be given.
The other patient statements indicate appropriate
management of the Addison's disease.
2. A pt who uses every-otheRationale :-day prednisone therapy
for rheumatoid arthritis complains of not feeling as well on the
non-prednisone days and asks nurse about taking prednisone
daily instead. The best response to the pt is that
a. an every-otheRationale :-day schedule mimics the normal
pattern of cortisol secretion from the adrenal gland.
b. glucocorticoids are taken on a daily basis only when theyre
being used for replacement therapy.
,c. if it improves the symptoms, it would be acceptable to take
half the usual dose every day.
d. there is less effect on normal adrenal function when
prednisone is taken every other day. -Answer:-D
RATIONALE:-An alternate-day regimen is given to minimize
the impact of exogenous glucocorticoids on adrenal gland
function. The normal pattern of cortisol secretion is diurnal.
Glucocorticoids are taken daily when being used for
replacement therapy, but this is not the only indication for
daily use. Taking half the usual dose would not achieve the
goal of minimizing adrenal gland suppression.
3. A pt is taking high doses of prednisone to control the
symptoms of an acute exacerbation of systemic lupus
erythematosus. When teaching the pt about use of prednisone,
which information is most important for the nurse to include?
a. Call the doctor if you experience any mood alterations with
the prednisone.
b. Do not stop taking the prednisone suddenly; it should be
decreased gradually.
c. Weigh yourself daily to monitor for weight gain caused by
water or increased fat.
d. Check your temperature daily because prednisone can hide
signs of infection. -Answer:-B
, RATIONALE:-Acute adrenal insufficiency may occur if
exogenous glucocorticoids are suddenly stopped. Mood
alterations and weight gain are possible adverse effects of
glucocorticoid use, but these are not life-threatening effects.
Glucocorticoids do mask the signs of infection, but
temperature elevation tends to be suppressed, so other signs of
infection should be monitored.
(Cognitive Level: Application Text Reference: p. 1314
NProcess: Implementation NCLEX: Physiological Integrity)
4. A patient has an adrenocortical adenoma causing
hyperaldosteronism and is scheduled for laparoscopic surgery
to remove the tumor. During care before surgery, the nurse
should
a. monitor blood glucose level every 4 hours.
b. provide a potassium-restricted diet.
c. monitor the blood pressure every 4 hours.
d. relieve edema by elevating the extremities. -Answer:-C
RATIONALE:-HTN caused by Na retention is a common
complication of hyperaldosteronism. Hyperaldosteronism does
not cause elevation in blood glucose. pt will be hypokalemic
and require potassium supplementation prior to surgery.
Edema does not usually occur with hyperaldosteronism.
Endocrine System NCLEX Practice Questions,
Nursing Exam Preparation Material
Introduction:
This document contains a comprehensive collection of NCLEX-
style practice questions with detailed answers and rationales
focused on endocrine disorders in Medical-Surgical Nursing II.
Topics include adrenal, pituitary, thyroid, and parathyroid
disorders such as Addison’s disease, Cushing syndrome, SIADH,
diabetes insipidus, Graves’ disease, hypothyroidism, and
acromegaly, making it ideal for exam review and clinical
reasoning practice. The questions are designed to reinforce
priority nursing assessments, interventions, and patient
education commonly tested in nursing exams.
Exam Questions and Detailed Answers with Rationale:
1. A pt is admitted to the hospital in addisonian crisis 1 month
after a diagnosis of Addison's disease. The nurse identifies the
nursing diagnosis of ineffective therapeutic regimen
management related to lack of knowledge of management of
condition when the patient says,
,a. "I double my dose of hydrocortisone on the days that I go for
a run."
b. "I had the stomach flu earlier this week and couldn't take
the hydrocortisone."
c. "I frequently eat at restaurants, and so my food has a lot of
added salt."
d. "I do yoga exercises almost every day to help me reduce
stress and relax." -Answer:-B
RATIONALE:-The need for hydrocortisone replacement is
increased with stressors such as illness, and the patient needs
to be taught to call the health care provider because
medication and IV fluids and electrolytes may need to be given.
The other patient statements indicate appropriate
management of the Addison's disease.
2. A pt who uses every-otheRationale :-day prednisone therapy
for rheumatoid arthritis complains of not feeling as well on the
non-prednisone days and asks nurse about taking prednisone
daily instead. The best response to the pt is that
a. an every-otheRationale :-day schedule mimics the normal
pattern of cortisol secretion from the adrenal gland.
b. glucocorticoids are taken on a daily basis only when theyre
being used for replacement therapy.
,c. if it improves the symptoms, it would be acceptable to take
half the usual dose every day.
d. there is less effect on normal adrenal function when
prednisone is taken every other day. -Answer:-D
RATIONALE:-An alternate-day regimen is given to minimize
the impact of exogenous glucocorticoids on adrenal gland
function. The normal pattern of cortisol secretion is diurnal.
Glucocorticoids are taken daily when being used for
replacement therapy, but this is not the only indication for
daily use. Taking half the usual dose would not achieve the
goal of minimizing adrenal gland suppression.
3. A pt is taking high doses of prednisone to control the
symptoms of an acute exacerbation of systemic lupus
erythematosus. When teaching the pt about use of prednisone,
which information is most important for the nurse to include?
a. Call the doctor if you experience any mood alterations with
the prednisone.
b. Do not stop taking the prednisone suddenly; it should be
decreased gradually.
c. Weigh yourself daily to monitor for weight gain caused by
water or increased fat.
d. Check your temperature daily because prednisone can hide
signs of infection. -Answer:-B
, RATIONALE:-Acute adrenal insufficiency may occur if
exogenous glucocorticoids are suddenly stopped. Mood
alterations and weight gain are possible adverse effects of
glucocorticoid use, but these are not life-threatening effects.
Glucocorticoids do mask the signs of infection, but
temperature elevation tends to be suppressed, so other signs of
infection should be monitored.
(Cognitive Level: Application Text Reference: p. 1314
NProcess: Implementation NCLEX: Physiological Integrity)
4. A patient has an adrenocortical adenoma causing
hyperaldosteronism and is scheduled for laparoscopic surgery
to remove the tumor. During care before surgery, the nurse
should
a. monitor blood glucose level every 4 hours.
b. provide a potassium-restricted diet.
c. monitor the blood pressure every 4 hours.
d. relieve edema by elevating the extremities. -Answer:-C
RATIONALE:-HTN caused by Na retention is a common
complication of hyperaldosteronism. Hyperaldosteronism does
not cause elevation in blood glucose. pt will be hypokalemic
and require potassium supplementation prior to surgery.
Edema does not usually occur with hyperaldosteronism.
