KAPLAN ENDOCRINE NURSING EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Diabetes Mellitus (Type 1, Type 2, DKA, HHS)*
- Insulin Administration & Pharmacology
*- Thyroid Disorders (Hyperthyroidism, Hypothyroidism, Thyroidectomy)*
- Adrenal Disorders (Cushing Syndrome, Addison Disease, Pheochromocytoma)
- Pituitary Gland Disorders (SIADH, DI, Growth Hormone, ACTH)
- Parathyroid & Calcium Regulation (Hyper/Hypoparathyroidism)
- Endocrine Emergency Management
*- Nursing Assessment & Diagnostic Testing*
*- Patient Education & Chronic Disease Management*
*- Ethics, Legal Compliance & Professional Standards in Endocrine Care*
Introduction
This comprehensive endocrine nursing assessment evaluates critical knowledge and clinical decision-making skills essential for safe, effective
patient care in endocrine disorders. The exam consists of 100 multiple-choice questions featuring scenario-based clinical situations that test
foundational theory, applied professional knowledge, regulatory compliance, ethics, and real-world clinical judgment. Questions emphasize
prioritization, medication safety, emergency intervention, patient education, and critical thinking required for nursing practice. The assessment
mirrors professional nursing exam formats with balanced difficulty distribution, ensuring candidates demonstrate mastery of diabetes
management, insulin therapy, thyroid and adrenal disorders, pituitary dysfunction, calcium regulation, and endocrine emergencies. Success
requires understanding pathophysiology, nursing interventions, pharmacological principles, and evidence-based practice standards.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient with type 1 diabetes presents with blood glucose of 450 mg/dL, ketones in urine, pH 7.22, and deep rapid breathing. Which intervention
should the nurse prioritize?
A. Administer oral glucose immediately
B. Start IV insulin infusion and IV fluids
C. Give subcutaneous regular insulin 10 units
D. Administer bicarbonate infusion
🟢 Correct answer: B
,🔴 RATIONALE: The patient has diabetic ketoacidosis (DKA) characterized by hyperglycemia, ketosis, acidosis, and Kussmaul respirations. Priority
treatment is IV insulin infusion to stop ketogenesis and IV fluids to correct dehydration and improve perfusion.
Question 2
Which statement by a patient taking levothyroxine indicates correct understanding of medication teaching?
A. "I will take this medication with my breakfast"
B. "I will stop taking it if I feel better"
C. "I will take this medication on an empty stomach, 30-60 minutes before breakfast"
D. "I will double the dose if I miss a day"
🟢 Correct answer: C
🔴 RATIONALE: Levothyroxine should be taken on an empty stomach 30-60 minutes before breakfast for optimal absorption. Taking it with food
decreases absorption, and stopping or doubling doses without provider guidance is dangerous.
Question 3
A patient with Addison disease is admitted with hypotension (82/50 mmHg), hyponatremia, and hyperkalemia. Which medication should the nurse
administer first?
A. Potassium supplement
B. IV hydrocortisone
C. IV insulin
D. Oral fludrocortisone
🟢 Correct answer: B
🔴 RATIONALE: The patient is experiencing Addisonian crisis (acute adrenal insufficiency) with life-threatening hypotension and electrolyte
abnormalities. IV hydrocortisone is the emergency treatment to replace cortisol and restore vascular tone.
Question 4
When administering mixed insulin (regular and NPH), which action is correct?
,A. Draw up NPH first, then regular
B. Draw up regular first, then NPH
C. Mix both in separate syringes
D. Shake the NPH vial vigorously before drawing
🟢 Correct answer: B
🔴 RATIONALE: Regular insulin (clear) should always be drawn up first, followed by NPH (cloudy). This prevents contamination of the regular
insulin with NPH, which would alter its onset and peak times.
Question 5
A patient post-thyroidectomy develops hoarseness and difficulty breathing. Which complication should the nurse suspect?
A. Hypocalcemia
B. Hemorrhage causing tracheal compression
C. Hyperthyroidism
D. Thyroid storm
🟢 Correct answer: B
🔴 RATIONALE: Hoarseness and breathing difficulty post-thyroidectomy suggest hemorrhage causing tracheal compression, a life-threatening
complication requiring immediate surgical intervention.
Question 6
Which laboratory finding indicates effective treatment of hyperparathyroidism?
A. Increased serum calcium
B. Decreased serum calcium
C. Increased PTH
D. Decreased vitamin D
🟢 Correct answer: B
🔴 RATIONALE: Hyperparathyroidism causes elevated serum calcium. Effective treatment (surgery or medications) should decrease serum calcium
to normal range (8.5-10.5 mg/dL).
, Question 7
A patient with type 2 diabetes is prescribed metformin. Which instruction is most important for the nurse to provide?
A. "Take this medication with insulin"
B. "Report muscle pain or weakness immediately"
C. "Stop taking it 48 hours before contrast imaging"
D. "Take with grapefruit juice"
🟢 Correct answer: C
🔴 RATIONALE: Metformin must be stopped 48 hours before contrast imaging procedures to prevent contrast-induced nephropathy and lactic
acidosis. This is a critical safety precaution.
Question 8
Which sign indicates hypoglycemia in a patient with diabetes?
A. Dry skin and slow pulse
B. Tremors, sweating, and tachycardia
C. Flushed skin and polyuria
D. Bradycardia and hypotension
🟢 Correct answer: B
🔴 RATIONALE: Hypoglycemia triggers autonomic nervous system activation causing tremors, sweating (diaphoresis), tachycardia, anxiety, and
palpitations. These are classic early signs requiring immediate glucose.
Question 9
A patient with SIADH (Syndrome of Inappropriate ADH) would most likely present with:
A. Hypernatremia and dehydration
B. Hypnatremia and fluid overload
C. Hyperkalemia and acidosis
D. Hypocalcemia and tetany
🟢 Correct answer: B
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Diabetes Mellitus (Type 1, Type 2, DKA, HHS)*
- Insulin Administration & Pharmacology
*- Thyroid Disorders (Hyperthyroidism, Hypothyroidism, Thyroidectomy)*
- Adrenal Disorders (Cushing Syndrome, Addison Disease, Pheochromocytoma)
- Pituitary Gland Disorders (SIADH, DI, Growth Hormone, ACTH)
- Parathyroid & Calcium Regulation (Hyper/Hypoparathyroidism)
- Endocrine Emergency Management
*- Nursing Assessment & Diagnostic Testing*
*- Patient Education & Chronic Disease Management*
*- Ethics, Legal Compliance & Professional Standards in Endocrine Care*
Introduction
This comprehensive endocrine nursing assessment evaluates critical knowledge and clinical decision-making skills essential for safe, effective
patient care in endocrine disorders. The exam consists of 100 multiple-choice questions featuring scenario-based clinical situations that test
foundational theory, applied professional knowledge, regulatory compliance, ethics, and real-world clinical judgment. Questions emphasize
prioritization, medication safety, emergency intervention, patient education, and critical thinking required for nursing practice. The assessment
mirrors professional nursing exam formats with balanced difficulty distribution, ensuring candidates demonstrate mastery of diabetes
management, insulin therapy, thyroid and adrenal disorders, pituitary dysfunction, calcium regulation, and endocrine emergencies. Success
requires understanding pathophysiology, nursing interventions, pharmacological principles, and evidence-based practice standards.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient with type 1 diabetes presents with blood glucose of 450 mg/dL, ketones in urine, pH 7.22, and deep rapid breathing. Which intervention
should the nurse prioritize?
A. Administer oral glucose immediately
B. Start IV insulin infusion and IV fluids
C. Give subcutaneous regular insulin 10 units
D. Administer bicarbonate infusion
🟢 Correct answer: B
,🔴 RATIONALE: The patient has diabetic ketoacidosis (DKA) characterized by hyperglycemia, ketosis, acidosis, and Kussmaul respirations. Priority
treatment is IV insulin infusion to stop ketogenesis and IV fluids to correct dehydration and improve perfusion.
Question 2
Which statement by a patient taking levothyroxine indicates correct understanding of medication teaching?
A. "I will take this medication with my breakfast"
B. "I will stop taking it if I feel better"
C. "I will take this medication on an empty stomach, 30-60 minutes before breakfast"
D. "I will double the dose if I miss a day"
🟢 Correct answer: C
🔴 RATIONALE: Levothyroxine should be taken on an empty stomach 30-60 minutes before breakfast for optimal absorption. Taking it with food
decreases absorption, and stopping or doubling doses without provider guidance is dangerous.
Question 3
A patient with Addison disease is admitted with hypotension (82/50 mmHg), hyponatremia, and hyperkalemia. Which medication should the nurse
administer first?
A. Potassium supplement
B. IV hydrocortisone
C. IV insulin
D. Oral fludrocortisone
🟢 Correct answer: B
🔴 RATIONALE: The patient is experiencing Addisonian crisis (acute adrenal insufficiency) with life-threatening hypotension and electrolyte
abnormalities. IV hydrocortisone is the emergency treatment to replace cortisol and restore vascular tone.
Question 4
When administering mixed insulin (regular and NPH), which action is correct?
,A. Draw up NPH first, then regular
B. Draw up regular first, then NPH
C. Mix both in separate syringes
D. Shake the NPH vial vigorously before drawing
🟢 Correct answer: B
🔴 RATIONALE: Regular insulin (clear) should always be drawn up first, followed by NPH (cloudy). This prevents contamination of the regular
insulin with NPH, which would alter its onset and peak times.
Question 5
A patient post-thyroidectomy develops hoarseness and difficulty breathing. Which complication should the nurse suspect?
A. Hypocalcemia
B. Hemorrhage causing tracheal compression
C. Hyperthyroidism
D. Thyroid storm
🟢 Correct answer: B
🔴 RATIONALE: Hoarseness and breathing difficulty post-thyroidectomy suggest hemorrhage causing tracheal compression, a life-threatening
complication requiring immediate surgical intervention.
Question 6
Which laboratory finding indicates effective treatment of hyperparathyroidism?
A. Increased serum calcium
B. Decreased serum calcium
C. Increased PTH
D. Decreased vitamin D
🟢 Correct answer: B
🔴 RATIONALE: Hyperparathyroidism causes elevated serum calcium. Effective treatment (surgery or medications) should decrease serum calcium
to normal range (8.5-10.5 mg/dL).
, Question 7
A patient with type 2 diabetes is prescribed metformin. Which instruction is most important for the nurse to provide?
A. "Take this medication with insulin"
B. "Report muscle pain or weakness immediately"
C. "Stop taking it 48 hours before contrast imaging"
D. "Take with grapefruit juice"
🟢 Correct answer: C
🔴 RATIONALE: Metformin must be stopped 48 hours before contrast imaging procedures to prevent contrast-induced nephropathy and lactic
acidosis. This is a critical safety precaution.
Question 8
Which sign indicates hypoglycemia in a patient with diabetes?
A. Dry skin and slow pulse
B. Tremors, sweating, and tachycardia
C. Flushed skin and polyuria
D. Bradycardia and hypotension
🟢 Correct answer: B
🔴 RATIONALE: Hypoglycemia triggers autonomic nervous system activation causing tremors, sweating (diaphoresis), tachycardia, anxiety, and
palpitations. These are classic early signs requiring immediate glucose.
Question 9
A patient with SIADH (Syndrome of Inappropriate ADH) would most likely present with:
A. Hypernatremia and dehydration
B. Hypnatremia and fluid overload
C. Hyperkalemia and acidosis
D. Hypocalcemia and tetany
🟢 Correct answer: B
