NCLEX-RN Pharmacology Practice
Questions: 20 Endocrine System MCQs
with Detailed Rationales |
ATI & NGN Style Nursing Exam Prep
Question 1
Clinical Scenario
A 42-year-old woman with newly diagnosed primary
hypothyroidism is prescribed levothyroxine 75 mcg PO daily.
During discharge teaching, she asks the nurse how to take
the medication. She also takes calcium carbonate, ferrous
sulfate, and a multivitamin each morning.
Question Stem
Which statement by the client indicates correct
understanding of levothyroxine administration?
A. "I will take levothyroxine with breakfast and my calcium
supplement."
,B. "I will take levothyroxine at bedtime with my iron tablet."
C. "I will take levothyroxine on an empty stomach and wait
before taking calcium."
D. "I will stop taking levothyroxine once my symptoms
improve."
Correct Answer
Correct Answer: C. "I will take levothyroxine on an empty
stomach and wait before taking calcium."
Detailed Rationale
Levothyroxine absorption is significantly reduced by
calcium, iron, antacids, and certain foods. The medication
should be taken on an empty stomach, preferably 30–60
minutes before breakfast, with water. Calcium and iron
supplements should generally be separated by at least 4
hours. Proper administration promotes consistent
absorption and therapeutic effectiveness.
Option A is incorrect because calcium decreases
levothyroxine absorption. Option B is incorrect because iron
also impairs absorption. Option D is incorrect because
hypothyroidism is commonly a lifelong condition requiring
ongoing therapy and monitoring.
Nurses should emphasize adherence, timing consistency,
and periodic monitoring of thyroid-stimulating hormone
,(TSH) levels. Patients should be informed that symptom
improvement may take several weeks. Medication
reconciliation is important because many common over-the-
counter products interfere with levothyroxine absorption.
Learning Objective
After completing this question, the learner should be able
to:
• Explain proper levothyroxine administration.
• Identify medications that interfere with levothyroxine
absorption.
• Teach clients about lifelong thyroid replacement
therapy.
• Recognize the importance of TSH monitoring.
Medication Safety Focus
Medication administration
Question 2
Clinical Scenario
A 67-year-old man with type 2 diabetes mellitus receives
insulin glargine 20 units subcutaneously every evening.
During medication administration, a newly licensed nurse
, prepares to mix the insulin glargine with regular insulin in the
same syringe.
Question Stem
Which action should the charge nurse take?
A. Allow the mixture if administered immediately.
B. Instruct the nurse to administer glargine separately.
C. Add NPH insulin to stabilize the mixture.
D. Dilute the glargine with normal saline before
administration.
Correct Answer
Correct Answer: B. Instruct the nurse to administer
glargine separately.
Detailed Rationale
Insulin glargine is a long-acting insulin formulated at an
acidic pH that should never be mixed with other insulins.
Mixing can alter its pharmacokinetic profile and lead to
unpredictable glucose control. The charge nurse should
intervene immediately to prevent a medication
administration error.
Option A is incorrect because glargine should never be
mixed regardless of timing. Option C is incorrect because
Questions: 20 Endocrine System MCQs
with Detailed Rationales |
ATI & NGN Style Nursing Exam Prep
Question 1
Clinical Scenario
A 42-year-old woman with newly diagnosed primary
hypothyroidism is prescribed levothyroxine 75 mcg PO daily.
During discharge teaching, she asks the nurse how to take
the medication. She also takes calcium carbonate, ferrous
sulfate, and a multivitamin each morning.
Question Stem
Which statement by the client indicates correct
understanding of levothyroxine administration?
A. "I will take levothyroxine with breakfast and my calcium
supplement."
,B. "I will take levothyroxine at bedtime with my iron tablet."
C. "I will take levothyroxine on an empty stomach and wait
before taking calcium."
D. "I will stop taking levothyroxine once my symptoms
improve."
Correct Answer
Correct Answer: C. "I will take levothyroxine on an empty
stomach and wait before taking calcium."
Detailed Rationale
Levothyroxine absorption is significantly reduced by
calcium, iron, antacids, and certain foods. The medication
should be taken on an empty stomach, preferably 30–60
minutes before breakfast, with water. Calcium and iron
supplements should generally be separated by at least 4
hours. Proper administration promotes consistent
absorption and therapeutic effectiveness.
Option A is incorrect because calcium decreases
levothyroxine absorption. Option B is incorrect because iron
also impairs absorption. Option D is incorrect because
hypothyroidism is commonly a lifelong condition requiring
ongoing therapy and monitoring.
Nurses should emphasize adherence, timing consistency,
and periodic monitoring of thyroid-stimulating hormone
,(TSH) levels. Patients should be informed that symptom
improvement may take several weeks. Medication
reconciliation is important because many common over-the-
counter products interfere with levothyroxine absorption.
Learning Objective
After completing this question, the learner should be able
to:
• Explain proper levothyroxine administration.
• Identify medications that interfere with levothyroxine
absorption.
• Teach clients about lifelong thyroid replacement
therapy.
• Recognize the importance of TSH monitoring.
Medication Safety Focus
Medication administration
Question 2
Clinical Scenario
A 67-year-old man with type 2 diabetes mellitus receives
insulin glargine 20 units subcutaneously every evening.
During medication administration, a newly licensed nurse
, prepares to mix the insulin glargine with regular insulin in the
same syringe.
Question Stem
Which action should the charge nurse take?
A. Allow the mixture if administered immediately.
B. Instruct the nurse to administer glargine separately.
C. Add NPH insulin to stabilize the mixture.
D. Dilute the glargine with normal saline before
administration.
Correct Answer
Correct Answer: B. Instruct the nurse to administer
glargine separately.
Detailed Rationale
Insulin glargine is a long-acting insulin formulated at an
acidic pH that should never be mixed with other insulins.
Mixing can alter its pharmacokinetic profile and lead to
unpredictable glucose control. The charge nurse should
intervene immediately to prevent a medication
administration error.
Option A is incorrect because glargine should never be
mixed regardless of timing. Option C is incorrect because
