MCA 2 Exam: Endocrine Disorders
Questions and Answers
Question 1
A patient with hypothyroidism is at risk for myxedema. Which assessment finding
would be most concerning?
A. Puffiness around the eyes and face
B. Hypothermia and hypoventilation
C. Weight gain of 5 lbs over 2 months
D. Dry hair and brittle nails
Correct Answer
B. Hypothermia and hypoventilation
Rationale: Myxedema crisis is life-threatening, with hypothermia, hypotension, and
hypoventilation; mechanical ventilation may be required (noted on slide).
Question 2
A patient with chronic SIADH is prescribed tolvaptan. What is the primary mechanism
of action of tolvaptan and conivaptan in treating this condition?
A. Increase release of ADH from the posterior pituitary
B. Block the action of ADH at the renal collecting ducts which increases output
C. Stimulate sodium excretion in the renal tubules
D. Promote secretion of growth hormone to enhance renal perfusion
Correct Answer
B. Block the action of ADH at the renal collecting ducts which increases output
Rationale: The slide notes that tolvaptan and conivaptan are ADH antagonists —
they work by blocking ADH receptors, reducing water reabsorption and helping
correct dilutional hyponatremia. They can also be HEPATOTOXIC.
Page 1 of 42
,Question 3
An ECG of a patient with hypoparathyroidism shows a prolonged QT interval. Which
lab abnormality does this correspond to?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Correct Answer
B. Hypocalcemia
Rationale: Handwritten notes specify prolonged QT interval as a complication of low
calcium.
Question 4
The nurse recognizes which assessment findings as consistent with severe
hypocalcemia in hypoparathyroidism? (Select all that apply)
• A. Tetany
• B. Dysphagia
• C. Anxiety and irritability
• D. Constipation
• E. Hypotension
Correct Answer
A, B, C, E
Rationale: Slide lists tetany, dysphagia, anxiety/irritability, hypotension. Constipation
is linked to hypercalcemia (hyperparathyroidism).
Page 2 of 42
,Question 5
The nurse is planning care for a patient with hypothyroidism. Which interventions are
appropriate? (Select all that apply)
• A. Monitor vital signs
• B. Provide written instructions for education
• C. Encourage low-calorie, low-fat, low-cholesterol diet
• D. Place patient in warm environment
• E. Administer levothyroxine as ordered
Correct Answer
A, B, D, E
Rationale: Management includes monitoring VS, written instructions (due to
forgetfulness), warm environment, levothyroxine. Diet is low-calorie but high fiber,
not necessarily low-fat/low-cholesterol (cholesterol tends to be elevated).
Question 6
The provider suspects pheochromocytoma in a patient with paroxysmal hypertension.
Which diagnostic test would best confirm the diagnosis?
A. Thyroid function test (T3/T4)
B. Plasma catecholamine levels
C. Cortisol suppression test
D. Serum aldosterone level
Correct Answer
B. Plasma catecholamine levels
Rationale: Slide lists catecholamine level (blood), CT, MRI as diagnostic studies for
pheochromocytoma.
Question 7
Which are recognized causes of Cushing's syndrome? (Select all that apply)
• A. Pituitary tumor
• B. Adrenal tumor
• C. Steroid abuse
• D. Addison's disease
• E. Adrenal cortex insufficiency
Correct Answer
A, B, C
Rationale: Slide highlights pituitary tumor, adrenal tumor, and steroid abuse.
Addison's and adrenal insufficiency are opposite conditions (↓ cortisol).
Page 3 of 42
, Question 8
A nurse reviews orders for a patient with SIADH. Which order should the nurse
question?
A. Strict fluid restriction
B. Administer demeclocycline
C. Daily weight monitoring
D. Encourage oral free water intake >2 liters/day
Correct Answer
D. Encourage oral free water intake >2 liters/day
Rationale: SIADH patients should have restricted fluids to prevent worsening
hyponatremia.
Question 9
The nurse recognizes which laboratory findings as possible complications of
untreated acromegaly? (Select all that apply)
• A. Elevated fasting glucose
• B. Low serum sodium
• C. Elevated blood pressure
• D. Hypercalcemia
Correct Answer
A, C
Rationale: Acromegaly leads to hyperglycemia and hypertension. Hyponatremia is
more associated with SIADH, and hypercalcemia is not a hallmark of acromegaly.
Question 10
Which nursing management interventions are appropriate for a patient with
hyperthyroidism? (Select all that apply)
• A. Provide rest and quiet environment
• B. Encourage high-calorie, high-protein diet
• C. Monitor for thyroid storm (HTN, tachycardia, agitation, fever)
• D. Administer PTU or Tapazole as ordered
• E. Encourage iodine-rich foods to suppress hormone release
Correct Answer
A, B, C, D
Rationale: Slide lists rest, quiet environment, high-calorie/protein diet,
PTU/Tapazole; handwritten note highlights thyroid storm management. Iodine-rich
foods are avoided.
Page 4 of 42
Questions and Answers
Question 1
A patient with hypothyroidism is at risk for myxedema. Which assessment finding
would be most concerning?
A. Puffiness around the eyes and face
B. Hypothermia and hypoventilation
C. Weight gain of 5 lbs over 2 months
D. Dry hair and brittle nails
Correct Answer
B. Hypothermia and hypoventilation
Rationale: Myxedema crisis is life-threatening, with hypothermia, hypotension, and
hypoventilation; mechanical ventilation may be required (noted on slide).
Question 2
A patient with chronic SIADH is prescribed tolvaptan. What is the primary mechanism
of action of tolvaptan and conivaptan in treating this condition?
A. Increase release of ADH from the posterior pituitary
B. Block the action of ADH at the renal collecting ducts which increases output
C. Stimulate sodium excretion in the renal tubules
D. Promote secretion of growth hormone to enhance renal perfusion
Correct Answer
B. Block the action of ADH at the renal collecting ducts which increases output
Rationale: The slide notes that tolvaptan and conivaptan are ADH antagonists —
they work by blocking ADH receptors, reducing water reabsorption and helping
correct dilutional hyponatremia. They can also be HEPATOTOXIC.
Page 1 of 42
,Question 3
An ECG of a patient with hypoparathyroidism shows a prolonged QT interval. Which
lab abnormality does this correspond to?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Correct Answer
B. Hypocalcemia
Rationale: Handwritten notes specify prolonged QT interval as a complication of low
calcium.
Question 4
The nurse recognizes which assessment findings as consistent with severe
hypocalcemia in hypoparathyroidism? (Select all that apply)
• A. Tetany
• B. Dysphagia
• C. Anxiety and irritability
• D. Constipation
• E. Hypotension
Correct Answer
A, B, C, E
Rationale: Slide lists tetany, dysphagia, anxiety/irritability, hypotension. Constipation
is linked to hypercalcemia (hyperparathyroidism).
Page 2 of 42
,Question 5
The nurse is planning care for a patient with hypothyroidism. Which interventions are
appropriate? (Select all that apply)
• A. Monitor vital signs
• B. Provide written instructions for education
• C. Encourage low-calorie, low-fat, low-cholesterol diet
• D. Place patient in warm environment
• E. Administer levothyroxine as ordered
Correct Answer
A, B, D, E
Rationale: Management includes monitoring VS, written instructions (due to
forgetfulness), warm environment, levothyroxine. Diet is low-calorie but high fiber,
not necessarily low-fat/low-cholesterol (cholesterol tends to be elevated).
Question 6
The provider suspects pheochromocytoma in a patient with paroxysmal hypertension.
Which diagnostic test would best confirm the diagnosis?
A. Thyroid function test (T3/T4)
B. Plasma catecholamine levels
C. Cortisol suppression test
D. Serum aldosterone level
Correct Answer
B. Plasma catecholamine levels
Rationale: Slide lists catecholamine level (blood), CT, MRI as diagnostic studies for
pheochromocytoma.
Question 7
Which are recognized causes of Cushing's syndrome? (Select all that apply)
• A. Pituitary tumor
• B. Adrenal tumor
• C. Steroid abuse
• D. Addison's disease
• E. Adrenal cortex insufficiency
Correct Answer
A, B, C
Rationale: Slide highlights pituitary tumor, adrenal tumor, and steroid abuse.
Addison's and adrenal insufficiency are opposite conditions (↓ cortisol).
Page 3 of 42
, Question 8
A nurse reviews orders for a patient with SIADH. Which order should the nurse
question?
A. Strict fluid restriction
B. Administer demeclocycline
C. Daily weight monitoring
D. Encourage oral free water intake >2 liters/day
Correct Answer
D. Encourage oral free water intake >2 liters/day
Rationale: SIADH patients should have restricted fluids to prevent worsening
hyponatremia.
Question 9
The nurse recognizes which laboratory findings as possible complications of
untreated acromegaly? (Select all that apply)
• A. Elevated fasting glucose
• B. Low serum sodium
• C. Elevated blood pressure
• D. Hypercalcemia
Correct Answer
A, C
Rationale: Acromegaly leads to hyperglycemia and hypertension. Hyponatremia is
more associated with SIADH, and hypercalcemia is not a hallmark of acromegaly.
Question 10
Which nursing management interventions are appropriate for a patient with
hyperthyroidism? (Select all that apply)
• A. Provide rest and quiet environment
• B. Encourage high-calorie, high-protein diet
• C. Monitor for thyroid storm (HTN, tachycardia, agitation, fever)
• D. Administer PTU or Tapazole as ordered
• E. Encourage iodine-rich foods to suppress hormone release
Correct Answer
A, B, C, D
Rationale: Slide lists rest, quiet environment, high-calorie/protein diet,
PTU/Tapazole; handwritten note highlights thyroid storm management. Iodine-rich
foods are avoided.
Page 4 of 42
