Nursing 354 Endocrine Nursing Exam
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
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1. A patient with type 1 diabetes mellitus asks why insulin therapy is required.
Which response by the nurse is most accurate?
A. Insulin increases glucose production by the liver.
B. Insulin replaces the hormone that the pancreas can no longer produce
adequately.
C. Insulin prevents the kidneys from excreting glucose.
D. Insulin stimulates the thyroid gland to regulate blood glucose.
**Answer: Insulin replaces the hormone that the pancreas can no longer
produce adequately.
Rationale: Type 1 diabetes involves destruction of pancreatic beta cells, resulting
in an absolute deficiency of insulin. Exogenous insulin is therefore necessary to
facilitate glucose uptake and metabolism.
2. Which finding is most characteristic of hyperglycemia?
A. Tremors
B. Diaphoresis
,C. Polyuria and polydipsia
D. Bradycardia
**Answer: Polyuria and polydipsia
Rationale: Excess glucose in the blood causes osmotic diuresis, resulting in
increased urination and subsequent thirst. Tremors and diaphoresis are more
typical of hypoglycemia.
3. A patient with diabetes is awake and has a blood glucose level of 58 mg/dL.
What should the nurse do first?
A. Administer rapid-acting insulin.
B. Give approximately 15 grams of fast-acting carbohydrate.
C. Encourage the patient to exercise.
D. Administer a high-protein meal.
**Answer: Give approximately 15 grams of fast-acting carbohydrate.
Rationale: An alert patient with symptomatic or documented hypoglycemia
should receive approximately 15 grams of rapid-acting carbohydrate, followed
by reassessment of blood glucose according to facility protocol.
4. Which assessment finding is most concerning for diabetic ketoacidosis (DKA)?
A. Blood glucose of 92 mg/dL
B. Respiratory rate of 10/min
C. Kussmaul respirations
D. Increased appetite
**Answer: Kussmaul respirations
Rationale: Kussmaul respirations are deep, rapid respirations that occur as the
body attempts to compensate for metabolic acidosis associated with DKA.
,5. Which laboratory finding is expected in a patient experiencing diabetic
ketoacidosis?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis only
D. Decreased serum ketones
**Answer: Metabolic acidosis
Rationale: In DKA, inadequate insulin causes increased fat breakdown and
ketone production, leading to metabolic acidosis.
6. A nurse is caring for a patient with DKA. Which intervention is a priority?
A. Restrict all fluids.
B. Initiate prescribed intravenous fluid replacement.
C. Administer oral potassium immediately.
D. Encourage strenuous activity.
**Answer: Initiate prescribed intravenous fluid replacement.
Rationale: Significant dehydration occurs in DKA because of osmotic diuresis.
Intravenous fluid replacement is a major component of initial management,
along with insulin and careful electrolyte monitoring.
7. Which finding is most consistent with hyperosmolar hyperglycemic state (HHS)?
A. Severe hyperglycemia with profound dehydration and minimal ketosis
B. Severe hypoglycemia with metabolic alkalosis
C. Low blood glucose with excessive insulin production
D. Severe hypercalcemia caused by parathyroid disease
**Answer: Severe hyperglycemia with profound dehydration and minimal
ketosis
, Rationale: HHS is characterized by very high blood glucose, marked dehydration,
increased serum osmolality, and usually little or no significant ketoacidosis.
8. Which patient is at greatest risk for developing HHS?
A. A patient with type 2 diabetes and an acute infection
B. A healthy adolescent without diabetes
C. A patient with mild seasonal allergies
D. A patient with controlled hypothyroidism
**Answer: A patient with type 2 diabetes and an acute infection
Rationale: HHS commonly occurs in older adults with type 2 diabetes and may
be precipitated by infection, illness, inadequate fluid intake, or other physiologic
stressors.
9. Which instruction should the nurse provide regarding insulin injection sites?
A. Inject repeatedly into exactly the same location.
B. Rotate injection sites within an appropriate anatomical area.
C. Massage the injection site vigorously afterward.
D. Inject insulin only into the deltoid muscle.
**Answer: Rotate injection sites within an appropriate anatomical area.
Rationale: Rotating sites helps prevent lipodystrophy and promotes more
predictable insulin absorption.
10. Which insulin has the most rapid onset of action?
A. Lispro
B. NPH
C. Glargine
D. Detemir
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
Instant Download Pdf
1. A patient with type 1 diabetes mellitus asks why insulin therapy is required.
Which response by the nurse is most accurate?
A. Insulin increases glucose production by the liver.
B. Insulin replaces the hormone that the pancreas can no longer produce
adequately.
C. Insulin prevents the kidneys from excreting glucose.
D. Insulin stimulates the thyroid gland to regulate blood glucose.
**Answer: Insulin replaces the hormone that the pancreas can no longer
produce adequately.
Rationale: Type 1 diabetes involves destruction of pancreatic beta cells, resulting
in an absolute deficiency of insulin. Exogenous insulin is therefore necessary to
facilitate glucose uptake and metabolism.
2. Which finding is most characteristic of hyperglycemia?
A. Tremors
B. Diaphoresis
,C. Polyuria and polydipsia
D. Bradycardia
**Answer: Polyuria and polydipsia
Rationale: Excess glucose in the blood causes osmotic diuresis, resulting in
increased urination and subsequent thirst. Tremors and diaphoresis are more
typical of hypoglycemia.
3. A patient with diabetes is awake and has a blood glucose level of 58 mg/dL.
What should the nurse do first?
A. Administer rapid-acting insulin.
B. Give approximately 15 grams of fast-acting carbohydrate.
C. Encourage the patient to exercise.
D. Administer a high-protein meal.
**Answer: Give approximately 15 grams of fast-acting carbohydrate.
Rationale: An alert patient with symptomatic or documented hypoglycemia
should receive approximately 15 grams of rapid-acting carbohydrate, followed
by reassessment of blood glucose according to facility protocol.
4. Which assessment finding is most concerning for diabetic ketoacidosis (DKA)?
A. Blood glucose of 92 mg/dL
B. Respiratory rate of 10/min
C. Kussmaul respirations
D. Increased appetite
**Answer: Kussmaul respirations
Rationale: Kussmaul respirations are deep, rapid respirations that occur as the
body attempts to compensate for metabolic acidosis associated with DKA.
,5. Which laboratory finding is expected in a patient experiencing diabetic
ketoacidosis?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis only
D. Decreased serum ketones
**Answer: Metabolic acidosis
Rationale: In DKA, inadequate insulin causes increased fat breakdown and
ketone production, leading to metabolic acidosis.
6. A nurse is caring for a patient with DKA. Which intervention is a priority?
A. Restrict all fluids.
B. Initiate prescribed intravenous fluid replacement.
C. Administer oral potassium immediately.
D. Encourage strenuous activity.
**Answer: Initiate prescribed intravenous fluid replacement.
Rationale: Significant dehydration occurs in DKA because of osmotic diuresis.
Intravenous fluid replacement is a major component of initial management,
along with insulin and careful electrolyte monitoring.
7. Which finding is most consistent with hyperosmolar hyperglycemic state (HHS)?
A. Severe hyperglycemia with profound dehydration and minimal ketosis
B. Severe hypoglycemia with metabolic alkalosis
C. Low blood glucose with excessive insulin production
D. Severe hypercalcemia caused by parathyroid disease
**Answer: Severe hyperglycemia with profound dehydration and minimal
ketosis
, Rationale: HHS is characterized by very high blood glucose, marked dehydration,
increased serum osmolality, and usually little or no significant ketoacidosis.
8. Which patient is at greatest risk for developing HHS?
A. A patient with type 2 diabetes and an acute infection
B. A healthy adolescent without diabetes
C. A patient with mild seasonal allergies
D. A patient with controlled hypothyroidism
**Answer: A patient with type 2 diabetes and an acute infection
Rationale: HHS commonly occurs in older adults with type 2 diabetes and may
be precipitated by infection, illness, inadequate fluid intake, or other physiologic
stressors.
9. Which instruction should the nurse provide regarding insulin injection sites?
A. Inject repeatedly into exactly the same location.
B. Rotate injection sites within an appropriate anatomical area.
C. Massage the injection site vigorously afterward.
D. Inject insulin only into the deltoid muscle.
**Answer: Rotate injection sites within an appropriate anatomical area.
Rationale: Rotating sites helps prevent lipodystrophy and promotes more
predictable insulin absorption.
10. Which insulin has the most rapid onset of action?
A. Lispro
B. NPH
C. Glargine
D. Detemir
