Endocrine NCLEX Questions –
Practice Exam & Nursing Study
Guide
1. An agitated, confused female client arrives in the emergency department. Her
history includes type 1 diabetes mellitus, hypertension, and angina pectoris.
Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat
blood glucose sample measures 42 mg/dl, and the client is treated for an acute
hypoglycemic reaction. After recovery, nurse Lily teaches the client to treat
hypoglycemia by ingesting:
a. 2 to 5 g of a simple carbohydrate.
b. 10 to 15 g of a simple carbohydrate.
c. 18 to 20 g of a simple carbohydrate.
d. 25 to 30 g of a simple carbohydrate. - ANSWER-B.
To reverse hypoglycemia, the American Diabetes Association recommends
ingesting 10 to 15 g of a simple carbohydrate, such as three to five pieces of hard
candy, two to three packets of sugar (4 to 6 tsp), or 4 oz of fruit juice. If necessary,
this treatment can be repeated in 15 minutes. Ingesting only 2 to 5 g of a simple
carbohydrate may not raise the blood glucose level sufficiently. Ingesting more
than 15 g may raise it above normal, causing hyperglycemia.
2. A female adult client with a history of chronic hyperparathyroidism admits to
being noncompliant. Based on initial assessment findings, nurse Julia formulates
,the nursing diagnosis of Risk for injury. To complete the nursing diagnosis
statement for this client, which "related-to" phrase should the nurse add?
a. Related to bone demineralization resulting in pathologic fractures
b. Related to exhaustion secondary to an accelerated metabolic rate
c. Related to edema and dry skin secondary to fluid infiltration into the interstitial
spaces
d. Related to tetany secondary to a decreased serum calcium level - ANSWER-A.
Poorly controlled hyperparathyroidism may cause an elevated serum calcium
level. This, in turn, may diminish calcium stores in the bone, causing bone
demineralization and setting the stage for pathologic fractures and a risk for injury.
Hyperparathyroidism doesn't accelerate the metabolic rate. A decreased thyroid
hormone level, not an increased parathyroid hormone level, may cause edema
and dry skin secondary to fluid infiltration into the interstitial spaces.
Hyperparathyroidism causes hypercalcemia, not hypocalcemia; therefore, it isn't
associated with tetany.
3. Nurse John is assigned to care for a postoperative male client who has diabetes
mellitus. During the assessment interview, the client reports that he's impotent
and says he's concerned about its effect on his marriage. In planning this client's
care, the most appropriate intervention would be to:
a. Encourage the client to ask questions about personal sexuality.
b. Provide time for privacy.
c. Provide support for the spouse or significant other.
d. Suggest referral to a sex counselor or other appropriate professional. -
ANSWER-D.
The nurse should refer this client to a sex counselor or other professional. Making
appropriate referrals is a valid part of planning the client's care. The nurse doesn't
normally provide sex counseling.
,4. During a class on exercise for diabetic clients, a female client asks the nurse
educator how often to exercise. The nurse educator advises the clients to exercise
how often to meet the goals of planned exercise?
a. At least once a week
b. At least three times a week
c. At least five times a week
d. Every day - ANSWER-B.
Diabetic clients must exercise at least three times a week to meet the goals of
planned exercise — lowering the blood glucose level, reducing or maintaining the
proper weight, increasing the serum high-density lipoprotein level, decreasing
serum triglyceride levels, reducing blood pressure, and minimizing stress.
Exercising once a week wouldn't achieve these goals. Exercising more than three
times a week, although beneficial, would exceed the minimum requirement.
5. Nurse Oliver should expect a client with hypothyroidism to report which health
concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
c. Nervousness and tremors
d. Thyroid gland swelling - ANSWER-B.
Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight
gain. Signs and symptoms of hyperthyroidism (Graves' disease) include an
increased appetite, weight loss, nervousness, tremors, and thyroid gland
enlargement (goiter).
, 6. A female client with hypothyroidism (myxedema) is receiving levothyroxine
(Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an
adverse drug effect?
a. Dysuria
b. Leg cramps
c. Tachycardia
d. Blurred vision - ANSWER-C.
Levothyroxine, a synthetic thyroid hormone, is given to a client with
hypothyroidism to simulate the effects of thyroxine. Adverse effects of this agent
include tachycardia. The other options aren't associated with levothyroxine.
7. A 67-year-old male client has been complaining of sleeping more, increased
urination, anorexia, weakness, irritability, depression, and bone pain that
interferes with her going outdoors. Based on these assessment findings, nurse
Richard would suspect which of the following disorders?
a. Diabetes mellitus
b. Diabetes insipidus
c. Hypoparathyroidism
d. Hyperparathyroidism - ANSWER-D.
Hyperparathyroidism is most common in older women and is characterized by
bone pain and weakness from excess parathyroid hormone (PTH). Clients also
exhibit hypercaliuria-causing polyuria. While clients with diabetes mellitus and
diabetes insipidus also have polyuria, they don't have bone pain and increased
sleeping. Hypoparathyroidism is characterized by urinary frequency rather than
polyuria.
Practice Exam & Nursing Study
Guide
1. An agitated, confused female client arrives in the emergency department. Her
history includes type 1 diabetes mellitus, hypertension, and angina pectoris.
Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat
blood glucose sample measures 42 mg/dl, and the client is treated for an acute
hypoglycemic reaction. After recovery, nurse Lily teaches the client to treat
hypoglycemia by ingesting:
a. 2 to 5 g of a simple carbohydrate.
b. 10 to 15 g of a simple carbohydrate.
c. 18 to 20 g of a simple carbohydrate.
d. 25 to 30 g of a simple carbohydrate. - ANSWER-B.
To reverse hypoglycemia, the American Diabetes Association recommends
ingesting 10 to 15 g of a simple carbohydrate, such as three to five pieces of hard
candy, two to three packets of sugar (4 to 6 tsp), or 4 oz of fruit juice. If necessary,
this treatment can be repeated in 15 minutes. Ingesting only 2 to 5 g of a simple
carbohydrate may not raise the blood glucose level sufficiently. Ingesting more
than 15 g may raise it above normal, causing hyperglycemia.
2. A female adult client with a history of chronic hyperparathyroidism admits to
being noncompliant. Based on initial assessment findings, nurse Julia formulates
,the nursing diagnosis of Risk for injury. To complete the nursing diagnosis
statement for this client, which "related-to" phrase should the nurse add?
a. Related to bone demineralization resulting in pathologic fractures
b. Related to exhaustion secondary to an accelerated metabolic rate
c. Related to edema and dry skin secondary to fluid infiltration into the interstitial
spaces
d. Related to tetany secondary to a decreased serum calcium level - ANSWER-A.
Poorly controlled hyperparathyroidism may cause an elevated serum calcium
level. This, in turn, may diminish calcium stores in the bone, causing bone
demineralization and setting the stage for pathologic fractures and a risk for injury.
Hyperparathyroidism doesn't accelerate the metabolic rate. A decreased thyroid
hormone level, not an increased parathyroid hormone level, may cause edema
and dry skin secondary to fluid infiltration into the interstitial spaces.
Hyperparathyroidism causes hypercalcemia, not hypocalcemia; therefore, it isn't
associated with tetany.
3. Nurse John is assigned to care for a postoperative male client who has diabetes
mellitus. During the assessment interview, the client reports that he's impotent
and says he's concerned about its effect on his marriage. In planning this client's
care, the most appropriate intervention would be to:
a. Encourage the client to ask questions about personal sexuality.
b. Provide time for privacy.
c. Provide support for the spouse or significant other.
d. Suggest referral to a sex counselor or other appropriate professional. -
ANSWER-D.
The nurse should refer this client to a sex counselor or other professional. Making
appropriate referrals is a valid part of planning the client's care. The nurse doesn't
normally provide sex counseling.
,4. During a class on exercise for diabetic clients, a female client asks the nurse
educator how often to exercise. The nurse educator advises the clients to exercise
how often to meet the goals of planned exercise?
a. At least once a week
b. At least three times a week
c. At least five times a week
d. Every day - ANSWER-B.
Diabetic clients must exercise at least three times a week to meet the goals of
planned exercise — lowering the blood glucose level, reducing or maintaining the
proper weight, increasing the serum high-density lipoprotein level, decreasing
serum triglyceride levels, reducing blood pressure, and minimizing stress.
Exercising once a week wouldn't achieve these goals. Exercising more than three
times a week, although beneficial, would exceed the minimum requirement.
5. Nurse Oliver should expect a client with hypothyroidism to report which health
concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
c. Nervousness and tremors
d. Thyroid gland swelling - ANSWER-B.
Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight
gain. Signs and symptoms of hyperthyroidism (Graves' disease) include an
increased appetite, weight loss, nervousness, tremors, and thyroid gland
enlargement (goiter).
, 6. A female client with hypothyroidism (myxedema) is receiving levothyroxine
(Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an
adverse drug effect?
a. Dysuria
b. Leg cramps
c. Tachycardia
d. Blurred vision - ANSWER-C.
Levothyroxine, a synthetic thyroid hormone, is given to a client with
hypothyroidism to simulate the effects of thyroxine. Adverse effects of this agent
include tachycardia. The other options aren't associated with levothyroxine.
7. A 67-year-old male client has been complaining of sleeping more, increased
urination, anorexia, weakness, irritability, depression, and bone pain that
interferes with her going outdoors. Based on these assessment findings, nurse
Richard would suspect which of the following disorders?
a. Diabetes mellitus
b. Diabetes insipidus
c. Hypoparathyroidism
d. Hyperparathyroidism - ANSWER-D.
Hyperparathyroidism is most common in older women and is characterized by
bone pain and weakness from excess parathyroid hormone (PTH). Clients also
exhibit hypercaliuria-causing polyuria. While clients with diabetes mellitus and
diabetes insipidus also have polyuria, they don't have bone pain and increased
sleeping. Hypoparathyroidism is characterized by urinary frequency rather than
polyuria.
