Endocrine NCLEX Questions and
Answers
. A client has been diagnosed with goiter. The nurse looks for documentation
of which of the following in the client's medical record?
a) decreased wound healing
b) chronic fatigue
c) enlarged thyroid gland
d) heart damage - ----ANS:6) C
- An enlarged thyroid gland occurs in goiter. Decreased wound healing,
chronic fatigue, and heart damage are not specifically associated with this
condition.
. The nurse assessing a female client with Cushing's syndrome would expect
to note which of the following?
a) hirsutism
b) hypotension
c) hypoglycemia
d) pallor - ----ANS:1) A
- An increased production of androgens that accompanies a rise in cortisol
levels with Cushing's syndrome produces hirsutism and acne in women. Other
clinical findings of Cushing's syndrome include hypertension caused by
sodium retention, impaired glucose tolerance or diabetes mellitus caused by
cortisol's anti-insulin effect and ability to enhance gluconeogenesis, and skin
changes including bruising and purplish red striae caused by protein
catabolism.
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. - ----ANS: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 -
----ANS: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.
2. A nurse is admitting a client with a diagnosis of Addison's disease to the
hospital. On assessment, the nurse would expect to note which finding that is
a manifestation of this disorder?
a) peripheral edema
b) excessive facial hair
c) lower than normal blood glucose level
d) high blood pressure - ----ANS:2) C
- Blood glucose levels are low in Addison's disease as a result of decreased
secretion of glucocorticoids (cortisol). Edema is absent, and aldosterone
secretion is decreased so the client develops a deficient fluid volume. Facial
hair increases with adrenocortical hyperfunction. Clients with Addison's
,disease develop hypotension as a result of deficient fluid volume. Options A, B
and D are unrelated to Addison's disease.
2. Grave's disease is:
a. The most common cause of hypothyroidism
b. The most common cause of hyperparathyroidism
c. The most common cause of hyperthyroidism
d. The most common cause of adrenal insufficiency - ----ANS:type 2 diabetes,
hypertension and increased risk of cardiovascular disease, arthritis and colon
polyps.
2. C: Grave's disease is an autoimmune disorder characterized by an
enlarged thyroid gland and overproduction of thyroid hormones producing
symptoms of hyperthyroidism such as rapid heartbeat, heat intolerance,
agitation or irritability, weight loss, and trouble sleeping. It usually presents in
persons age 20 to 40 and it is much more common in women than in men.
3. A nurse is preparing to perform an assessment on a client being admitted to
the hospital with a diagnosis of Cushing's syndrome. When performing the
assessment, the nurse checks for which significant manifestation of the
disorder?
a) fluid retention
b) stretch marks
c) goiter
d) melanosis - ----ANS:3) A
- Excessive secretion of adrenocortical hormones results in water and sodium
reabsorption, causing fluid retention. Stretch marks (striae) are a common
feature and can result in a disturbed body image, but are not significant and
do not represent a life-threatening situation. Goiter is not a manifestation of
Cushing's syndrome. Melanosis is a common manifestation associated with
Addison's disease.
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. -
----ANS: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.
3. Symptoms of Grave's ophthalmopathy include all of the following except:
a. Bulging eyeballs
b. Dry, irritated eyes and puffy eyelids
c. Cataracts
d. Light sensitivity - ----ANS:3. C: Grave's ophthalmopathy is an inflammation
of tissue behind the eye causing the eyeballs to bulge. In addition to the
above-mentioned symptoms, Grave's ophthalmopathy may cause pressure or
pain in the eyes, double vision, and trouble moving the eyes. About
one-quarter of persons with Grave's disease develop Grave's ophthalmopathy.
The condition is frequently self-limiting, resolving without treatment over the
course of a year or two.
4. A clinic nurse is performing an assessment on a client who has
hypothyroidism. The nurse would expect to note which clinical manifestation?
a) complaints of difficulty sleeping
b) complaints of diarrhea
c) significant weight loss since the last clinic visit
d) complaints of intolerance to cold weather - ----ANS:4) D
- An insufficient level of thyroid hormone causes a decrease in metabolic rate
and heat production. Intolerance to cold would be noted. Options A, B and C
are clinical manifestations of hyperthyroidism.
4. An ACTH stimulation test is commonly used to diagnose:
a. Grave's disease
b. Adrenal insufficiency and Addison's disease
c. Cystic fibrosis
d. Hashimoto's disease - ----ANS:4. B: The ACTH stimulation test measures
blood and urine cortisol before and after injection of ACTH. Persons with
chronic adrenal insufficiency or Addison's disease generally do not respond
with the expected increase in cortisol levels. An abnormal ACTH stimulation
test may be followed with a CRH stimulation test to pinpoint the cause of
adrenal insufficiency.
Answers
. A client has been diagnosed with goiter. The nurse looks for documentation
of which of the following in the client's medical record?
a) decreased wound healing
b) chronic fatigue
c) enlarged thyroid gland
d) heart damage - ----ANS:6) C
- An enlarged thyroid gland occurs in goiter. Decreased wound healing,
chronic fatigue, and heart damage are not specifically associated with this
condition.
. The nurse assessing a female client with Cushing's syndrome would expect
to note which of the following?
a) hirsutism
b) hypotension
c) hypoglycemia
d) pallor - ----ANS:1) A
- An increased production of androgens that accompanies a rise in cortisol
levels with Cushing's syndrome produces hirsutism and acne in women. Other
clinical findings of Cushing's syndrome include hypertension caused by
sodium retention, impaired glucose tolerance or diabetes mellitus caused by
cortisol's anti-insulin effect and ability to enhance gluconeogenesis, and skin
changes including bruising and purplish red striae caused by protein
catabolism.
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. - ----ANS: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 -
----ANS: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.
2. A nurse is admitting a client with a diagnosis of Addison's disease to the
hospital. On assessment, the nurse would expect to note which finding that is
a manifestation of this disorder?
a) peripheral edema
b) excessive facial hair
c) lower than normal blood glucose level
d) high blood pressure - ----ANS:2) C
- Blood glucose levels are low in Addison's disease as a result of decreased
secretion of glucocorticoids (cortisol). Edema is absent, and aldosterone
secretion is decreased so the client develops a deficient fluid volume. Facial
hair increases with adrenocortical hyperfunction. Clients with Addison's
,disease develop hypotension as a result of deficient fluid volume. Options A, B
and D are unrelated to Addison's disease.
2. Grave's disease is:
a. The most common cause of hypothyroidism
b. The most common cause of hyperparathyroidism
c. The most common cause of hyperthyroidism
d. The most common cause of adrenal insufficiency - ----ANS:type 2 diabetes,
hypertension and increased risk of cardiovascular disease, arthritis and colon
polyps.
2. C: Grave's disease is an autoimmune disorder characterized by an
enlarged thyroid gland and overproduction of thyroid hormones producing
symptoms of hyperthyroidism such as rapid heartbeat, heat intolerance,
agitation or irritability, weight loss, and trouble sleeping. It usually presents in
persons age 20 to 40 and it is much more common in women than in men.
3. A nurse is preparing to perform an assessment on a client being admitted to
the hospital with a diagnosis of Cushing's syndrome. When performing the
assessment, the nurse checks for which significant manifestation of the
disorder?
a) fluid retention
b) stretch marks
c) goiter
d) melanosis - ----ANS:3) A
- Excessive secretion of adrenocortical hormones results in water and sodium
reabsorption, causing fluid retention. Stretch marks (striae) are a common
feature and can result in a disturbed body image, but are not significant and
do not represent a life-threatening situation. Goiter is not a manifestation of
Cushing's syndrome. Melanosis is a common manifestation associated with
Addison's disease.
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. -
----ANS: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.
3. Symptoms of Grave's ophthalmopathy include all of the following except:
a. Bulging eyeballs
b. Dry, irritated eyes and puffy eyelids
c. Cataracts
d. Light sensitivity - ----ANS:3. C: Grave's ophthalmopathy is an inflammation
of tissue behind the eye causing the eyeballs to bulge. In addition to the
above-mentioned symptoms, Grave's ophthalmopathy may cause pressure or
pain in the eyes, double vision, and trouble moving the eyes. About
one-quarter of persons with Grave's disease develop Grave's ophthalmopathy.
The condition is frequently self-limiting, resolving without treatment over the
course of a year or two.
4. A clinic nurse is performing an assessment on a client who has
hypothyroidism. The nurse would expect to note which clinical manifestation?
a) complaints of difficulty sleeping
b) complaints of diarrhea
c) significant weight loss since the last clinic visit
d) complaints of intolerance to cold weather - ----ANS:4) D
- An insufficient level of thyroid hormone causes a decrease in metabolic rate
and heat production. Intolerance to cold would be noted. Options A, B and C
are clinical manifestations of hyperthyroidism.
4. An ACTH stimulation test is commonly used to diagnose:
a. Grave's disease
b. Adrenal insufficiency and Addison's disease
c. Cystic fibrosis
d. Hashimoto's disease - ----ANS:4. B: The ACTH stimulation test measures
blood and urine cortisol before and after injection of ACTH. Persons with
chronic adrenal insufficiency or Addison's disease generally do not respond
with the expected increase in cortisol levels. An abnormal ACTH stimulation
test may be followed with a CRH stimulation test to pinpoint the cause of
adrenal insufficiency.
