ATI RN–Style Medical-Surgical
Endocrine Practice Exam
2026–2027| Complete Test
Prep Practice Questions With
Answers & Detailed
Rationales |clinical Judgment
&Safety |A+ Rated
Diabetes Mellitus
Question 1
A nurse is assessing a client who has type 1 diabetes mellitus. Which
finding is most concerning for diabetic ketoacidosis (DKA)?
A. Blood glucose of 180 mg/dL (10 mmol/L)
B. Respiratory rate of 18/min
C. Urine ketones negative
D. Blood glucose of 420 mg/dL (23.3 mmol/L) with deep, rapid
respirations
DKA is characterized by hyperglycemia, ketosis, metabolic acidosis,
dehydration, and compensatory Kussmaul respirations.
Question 2
,A client with diabetes mellitus reports shakiness, diaphoresis, and
palpitations. Which action should the nurse take first?
A. Administer regular insulin.
B. Check the client's blood glucose.
C. Encourage the client to exercise.
D. Restrict oral fluids.
These manifestations suggest hypoglycemia. Blood glucose should be
checked promptly to confirm the condition and guide treatment.
Question 3
A conscious client with diabetes has a blood glucose of 54 mg/dL (3.0
mmol/L). Which intervention should the nurse implement?
A. Administer 10 units of regular insulin.
B. Give a high-protein meal only.
C. Give 15 g of a rapid-acting carbohydrate.
D. Encourage the client to sleep.
The 15-15 approach is commonly used: give about 15 g of rapid-
acting carbohydrate and recheck glucose after approximately 15
minutes.
Question 4
Which food contains approximately 15 g of carbohydrate and can be
used to treat mild hypoglycemia?
A. 1 oz cheese
B. 1 hard-boiled egg
C. 4 oz (120 mL) orange juice
D. 2 tbsp peanut butter
Approximately 4 oz of fruit juice provides about 15 g of rapidly
absorbed carbohydrate.
Question 5
,A nurse is teaching a client about symptoms of hypoglycemia. Which
manifestations should the nurse include?
A. Polyuria and polydipsia
B. Fruity breath and abdominal pain
C. Tremors, sweating, and confusion
D. Warm, dry skin and deep respirations
Adrenergic and neuroglycopenic manifestations of hypoglycemia
include sweating, tremors, palpitations, irritability, confusion, and
seizures.
Question 6
A client with diabetes mellitus is unconscious and has a blood
glucose of 38 mg/dL (2.1 mmol/L). Which medication should the
nurse anticipate administering if IV access is unavailable?
A. Regular insulin
B. Metformin
C. Glucagon
D. NPH insulin
Glucagon raises blood glucose by stimulating hepatic glycogen
breakdown and is appropriate for severe hypoglycemia when the
client cannot safely take oral carbohydrate.
Question 7
Which finding is expected in a client experiencing diabetic
ketoacidosis?
A. Bradycardia
B. Kussmaul respirations
C. Hypoglycemia
D. Respiratory alkalosis
Kussmaul respirations are deep and rapid respirations that
compensate for metabolic acidosis associated with DKA.
, Question 8
A client with DKA has a serum potassium level of 5.8 mEq/L (5.8
mmol/L). Which explanation should the nurse give regarding this
finding?
A. The client has excessive dietary potassium intake.
B. Insulin causes potassium to leave cells.
C. Acidosis and insulin deficiency cause potassium to shift from cells
into the blood.
D. The kidneys immediately excrete all excess potassium.
Although serum potassium can initially be elevated in DKA, total-
body potassium is usually depleted because of osmotic diuresis and
urinary losses.
Question 9
Which prescription should the nurse anticipate as a priority for a
client with DKA?
A. Oral hypoglycemic medication
B. Fluid restriction
C. IV isotonic fluid replacement
D. High-dose potassium restriction
Severe dehydration is a major component of DKA. Initial treatment
commonly includes IV isotonic fluids, followed by insulin and
electrolyte management.
Question 10
A nurse is caring for a client receiving IV insulin for DKA. Which
laboratory value requires particularly close monitoring?
A. Calcium
B. Hemoglobin
C. Potassium
D. Albumin
Endocrine Practice Exam
2026–2027| Complete Test
Prep Practice Questions With
Answers & Detailed
Rationales |clinical Judgment
&Safety |A+ Rated
Diabetes Mellitus
Question 1
A nurse is assessing a client who has type 1 diabetes mellitus. Which
finding is most concerning for diabetic ketoacidosis (DKA)?
A. Blood glucose of 180 mg/dL (10 mmol/L)
B. Respiratory rate of 18/min
C. Urine ketones negative
D. Blood glucose of 420 mg/dL (23.3 mmol/L) with deep, rapid
respirations
DKA is characterized by hyperglycemia, ketosis, metabolic acidosis,
dehydration, and compensatory Kussmaul respirations.
Question 2
,A client with diabetes mellitus reports shakiness, diaphoresis, and
palpitations. Which action should the nurse take first?
A. Administer regular insulin.
B. Check the client's blood glucose.
C. Encourage the client to exercise.
D. Restrict oral fluids.
These manifestations suggest hypoglycemia. Blood glucose should be
checked promptly to confirm the condition and guide treatment.
Question 3
A conscious client with diabetes has a blood glucose of 54 mg/dL (3.0
mmol/L). Which intervention should the nurse implement?
A. Administer 10 units of regular insulin.
B. Give a high-protein meal only.
C. Give 15 g of a rapid-acting carbohydrate.
D. Encourage the client to sleep.
The 15-15 approach is commonly used: give about 15 g of rapid-
acting carbohydrate and recheck glucose after approximately 15
minutes.
Question 4
Which food contains approximately 15 g of carbohydrate and can be
used to treat mild hypoglycemia?
A. 1 oz cheese
B. 1 hard-boiled egg
C. 4 oz (120 mL) orange juice
D. 2 tbsp peanut butter
Approximately 4 oz of fruit juice provides about 15 g of rapidly
absorbed carbohydrate.
Question 5
,A nurse is teaching a client about symptoms of hypoglycemia. Which
manifestations should the nurse include?
A. Polyuria and polydipsia
B. Fruity breath and abdominal pain
C. Tremors, sweating, and confusion
D. Warm, dry skin and deep respirations
Adrenergic and neuroglycopenic manifestations of hypoglycemia
include sweating, tremors, palpitations, irritability, confusion, and
seizures.
Question 6
A client with diabetes mellitus is unconscious and has a blood
glucose of 38 mg/dL (2.1 mmol/L). Which medication should the
nurse anticipate administering if IV access is unavailable?
A. Regular insulin
B. Metformin
C. Glucagon
D. NPH insulin
Glucagon raises blood glucose by stimulating hepatic glycogen
breakdown and is appropriate for severe hypoglycemia when the
client cannot safely take oral carbohydrate.
Question 7
Which finding is expected in a client experiencing diabetic
ketoacidosis?
A. Bradycardia
B. Kussmaul respirations
C. Hypoglycemia
D. Respiratory alkalosis
Kussmaul respirations are deep and rapid respirations that
compensate for metabolic acidosis associated with DKA.
, Question 8
A client with DKA has a serum potassium level of 5.8 mEq/L (5.8
mmol/L). Which explanation should the nurse give regarding this
finding?
A. The client has excessive dietary potassium intake.
B. Insulin causes potassium to leave cells.
C. Acidosis and insulin deficiency cause potassium to shift from cells
into the blood.
D. The kidneys immediately excrete all excess potassium.
Although serum potassium can initially be elevated in DKA, total-
body potassium is usually depleted because of osmotic diuresis and
urinary losses.
Question 9
Which prescription should the nurse anticipate as a priority for a
client with DKA?
A. Oral hypoglycemic medication
B. Fluid restriction
C. IV isotonic fluid replacement
D. High-dose potassium restriction
Severe dehydration is a major component of DKA. Initial treatment
commonly includes IV isotonic fluids, followed by insulin and
electrolyte management.
Question 10
A nurse is caring for a client receiving IV insulin for DKA. Which
laboratory value requires particularly close monitoring?
A. Calcium
B. Hemoglobin
C. Potassium
D. Albumin
