NR 325 Exam 1 2026/2027 – Latest Questions
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Endocrine Disorders
1. A nurse is assessing a patient with suspected hypothyroidism. Which diagnostic
test should the nurse expect to be performed first?
A. Serum T4 level
B. Thyroid stimulating hormone (TSH)
C. Serum T3 level
D. Thyroid ultrasound
B| TSH is the most sensitive indicator for detecting hypothyroidism.
Because the pituitary gland responds to low thyroid hormone levels by
increasing TSH production, an elevated TSH is typically the earliest and most
reliable marker of primary hypothyroidism .
2. A patient with type 1 diabetes calls the clinic reporting nausea, vomiting, and
diarrhea. What is the most important advice the nurse should provide?
A. "Stop taking your insulin until you can eat again."
B. "Check your blood glucose every 2-4 hours."
C. "Take an over-the-counter antiemetic and rest."
D. "Increase your carbohydrate intake to prevent hypoglycemia."
B| Illness, infection, and stress are counterregulatory stressors that
increase blood glucose levels through cortisol and catecholamine release.
Patients with T1D must monitor glucose every 2-4 hours during illness to detect
hyperglycemia and prevent DKA .
,3. A patient is exhibiting signs and symptoms of hypothyroidism. Why is TSH the
first diagnostic test performed?
A. It directly measures thyroid hormone production.
B. It is the most sensitive test for detecting hypothyroidism.
C. It is the only test that can detect thyroid antibodies.
D. It is cheaper and faster than other thyroid tests.
B| TSH is the most sensitive indicator of thyroid function. Even small
changes in circulating T3/T4 levels cause significant reciprocal changes in TSH
secretion, making it the earliest detectable abnormality in primary thyroid
dysfunction .
4. A patient screened for diabetes has a fasting plasma glucose level of 120 mg/dL
(6.7 mmol/L). Which statement is most accurate?
A. "Your result is normal; no further testing is needed."
B. "You are at increased risk for developing diabetes."
C. "You have diabetes and need to start medication immediately."
D. "This result is inconclusive and needs to be repeated today."
B| A fasting plasma glucose of 100-125 mg/dL indicates prediabetes
(impaired fasting glucose). This places the patient at increased risk for
developing diabetes. Diagnostic criteria for diabetes require FPG ≥126 mg/dL on
two occasions .
5. How long should a patient fast prior to a fasting blood glucose test?
A. 4-6 hours
B. 8-12 hours
C. 12-16 hours
D. 24 hours
, B| A fasting blood glucose requires no caloric intake for at least 8 hours,
with 8-12 hours being the standard recommendation. This ensures accurate
baseline glucose measurement without postprandial interference .
6. What is the normal fasting blood glucose range?
A. 60-90 mg/dL
B. 74-106 mg/dL
C. 100-120 mg/dL
D. 120-140 mg/dL
B| Normal fasting plasma glucose is typically defined as 74-106 mg/dL
(or 70-99 mg/dL per ADA). Values below 70 indicate hypoglycemia; values 100-
125 indicate prediabetes; values ≥126 indicate diabetes .
7. What fasting blood glucose result indicates a patient is at risk for developing
diabetes?
A. > 100 mg/dL
B. > 126 mg/dL
C. > 140 mg/dL
D. > 200 mg/dL
A| A fasting glucose of 100-125 mg/dL indicates impaired fasting
glucose (prediabetes), placing the patient at increased risk. Values ≥126 mg/dL
on two occasions indicate diabetes .
8. What are signs and symptoms of thyroid storm? Select all that apply.
A. Elevated temperature
B. Bradycardia
C. Signs of heart failure
D. Hypotension
E. Signs of hyperthyroidism
, A, C, E | Thyroid storm is a life-threatening exacerbation of
hyperthyroidism characterized by hyperpyrexia (elevated temperature),
tachycardia (not bradycardia), signs of heart failure, agitation, and severe
hyperthyroid manifestations. Blood pressure typically increases due to
heightened metabolic state .
9. What electrolyte imbalances are associated with diabetic ketoacidosis (DKA)?
Select all that apply.
A. Hyponatremia
B. Hyperkalemia initially
C. Hypokalemia total body
D. Hyperphosphatemia
E. Hypomagnesemia
A, C, E | DKA causes hyponatremia (dilutional and ketone-related), total
body potassium depletion (hypokalemia despite initially elevated serum K+ due
to acidosis), hypophosphatemia, hypochloremia, and hypomagnesemia .
10. What disorder causes low serum osmolality?
A. Diabetes insipidus (DI)
B. Syndrome of inappropriate antidiuretic hormone (SIADH)
C. Hyperglycemic hyperosmolar state (HHS)
D. Diabetic ketoacidosis (DKA)
B| SIADH causes excessive water retention due to inappropriate ADH
secretion, resulting in dilutional hyponatremia and low serum osmolality. DI
causes high serum osmolality due to water loss .
11. What disorder causes hemoconcentration of electrolytes?
A. SIADH
B. Diabetes insipidus (DI)
and Correct Answers – Instant Download –
Verified Solutions
Endocrine Disorders
1. A nurse is assessing a patient with suspected hypothyroidism. Which diagnostic
test should the nurse expect to be performed first?
A. Serum T4 level
B. Thyroid stimulating hormone (TSH)
C. Serum T3 level
D. Thyroid ultrasound
B| TSH is the most sensitive indicator for detecting hypothyroidism.
Because the pituitary gland responds to low thyroid hormone levels by
increasing TSH production, an elevated TSH is typically the earliest and most
reliable marker of primary hypothyroidism .
2. A patient with type 1 diabetes calls the clinic reporting nausea, vomiting, and
diarrhea. What is the most important advice the nurse should provide?
A. "Stop taking your insulin until you can eat again."
B. "Check your blood glucose every 2-4 hours."
C. "Take an over-the-counter antiemetic and rest."
D. "Increase your carbohydrate intake to prevent hypoglycemia."
B| Illness, infection, and stress are counterregulatory stressors that
increase blood glucose levels through cortisol and catecholamine release.
Patients with T1D must monitor glucose every 2-4 hours during illness to detect
hyperglycemia and prevent DKA .
,3. A patient is exhibiting signs and symptoms of hypothyroidism. Why is TSH the
first diagnostic test performed?
A. It directly measures thyroid hormone production.
B. It is the most sensitive test for detecting hypothyroidism.
C. It is the only test that can detect thyroid antibodies.
D. It is cheaper and faster than other thyroid tests.
B| TSH is the most sensitive indicator of thyroid function. Even small
changes in circulating T3/T4 levels cause significant reciprocal changes in TSH
secretion, making it the earliest detectable abnormality in primary thyroid
dysfunction .
4. A patient screened for diabetes has a fasting plasma glucose level of 120 mg/dL
(6.7 mmol/L). Which statement is most accurate?
A. "Your result is normal; no further testing is needed."
B. "You are at increased risk for developing diabetes."
C. "You have diabetes and need to start medication immediately."
D. "This result is inconclusive and needs to be repeated today."
B| A fasting plasma glucose of 100-125 mg/dL indicates prediabetes
(impaired fasting glucose). This places the patient at increased risk for
developing diabetes. Diagnostic criteria for diabetes require FPG ≥126 mg/dL on
two occasions .
5. How long should a patient fast prior to a fasting blood glucose test?
A. 4-6 hours
B. 8-12 hours
C. 12-16 hours
D. 24 hours
, B| A fasting blood glucose requires no caloric intake for at least 8 hours,
with 8-12 hours being the standard recommendation. This ensures accurate
baseline glucose measurement without postprandial interference .
6. What is the normal fasting blood glucose range?
A. 60-90 mg/dL
B. 74-106 mg/dL
C. 100-120 mg/dL
D. 120-140 mg/dL
B| Normal fasting plasma glucose is typically defined as 74-106 mg/dL
(or 70-99 mg/dL per ADA). Values below 70 indicate hypoglycemia; values 100-
125 indicate prediabetes; values ≥126 indicate diabetes .
7. What fasting blood glucose result indicates a patient is at risk for developing
diabetes?
A. > 100 mg/dL
B. > 126 mg/dL
C. > 140 mg/dL
D. > 200 mg/dL
A| A fasting glucose of 100-125 mg/dL indicates impaired fasting
glucose (prediabetes), placing the patient at increased risk. Values ≥126 mg/dL
on two occasions indicate diabetes .
8. What are signs and symptoms of thyroid storm? Select all that apply.
A. Elevated temperature
B. Bradycardia
C. Signs of heart failure
D. Hypotension
E. Signs of hyperthyroidism
, A, C, E | Thyroid storm is a life-threatening exacerbation of
hyperthyroidism characterized by hyperpyrexia (elevated temperature),
tachycardia (not bradycardia), signs of heart failure, agitation, and severe
hyperthyroid manifestations. Blood pressure typically increases due to
heightened metabolic state .
9. What electrolyte imbalances are associated with diabetic ketoacidosis (DKA)?
Select all that apply.
A. Hyponatremia
B. Hyperkalemia initially
C. Hypokalemia total body
D. Hyperphosphatemia
E. Hypomagnesemia
A, C, E | DKA causes hyponatremia (dilutional and ketone-related), total
body potassium depletion (hypokalemia despite initially elevated serum K+ due
to acidosis), hypophosphatemia, hypochloremia, and hypomagnesemia .
10. What disorder causes low serum osmolality?
A. Diabetes insipidus (DI)
B. Syndrome of inappropriate antidiuretic hormone (SIADH)
C. Hyperglycemic hyperosmolar state (HHS)
D. Diabetic ketoacidosis (DKA)
B| SIADH causes excessive water retention due to inappropriate ADH
secretion, resulting in dilutional hyponatremia and low serum osmolality. DI
causes high serum osmolality due to water loss .
11. What disorder causes hemoconcentration of electrolytes?
A. SIADH
B. Diabetes insipidus (DI)
