NCLEX 10000 ENDOCRINE AND METABOLIC
A client with primary diabetes insipidus is ready for discharge on desmopressin
(DDAVP). Which instruction should the nurse provide? - You may not be able to use
desmopressin nasally if you have nasal discharge or blockage."
A group of nursing assistants hired for the medical-surgical floors are attending hospital
orientation. Which topic should the educator cover when teaching the group about
caring for clients with diabetes mellitus? - Obtaining, reporting, and documenting
fingerstick glucose levels
While reviewing the day's charts, a nurse who's been under a great deal of personal
stress realizes that she forgot to administer insulin to client with diabetes mellitus. She's
made numerous errors in the past few weeks and is now afraid her job is in jeopardy.
What is her best course of action? - Report the error, complete the proper paperwork,
and meet with the unit manager.
Several hours into a shift, a nurse on a very busy medical-surgical unit privately asks
the charge nurse to change her assignment. She is frustrated because she has had to
devote so much time and energy to helping a newly licensed nurse provide discharge
teaching for clients with diabetes mellitus. The charge nurse should: - offer to assist with
the discharge teaching needs.
A nurse hears a staff member giving incorrect information to the family of a client newly
diagnosed with diabetes mellitus who is being discharged to home. The nurse wants to
make sure the family has the proper information before the client is discharged. What
should she do? - Have the nurse step outside of the room, discuss the situation, and
use it as a learning opportunity.
The nurse caring for a client with diabetes realizes that the client has a higher risk of
developing cataracts and should also assess the client for indications of: - diabetic
retinopathy.
Which factor, if described by the parents of a child with cystic fibrosis (CF), indicates
that the parents understand the underlying problem of the disease? - an abnormality in
the body's mucus-secreting glands
A client with thyrotoxicosis says to the nurse, "I am so irritable. I am having problems at
work because I lose my temper very easily." Which response by the nurse would give
the client the most accurate explanation of this behavior? - Your behavior is caused by
the excess thyroid hormone in your system."
A client who has undergone a subtotal thyroidectomy is subject to complications in the
first 48 hours after surgery. The nurse should obtain and keep at the bedside equipment
to: - perform a tracheotomy.
,A client with diabetes mellitus comes to the clinic for a regular 3-month follow-up
appointment. The nurse notes several small bandages covering cuts on the client's
hands. The client says, "I am so clumsy. I am always cutting my finger cooking or
burning myself on the iron." Which response by the nurse would be most appropriate? -
Keep all cuts clean and covered."
A nurse is teaching a client with type 1 diabetes mellitus who jogs daily about the
preferred sites for insulin absorption. What is the most appropriate site for a client who
jogs? - abdomen
A client with diabetes is taking insulin lispro injections. The nurse should advise the
client to eat: - within 10 to 15 minutes after the injection
Vasopressin is administered to the client with diabetes insipidus because it: - increases
tubular reabsorption of water.
The client with Addison's disease should anticipate the need for increased
glucocorticoid supplementation when? - having oral surgery
After a bilateral adrenalectomy for Cushing's disease, the client will receive periodic
testosterone injections. The expected outcome of these injections is: - stimulated
protein metabolism.
Pancreatic enzyme replacements are prescribed for the client with chronic pancreatitis.
When should the nurse instruct the client to take them to obtain the most therapeutic
effect? - with each meal and snack
The nurse develops a teaching plan for the client about how to prevent the transmission
of hepatitis A. Which discharge instruction is appropriate for the client? - Ask family
members to wash their hands frequently.
A client is admitted with a diagnosis of diabetic ketoacidosis. An insulin drip is initiated
with 50 units of insulin in 100 ml of normal saline solution administered via an infusion
pump set at 10 ml/hour. The nurse determines that the client is receiving how many
units of insulin each hour? Record your answer using a whole number. - 5
A nurse is caring for a client who was recently diagnosed with hyperparathyroidism.
Which statement by the client indicates the need for additional discharge teaching? - "I
will increase my fluid and calcium intake."
An incoherent client with a history of hypothyroidism is brought to the emergency
department by the rescue squad. Physical and laboratory findings reveal hypothermia,
hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of
the face and pretibial area. Knowing that these findings suggest severe hypothyroidism,
, the nurse prepares to take emergency action to prevent the potential complication of: -
myxedema coma.
A client with diabetes mellitus must learn how to self-administer insulin. The physician
has ordered 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin
suspension (NPH) to be taken before breakfast. When teaching the client how to select
and rotate insulin injection sites, the nurse should provide which instruction? - "Rotate
injection sites within the same anatomic region, not among different regions."
A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical
examination, the nurse expects to assess: - Trousseau's sign.
A client is being evaluated for hypothyroidism. During assessment, the nurse should
stay alert for: - decreased body temperature and cold intolerance.
For a client with hyperthyroidism, treatment is most likely to include: - a thyroid hormone
antagonist.
Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the
nurse assesses the client, who now has nausea, a temperature of 105° F (40.5° C),
tachycardia, and extreme restlessness. What is the most likely cause of these signs? -
Thyroid crisis
Which statement indicates that a client with diabetes mellitus understands proper foot
care? - "I'll wear cotton socks with well-fitting shoes.
A nurse explains to a client with thyroid disease that the thyroid gland normally
produces: - T3, thyroxine (T4), and calcitonin.
A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-
headedness, and aberrant behavior. The client is conscious. The nurse should first
administer: - 15 to 20 g of a fast-acting carbohydrate such as orange juice.
A client's blood glucose level is 45 mg/dl (2.5 mmol/L). The nurse should be alert for
which signs and symptoms? - Coma, anxiety, confusion, headache, and cool, moist skin
Which combination of adverse effects should a nurse monitor for when administering
I.V. insulin to a client with diabetic ketoacidosis? - Hypokalemia and hypoglycemia
A client tells the nurse that she has been working hard for the past 3 months to control
her type 2 diabetes with diet and exercise. To determine the effectiveness of the client's
efforts, the nurse should check: - glycosylated hemoglobin level.
A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia.
What should the nurse do? - Observe for muscle twitching and numbness or tingling of
the lips, fingers, and toes.
A client with primary diabetes insipidus is ready for discharge on desmopressin
(DDAVP). Which instruction should the nurse provide? - You may not be able to use
desmopressin nasally if you have nasal discharge or blockage."
A group of nursing assistants hired for the medical-surgical floors are attending hospital
orientation. Which topic should the educator cover when teaching the group about
caring for clients with diabetes mellitus? - Obtaining, reporting, and documenting
fingerstick glucose levels
While reviewing the day's charts, a nurse who's been under a great deal of personal
stress realizes that she forgot to administer insulin to client with diabetes mellitus. She's
made numerous errors in the past few weeks and is now afraid her job is in jeopardy.
What is her best course of action? - Report the error, complete the proper paperwork,
and meet with the unit manager.
Several hours into a shift, a nurse on a very busy medical-surgical unit privately asks
the charge nurse to change her assignment. She is frustrated because she has had to
devote so much time and energy to helping a newly licensed nurse provide discharge
teaching for clients with diabetes mellitus. The charge nurse should: - offer to assist with
the discharge teaching needs.
A nurse hears a staff member giving incorrect information to the family of a client newly
diagnosed with diabetes mellitus who is being discharged to home. The nurse wants to
make sure the family has the proper information before the client is discharged. What
should she do? - Have the nurse step outside of the room, discuss the situation, and
use it as a learning opportunity.
The nurse caring for a client with diabetes realizes that the client has a higher risk of
developing cataracts and should also assess the client for indications of: - diabetic
retinopathy.
Which factor, if described by the parents of a child with cystic fibrosis (CF), indicates
that the parents understand the underlying problem of the disease? - an abnormality in
the body's mucus-secreting glands
A client with thyrotoxicosis says to the nurse, "I am so irritable. I am having problems at
work because I lose my temper very easily." Which response by the nurse would give
the client the most accurate explanation of this behavior? - Your behavior is caused by
the excess thyroid hormone in your system."
A client who has undergone a subtotal thyroidectomy is subject to complications in the
first 48 hours after surgery. The nurse should obtain and keep at the bedside equipment
to: - perform a tracheotomy.
,A client with diabetes mellitus comes to the clinic for a regular 3-month follow-up
appointment. The nurse notes several small bandages covering cuts on the client's
hands. The client says, "I am so clumsy. I am always cutting my finger cooking or
burning myself on the iron." Which response by the nurse would be most appropriate? -
Keep all cuts clean and covered."
A nurse is teaching a client with type 1 diabetes mellitus who jogs daily about the
preferred sites for insulin absorption. What is the most appropriate site for a client who
jogs? - abdomen
A client with diabetes is taking insulin lispro injections. The nurse should advise the
client to eat: - within 10 to 15 minutes after the injection
Vasopressin is administered to the client with diabetes insipidus because it: - increases
tubular reabsorption of water.
The client with Addison's disease should anticipate the need for increased
glucocorticoid supplementation when? - having oral surgery
After a bilateral adrenalectomy for Cushing's disease, the client will receive periodic
testosterone injections. The expected outcome of these injections is: - stimulated
protein metabolism.
Pancreatic enzyme replacements are prescribed for the client with chronic pancreatitis.
When should the nurse instruct the client to take them to obtain the most therapeutic
effect? - with each meal and snack
The nurse develops a teaching plan for the client about how to prevent the transmission
of hepatitis A. Which discharge instruction is appropriate for the client? - Ask family
members to wash their hands frequently.
A client is admitted with a diagnosis of diabetic ketoacidosis. An insulin drip is initiated
with 50 units of insulin in 100 ml of normal saline solution administered via an infusion
pump set at 10 ml/hour. The nurse determines that the client is receiving how many
units of insulin each hour? Record your answer using a whole number. - 5
A nurse is caring for a client who was recently diagnosed with hyperparathyroidism.
Which statement by the client indicates the need for additional discharge teaching? - "I
will increase my fluid and calcium intake."
An incoherent client with a history of hypothyroidism is brought to the emergency
department by the rescue squad. Physical and laboratory findings reveal hypothermia,
hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of
the face and pretibial area. Knowing that these findings suggest severe hypothyroidism,
, the nurse prepares to take emergency action to prevent the potential complication of: -
myxedema coma.
A client with diabetes mellitus must learn how to self-administer insulin. The physician
has ordered 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin
suspension (NPH) to be taken before breakfast. When teaching the client how to select
and rotate insulin injection sites, the nurse should provide which instruction? - "Rotate
injection sites within the same anatomic region, not among different regions."
A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical
examination, the nurse expects to assess: - Trousseau's sign.
A client is being evaluated for hypothyroidism. During assessment, the nurse should
stay alert for: - decreased body temperature and cold intolerance.
For a client with hyperthyroidism, treatment is most likely to include: - a thyroid hormone
antagonist.
Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the
nurse assesses the client, who now has nausea, a temperature of 105° F (40.5° C),
tachycardia, and extreme restlessness. What is the most likely cause of these signs? -
Thyroid crisis
Which statement indicates that a client with diabetes mellitus understands proper foot
care? - "I'll wear cotton socks with well-fitting shoes.
A nurse explains to a client with thyroid disease that the thyroid gland normally
produces: - T3, thyroxine (T4), and calcitonin.
A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-
headedness, and aberrant behavior. The client is conscious. The nurse should first
administer: - 15 to 20 g of a fast-acting carbohydrate such as orange juice.
A client's blood glucose level is 45 mg/dl (2.5 mmol/L). The nurse should be alert for
which signs and symptoms? - Coma, anxiety, confusion, headache, and cool, moist skin
Which combination of adverse effects should a nurse monitor for when administering
I.V. insulin to a client with diabetic ketoacidosis? - Hypokalemia and hypoglycemia
A client tells the nurse that she has been working hard for the past 3 months to control
her type 2 diabetes with diet and exercise. To determine the effectiveness of the client's
efforts, the nurse should check: - glycosylated hemoglobin level.
A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia.
What should the nurse do? - Observe for muscle twitching and numbness or tingling of
the lips, fingers, and toes.
