AGACNP ANCC BOARDS ENDOCRINE EXAM 2025/2026
QUESTIONS WITH SOLUTIONS GRADED A+
✔✔Hypothyroidism causes - ✔✔Hashmimotos thyroiditis (#1 cause)
primary dz of thyroid gland
pituitary deficiency of TSH
goiter removed
✔✔Hyperthyroidism Tx (drugs) - ✔✔Methimazole and PTU
✔✔Thyroid Crisis Tx - ✔✔PTU
Propanolol IV
Hydrocortison
*avoid ASA on discharge
✔✔What side effect of levothyroxine is most likely to lead to non-compliance when first
initiated? - ✔✔alopecia
✔✔You are treating a patient for hypothyroidism. Which lab value is monitored for
treatment/synthroid effectiveness? - ✔✔TSH
✔✔Hypothyroidism Sx - ✔✔extreme weakness
muscle fatigue
cold intolerance
dry skin
hair loss
bradycardia
slowed DTRs
weight gain
cramps
✔✔Hypohyroidism Tx - ✔✔Levothyroxine 50-100mcg daily
✔✔TSH increased, T4 down consistent with - ✔✔hypothyroidism
✔✔Myxedema Coma TX - ✔✔-airway, IV Synthroid, slow rewarming, symptomatic care
✔✔Cushings - ✔✔ACTH hyper secretion by pituitary, adrenal tumors, chronic
glucocorticoids.
Sx: obesity, buffalo hump, acne, poor wound healing, hypertension, weakness, frequent
infections(steroids decrease inflammatory response).
Dx: Hyperglycemia, hypernatremia, hypokalemia, elevated cortisol in AM,
dexamethasone suppression test to differentiate.
, Tx: Determine cause. D/C meds, pituitary adenoma resection, surgical resection of
tumors.
✔✔Addisons Disease - ✔✔Deficiency in coristol, androgens, and aldosterone
✔✔Triad of labs in Cushings - ✔✔hyperglycemia
hypernatremia
hypokalemia
(due to aldosterone and RASS causing sodium retention and K+ and H+ loss in the
nephron at the DCT)
✔✔Pituitary tumor removal approach: - ✔✔transphenodial resection through the nose
✔✔Addisons S/S - ✔✔hyperpigmentation in buccal mucosa and skin creases
diffuse tanning/freckles
orthostatis and hypotension
scant axillary/pubic hair
✔✔Addisons Labs - ✔✔hypoglycemia
hyponatremia
hyperkalemia
elevated ESR
plasma cortisol < 5mcg/dl @ 8am
✔✔For the past few months, 29 year old Janine has been gaining weight while
experiencing amenorrhea and increasingly severe acne. She has gained more than 20
pounds, and you note that she is carrying her weight around the midline, w/BL purplish
striae across both flanks. You suspect Cushing's syndrome. Which of the following
findings would not contribute to a Dx?
1-Urine free cortisol = 360 μg/day
2-Glycosuria
3-WBC 19
4- After a high dose of dexamethasone, there is a 90% reduction in urinary free cortisol
- ✔✔D- in cushings the pituitary does not respond to dexamethasone
*note A- normal urine coristol is <50
✔✔Which of the following is not a criteria of Metabolic Syndrome?
1-BP > 140/90
2-Waist >40 inches
3-TG >150
4-HDL < 40 - ✔✔1- 140/90
QUESTIONS WITH SOLUTIONS GRADED A+
✔✔Hypothyroidism causes - ✔✔Hashmimotos thyroiditis (#1 cause)
primary dz of thyroid gland
pituitary deficiency of TSH
goiter removed
✔✔Hyperthyroidism Tx (drugs) - ✔✔Methimazole and PTU
✔✔Thyroid Crisis Tx - ✔✔PTU
Propanolol IV
Hydrocortison
*avoid ASA on discharge
✔✔What side effect of levothyroxine is most likely to lead to non-compliance when first
initiated? - ✔✔alopecia
✔✔You are treating a patient for hypothyroidism. Which lab value is monitored for
treatment/synthroid effectiveness? - ✔✔TSH
✔✔Hypothyroidism Sx - ✔✔extreme weakness
muscle fatigue
cold intolerance
dry skin
hair loss
bradycardia
slowed DTRs
weight gain
cramps
✔✔Hypohyroidism Tx - ✔✔Levothyroxine 50-100mcg daily
✔✔TSH increased, T4 down consistent with - ✔✔hypothyroidism
✔✔Myxedema Coma TX - ✔✔-airway, IV Synthroid, slow rewarming, symptomatic care
✔✔Cushings - ✔✔ACTH hyper secretion by pituitary, adrenal tumors, chronic
glucocorticoids.
Sx: obesity, buffalo hump, acne, poor wound healing, hypertension, weakness, frequent
infections(steroids decrease inflammatory response).
Dx: Hyperglycemia, hypernatremia, hypokalemia, elevated cortisol in AM,
dexamethasone suppression test to differentiate.
, Tx: Determine cause. D/C meds, pituitary adenoma resection, surgical resection of
tumors.
✔✔Addisons Disease - ✔✔Deficiency in coristol, androgens, and aldosterone
✔✔Triad of labs in Cushings - ✔✔hyperglycemia
hypernatremia
hypokalemia
(due to aldosterone and RASS causing sodium retention and K+ and H+ loss in the
nephron at the DCT)
✔✔Pituitary tumor removal approach: - ✔✔transphenodial resection through the nose
✔✔Addisons S/S - ✔✔hyperpigmentation in buccal mucosa and skin creases
diffuse tanning/freckles
orthostatis and hypotension
scant axillary/pubic hair
✔✔Addisons Labs - ✔✔hypoglycemia
hyponatremia
hyperkalemia
elevated ESR
plasma cortisol < 5mcg/dl @ 8am
✔✔For the past few months, 29 year old Janine has been gaining weight while
experiencing amenorrhea and increasingly severe acne. She has gained more than 20
pounds, and you note that she is carrying her weight around the midline, w/BL purplish
striae across both flanks. You suspect Cushing's syndrome. Which of the following
findings would not contribute to a Dx?
1-Urine free cortisol = 360 μg/day
2-Glycosuria
3-WBC 19
4- After a high dose of dexamethasone, there is a 90% reduction in urinary free cortisol
- ✔✔D- in cushings the pituitary does not respond to dexamethasone
*note A- normal urine coristol is <50
✔✔Which of the following is not a criteria of Metabolic Syndrome?
1-BP > 140/90
2-Waist >40 inches
3-TG >150
4-HDL < 40 - ✔✔1- 140/90
