UWorld Endocrine [ACTUAL EXAM] LATEST VERSION
[QUESTIONS AND ANSWERS] WITH PRACTICE EXAM
DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A
The nurse cares for a client with type 1 diabetes mellitus who is obtunded and
responding to only painful stimuli. A STAT blood sample reveals a blood glucose level
of 38 mg/dL (2.11 mmol/L). Which initial action by the nurse is best?
1. Administer 50% dextrose in water IV push
2. Assist the client to drink 4 oz (120 mL) of orange juice
3. Measure the client's heart rate and blood pressure
4. Observe for sweating, shakiness, and pallor - CORRECT ANSWER 1
Hypoglycemia, a potentially life-threatening complication of diabetes mellitus, is
identified by blood glucose <70 mg/dL (<3.9 mmol/L) and often occurs as a result of
illness or inappropriate use of antidiabetic medications. When blood glucose levels
(BGLs) are low, the body activates the autonomic nervous system, causing shakiness,
palpitations, and sweating. Without intervention, hypoglycemia may cause altered
mental status (eg, difficulty speaking, confusion), which may progress to seizures,
coma, and death.
Nurses caring for clients with hypoglycemia and altered mental status or dysphagia
should immediately administer IV glucose replacement (eg, 50% dextrose in water) to
quickly restore BGLs and prevent potentially lethal neurological changes (Option 1).
Afterward, the nurse should retest the BGL every 15 minutes, repeating treatment if it
remains low.
(Option 2) Clients with altered mental status (eg, obtunded, responsive only to painful
stimuli) are at high risk for aspiration and are not appropriate candidates for oral glucose
replacement.
(Options 3 and 4) Obtundation, a sign of severe hypoglycemia, and a confirmed BGL of
38 mg/dL (2.11 mmol/L) are sufficient indicators for implementing emergency
intervention. Assessment of additional signs of hypoglycemia, heart rate, and blood
pressure should not delay implementation of lifesaving treatment.
Educational objective: Hypoglycemia is a complication of diabetes mellitus that can lead
to coma, seizures, and death without prompt intervention. Nurses caring for clients with
hypoglycemia and altered mental status should administer IV glucose to quickly restore
blood glucose levels. Lifesaving treatment should not be delayed to perform further
assessments.
,A client is admitted to the intensive care unit with suspected pheochromocytoma. The
client's vital signs are temperature of 99.6 F (37.5 C), blood pressure (BP) of 200/110
mm Hg, heart rate of 110/min, and respirations of 20/min. The client is sweating
profusely and reports a severe headache. Which prescription should the nurse
implement first?
1. Draw labs to assess electrolyte panel
2. Give acetaminophen 650 mg by mouth as needed for headache
3. Place a fan in the client's room
4. Start nitroprusside infusion at 0.5 mcg/kg/min - CORRECT ANSWER 4
Pheochromocytoma is a condition caused by a tumor in the adrenal medulla. This
results in excess release of catecholamines such as epinephrine and norepinephrine,
leading to paroxysmal hypertensive crisis.
Important points to note when caring for these clients include the following:
1. Hypertension is difficult to treat and is often resistant to multiple drugs.
2. The client should avoid activities that can precipitate a hypertensive crisis (eg,
bending, lifting, Valsalva maneuver).
3. Abdominal palpation should be avoided as manipulation of the adrenal gland and
release of catecholamines can precipitate a hypertensive crisis.
Hypertensive crisis puts the client at risk for stroke and so has the highest priority for
treatment. Nitroprusside (Nitropress, Nipride) is a vasodilator given via infusion and can
be titrated to keep the BP within a desired parameter.
(Options 1, 2, and 3) Administration of acetaminophen and use of a fan may help relieve
symptoms. Drawing an electrolyte panel is appropriate. However, these are not life-
saving interventions and so are not the highest priority.
Educational objective: Pheochromocytoma is a condition caused by a tumor in the
adrenal medulla that causes release of catecholamines such as epinephrine and
norepinephrine, resulting in paroxysmal hypertensive crisis. Hypertensive crisis puts the
client at risk for stroke and should be treated promptly with intravenous nitroprusside or
another vasodilator (eg, phentolamine, nicardipine). Abdominal palpation should be
avoided in these clients.
The nurse in the emergency department is caring for a client recently diagnosed with
Graves' disease who was admitted following a motor vehicle accident. The nurse notes
the vital signs shown in the exhibit. The nurse alerts the primary health care provider
that the client may be experiencing which condition? Click on the exhibit button for
additional information.
Vital Signs: increasing temp, BP, HR, and RR
1. Hypertensive crisis
,2. Malignant hyperthermia
3. Serotonin syndrome
4. Thyroid storm - CORRECT ANSWER 4
Thyroid storm is a life-threatening condition that can occur in uncontrolled
hyperthyroidism or Graves' disease when a stressful incident, such as this client's motor
vehicle accident, triggers a sudden surge of thyroid hormone. Manifestations of thyroid
storm include a rapid onset of fever, tachycardia, and elevated blood pressure. The
client often feels anxious, tremulous, or restless. Confusion and psychosis can occur, as
can seizures and coma. Rapid treatment is necessary.
(Option 1) Hypertensive crisis alone would not cause fever.
(Option 2) Malignant hyperthermia would occur in the perioperative setting in response
to anesthesia. This client has no risk factors for malignant hyperthermia.
(Option 3) Serotonin syndrome would occur in the client taking more than one or an
overdose of antidepressant medication that increases serotonin levels.
Educational objective: Thyroid storm is a life-threatening complication of Graves'
disease (hyperthyroidism). Assessment findings include a rapid increase in
temperature, heart rate, and blood pressure in response to stress.
The nurse cares for a client with type 1 diabetes mellitus. Which laboratory result is
most important to report to the primary health care provider?
1. Fasting blood glucose 99 mg/dL (5.5 mmol/L)
2. Serum creatinine 2.0 mg/dL (177 µmol/L)
3. Serum potassium 3.9 mEq/L (3.9 mmol/L)
4. Serum sodium 140 mEq/L (140 mmol/L) - CORRECT ANSWER The normal
serum creatinine for an adult is 0.6-1.3 mg/dL (53-115 µmol/L). It provides an estimation
of the glomerular filtration rate and is an indicator of kidney function. A level of 2 mg/dL
(177 µmol/L) is clearly abnormal. The client with diabetes mellitus is at risk for diabetic
nephropathy, a complication associated with microvascular blood vessel damage in the
kidney. Early treatment and tight control of blood glucose levels are indicated to prevent
progressive renal injury in a client with diabetic nephropathy.
(Option 1) Normal serum fasting blood glucose is 70-99 mg/dL (3.9-5.5 mmol/L).
(Option 3) Normal serum potassium is 3.5-5.0 mEq/L (3.5-5.0 mmol/L).
(Option 4) Normal serum sodium is 135-145 mEq/L (135-145 mmol/L).
Educational objective: The normal serum creatinine for an adult is 0.6-1.3 mg/dL (53-
115 µmol/L). Serum creatinine provides an estimation of the glomerular filtration rate
and is an indicator of kidney function.
, The nurse is teaching a group of clients diagnosed with diabetes mellitus. Which lesson
regarding foot care should be included? Select all that apply.
1. Cut toenails straight across and file along the curves of the toes
2. Rub feet vigorously with a towel after bathing to ensure dryness
3. Use a mild foot powder on perspiring feet
4. Use cotton or lamb's wool to separate overlapping toes
5. Use an over-the-counter corn removal kit to remove corns or calluses - CORRECT
ANSWER 1, 3, 4
Individuals with type I or II diabetes mellitus are at increased risk for developing an
infection or ulcer on their feet. This is due to the chronic complication of peripheral
neuropathy, which results from nerve damage in the extremities.
Instructions for diabetic foot care include:
1. Wash feet daily with warm water and mild soap; test water temperature with
thermometer beforehand. Gently pat feet dry, particularly between the toes (Option 2).
Use lanolin to prevent dry and cracked skin, but do not apply between the toes.
2. Inspect for abrasions, cuts, or sores. Have others inspect the feet if eyesight is poor.
3. To prevent injury, use cotton or lamb's wool to separate overlapping toes. Cut
toenails straight across and use a nail file to file along the curves of the toes. Avoid
going barefoot and wear sturdy leather shoes. Use mild foot powder to absorb
perspiration and wear clean, absorbent socks with seams aligned (Options 1, 3, and 4).
4. Avoid using over-the-counter products (eg, iodine, alcohol, strong adhesives) on cuts
or abrasions (Option 5).
5. To improve circulation, do not sit with legs crossed or for extended periods, avoid
tight-fitting garments, and perform daily exercise.
6. Report other types of problems such as infections or athlete's foot immediately.
Educational objective: Individuals with type I or II diabetes mellitus are at increased risk
for developing an infection or ulcer on their feet due to the chronic complication of
peripheral neuropathy. Clients should keep feet clean, dry, and free from irritation.
The nurse cares for a client with type 2 diabetes mellitus and hemoglobin A1C results of
8% at an outpatient health clinic. Which statement by the nurse will best address these
results?
1. "It is important for us to review the signs and symptoms of a hypoglycemic reaction."
2. "Let's review your diet, exercise, and medication regimen over the past 2-3 months."
3. "Please describe what you have eaten in the last 24-48 hours."
4. "You should fast for at least 8 hours prior to your morning blood work." - CORRECT
ANSWER 2
Hemoglobin A1C is a diagnostic test used to measure the percentage of glycosylated
hemoglobin in the blood. A normal hemoglobin A1C is 4%-6% in clients without
[QUESTIONS AND ANSWERS] WITH PRACTICE EXAM
DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A
The nurse cares for a client with type 1 diabetes mellitus who is obtunded and
responding to only painful stimuli. A STAT blood sample reveals a blood glucose level
of 38 mg/dL (2.11 mmol/L). Which initial action by the nurse is best?
1. Administer 50% dextrose in water IV push
2. Assist the client to drink 4 oz (120 mL) of orange juice
3. Measure the client's heart rate and blood pressure
4. Observe for sweating, shakiness, and pallor - CORRECT ANSWER 1
Hypoglycemia, a potentially life-threatening complication of diabetes mellitus, is
identified by blood glucose <70 mg/dL (<3.9 mmol/L) and often occurs as a result of
illness or inappropriate use of antidiabetic medications. When blood glucose levels
(BGLs) are low, the body activates the autonomic nervous system, causing shakiness,
palpitations, and sweating. Without intervention, hypoglycemia may cause altered
mental status (eg, difficulty speaking, confusion), which may progress to seizures,
coma, and death.
Nurses caring for clients with hypoglycemia and altered mental status or dysphagia
should immediately administer IV glucose replacement (eg, 50% dextrose in water) to
quickly restore BGLs and prevent potentially lethal neurological changes (Option 1).
Afterward, the nurse should retest the BGL every 15 minutes, repeating treatment if it
remains low.
(Option 2) Clients with altered mental status (eg, obtunded, responsive only to painful
stimuli) are at high risk for aspiration and are not appropriate candidates for oral glucose
replacement.
(Options 3 and 4) Obtundation, a sign of severe hypoglycemia, and a confirmed BGL of
38 mg/dL (2.11 mmol/L) are sufficient indicators for implementing emergency
intervention. Assessment of additional signs of hypoglycemia, heart rate, and blood
pressure should not delay implementation of lifesaving treatment.
Educational objective: Hypoglycemia is a complication of diabetes mellitus that can lead
to coma, seizures, and death without prompt intervention. Nurses caring for clients with
hypoglycemia and altered mental status should administer IV glucose to quickly restore
blood glucose levels. Lifesaving treatment should not be delayed to perform further
assessments.
,A client is admitted to the intensive care unit with suspected pheochromocytoma. The
client's vital signs are temperature of 99.6 F (37.5 C), blood pressure (BP) of 200/110
mm Hg, heart rate of 110/min, and respirations of 20/min. The client is sweating
profusely and reports a severe headache. Which prescription should the nurse
implement first?
1. Draw labs to assess electrolyte panel
2. Give acetaminophen 650 mg by mouth as needed for headache
3. Place a fan in the client's room
4. Start nitroprusside infusion at 0.5 mcg/kg/min - CORRECT ANSWER 4
Pheochromocytoma is a condition caused by a tumor in the adrenal medulla. This
results in excess release of catecholamines such as epinephrine and norepinephrine,
leading to paroxysmal hypertensive crisis.
Important points to note when caring for these clients include the following:
1. Hypertension is difficult to treat and is often resistant to multiple drugs.
2. The client should avoid activities that can precipitate a hypertensive crisis (eg,
bending, lifting, Valsalva maneuver).
3. Abdominal palpation should be avoided as manipulation of the adrenal gland and
release of catecholamines can precipitate a hypertensive crisis.
Hypertensive crisis puts the client at risk for stroke and so has the highest priority for
treatment. Nitroprusside (Nitropress, Nipride) is a vasodilator given via infusion and can
be titrated to keep the BP within a desired parameter.
(Options 1, 2, and 3) Administration of acetaminophen and use of a fan may help relieve
symptoms. Drawing an electrolyte panel is appropriate. However, these are not life-
saving interventions and so are not the highest priority.
Educational objective: Pheochromocytoma is a condition caused by a tumor in the
adrenal medulla that causes release of catecholamines such as epinephrine and
norepinephrine, resulting in paroxysmal hypertensive crisis. Hypertensive crisis puts the
client at risk for stroke and should be treated promptly with intravenous nitroprusside or
another vasodilator (eg, phentolamine, nicardipine). Abdominal palpation should be
avoided in these clients.
The nurse in the emergency department is caring for a client recently diagnosed with
Graves' disease who was admitted following a motor vehicle accident. The nurse notes
the vital signs shown in the exhibit. The nurse alerts the primary health care provider
that the client may be experiencing which condition? Click on the exhibit button for
additional information.
Vital Signs: increasing temp, BP, HR, and RR
1. Hypertensive crisis
,2. Malignant hyperthermia
3. Serotonin syndrome
4. Thyroid storm - CORRECT ANSWER 4
Thyroid storm is a life-threatening condition that can occur in uncontrolled
hyperthyroidism or Graves' disease when a stressful incident, such as this client's motor
vehicle accident, triggers a sudden surge of thyroid hormone. Manifestations of thyroid
storm include a rapid onset of fever, tachycardia, and elevated blood pressure. The
client often feels anxious, tremulous, or restless. Confusion and psychosis can occur, as
can seizures and coma. Rapid treatment is necessary.
(Option 1) Hypertensive crisis alone would not cause fever.
(Option 2) Malignant hyperthermia would occur in the perioperative setting in response
to anesthesia. This client has no risk factors for malignant hyperthermia.
(Option 3) Serotonin syndrome would occur in the client taking more than one or an
overdose of antidepressant medication that increases serotonin levels.
Educational objective: Thyroid storm is a life-threatening complication of Graves'
disease (hyperthyroidism). Assessment findings include a rapid increase in
temperature, heart rate, and blood pressure in response to stress.
The nurse cares for a client with type 1 diabetes mellitus. Which laboratory result is
most important to report to the primary health care provider?
1. Fasting blood glucose 99 mg/dL (5.5 mmol/L)
2. Serum creatinine 2.0 mg/dL (177 µmol/L)
3. Serum potassium 3.9 mEq/L (3.9 mmol/L)
4. Serum sodium 140 mEq/L (140 mmol/L) - CORRECT ANSWER The normal
serum creatinine for an adult is 0.6-1.3 mg/dL (53-115 µmol/L). It provides an estimation
of the glomerular filtration rate and is an indicator of kidney function. A level of 2 mg/dL
(177 µmol/L) is clearly abnormal. The client with diabetes mellitus is at risk for diabetic
nephropathy, a complication associated with microvascular blood vessel damage in the
kidney. Early treatment and tight control of blood glucose levels are indicated to prevent
progressive renal injury in a client with diabetic nephropathy.
(Option 1) Normal serum fasting blood glucose is 70-99 mg/dL (3.9-5.5 mmol/L).
(Option 3) Normal serum potassium is 3.5-5.0 mEq/L (3.5-5.0 mmol/L).
(Option 4) Normal serum sodium is 135-145 mEq/L (135-145 mmol/L).
Educational objective: The normal serum creatinine for an adult is 0.6-1.3 mg/dL (53-
115 µmol/L). Serum creatinine provides an estimation of the glomerular filtration rate
and is an indicator of kidney function.
, The nurse is teaching a group of clients diagnosed with diabetes mellitus. Which lesson
regarding foot care should be included? Select all that apply.
1. Cut toenails straight across and file along the curves of the toes
2. Rub feet vigorously with a towel after bathing to ensure dryness
3. Use a mild foot powder on perspiring feet
4. Use cotton or lamb's wool to separate overlapping toes
5. Use an over-the-counter corn removal kit to remove corns or calluses - CORRECT
ANSWER 1, 3, 4
Individuals with type I or II diabetes mellitus are at increased risk for developing an
infection or ulcer on their feet. This is due to the chronic complication of peripheral
neuropathy, which results from nerve damage in the extremities.
Instructions for diabetic foot care include:
1. Wash feet daily with warm water and mild soap; test water temperature with
thermometer beforehand. Gently pat feet dry, particularly between the toes (Option 2).
Use lanolin to prevent dry and cracked skin, but do not apply between the toes.
2. Inspect for abrasions, cuts, or sores. Have others inspect the feet if eyesight is poor.
3. To prevent injury, use cotton or lamb's wool to separate overlapping toes. Cut
toenails straight across and use a nail file to file along the curves of the toes. Avoid
going barefoot and wear sturdy leather shoes. Use mild foot powder to absorb
perspiration and wear clean, absorbent socks with seams aligned (Options 1, 3, and 4).
4. Avoid using over-the-counter products (eg, iodine, alcohol, strong adhesives) on cuts
or abrasions (Option 5).
5. To improve circulation, do not sit with legs crossed or for extended periods, avoid
tight-fitting garments, and perform daily exercise.
6. Report other types of problems such as infections or athlete's foot immediately.
Educational objective: Individuals with type I or II diabetes mellitus are at increased risk
for developing an infection or ulcer on their feet due to the chronic complication of
peripheral neuropathy. Clients should keep feet clean, dry, and free from irritation.
The nurse cares for a client with type 2 diabetes mellitus and hemoglobin A1C results of
8% at an outpatient health clinic. Which statement by the nurse will best address these
results?
1. "It is important for us to review the signs and symptoms of a hypoglycemic reaction."
2. "Let's review your diet, exercise, and medication regimen over the past 2-3 months."
3. "Please describe what you have eaten in the last 24-48 hours."
4. "You should fast for at least 8 hours prior to your morning blood work." - CORRECT
ANSWER 2
Hemoglobin A1C is a diagnostic test used to measure the percentage of glycosylated
hemoglobin in the blood. A normal hemoglobin A1C is 4%-6% in clients without
