1|Page
NCLEX ENDOCRINE ACTUAL EXAM
PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS
WITH RATIONALES |RATED A+
1. An agitated, confused female client arrives in the emergency
department. Her history includes type 1 diabetes mellitus, hypertension,
and angina pectoris. Assessment reveals pallor, diaphoresis, headache,
and intense hunger. A stat blood glucose sample measures 42 mg/dl, and
the client is treated for an acute hypoglycemic reaction. After recovery,
nurse Lily teaches the client to treat hypoglycemia by ingesting:
a. 2 to 5 g of a simple carbohydrate.
b. 10 to 15 g of a simple carbohydrate.
c. 18 to 20 g of a simple carbohydrate.
d. 25 to 30 g of a simple carbohydrate. - ANSWER- B.
To reverse hypoglycemia, the American Diabetes Association
recommends ingesting 10 to 15 g of a simple carbohydrate, such as
three to five pieces of hard candy, two to three packets of sugar (4 to
6 tsp), or 4 oz of fruit juice. If necessary, this treatment can be
repeated in 15 minutes. Ingesting only 2 to 5 g of a simple
carbohydrate may not raise the blood glucose level sufficiently.
Ingesting more than 15 g may raise it above normal, causing
hyperglycemia.
,2|Page
2. A female adult client with a history of chronic hyperparathyroidism
admits to being noncompliant. Based on initial assessment findings,
nurse Julia formulates the nursing diagnosis of Risk for injury. To
complete the nursing diagnosis statement for this client, which "related-
to" phrase should the nurse add?
a. Related to bone demineralization resulting in pathologic fractures
b. Related to exhaustion secondary to an accelerated metabolic rate
c. Related to edema and dry skin secondary to fluid infiltration into the
interstitial spaces
d. Related to tetany secondary to a decreased serum calcium level -
ANSWER- A.
Poorly controlled hyperparathyroidism may cause an elevated
serum calcium level. This, in turn, may diminish calcium stores in
the bone, causing bone demineralization and setting the stage for
pathologic fractures and a risk for injury. Hyperparathyroidism
doesn't accelerate the metabolic rate. A decreased thyroid hormone
level, not an increased parathyroid hormone level, may cause edema
and dry skin secondary to fluid infiltration into the interstitial
spaces. Hyperparathyroidism causes hypercalcemia, not
hypocalcemia; therefore, it isn't associated with tetany.
3. Nurse John is assigned to care for a postoperative male client who has
diabetes mellitus. During the assessment interview, the client reports that
he's impotent and says he's concerned about its effect on his marriage. In
planning this client's care, the most appropriate intervention would be to:
a. Encourage the client to ask questions about personal sexuality.
b. Provide time for privacy.
c. Provide support for the spouse or significant other.
,3|Page
d. Suggest referral to a sex counselor or other appropriate professional. -
ANSWER- D.
The nurse should refer this client to a sex counselor or other
professional. Making appropriate referrals is a valid part of
planning the client's care. The nurse doesn't normally provide sex
counseling.
4. During a class on exercise for diabetic clients, a female client asks the
nurse educator how often to exercise. The nurse educator advises the
clients to exercise how often to meet the goals of planned exercise?
a. At least once a week
b. At least three times a week
c. At least five times a week
d. Every day - ANSWER- B.
Diabetic clients must exercise at least three times a week to meet the
goals of planned exercise — lowering the blood glucose level,
reducing or maintaining the proper weight, increasing the serum
high-density lipoprotein level, decreasing serum triglyceride levels,
reducing blood pressure, and minimizing stress. Exercising once a
week wouldn't achieve these goals. Exercising more than three times
a week, although beneficial, would exceed the minimum
requirement.
5. Nurse Oliver should expect a client with hypothyroidism to report
which health concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
, 4|Page
c. Nervousness and tremors
d. Thyroid gland swelling - ANSWER- B.
Hypothyroidism (myxedema) causes facial puffiness, extremity
edema, and weight gain. Signs and symptoms of hyperthyroidism
(Graves' disease) include an increased appetite, weight loss,
nervousness, tremors, and thyroid gland enlargement (goiter).
6. A female client with hypothyroidism (myxedema) is receiving
levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should
nurse Hans recognize as an adverse drug effect?
a. Dysuria
b. Leg cramps
c. Tachycardia
d. Blurred vision - ANSWER- C.
Levothyroxine, a synthetic thyroid hormone, is given to a client with
hypothyroidism to simulate the effects of thyroxine. Adverse effects
of this agent include tachycardia. The other options aren't
associated with levothyroxine.
7. A 67-year-old male client has been complaining of sleeping more,
increased urination, anorexia, weakness, irritability, depression, and
bone pain that interferes with her going outdoors. Based on these
assessment findings, nurse Richard would suspect which of the
following disorders?
a. Diabetes mellitus
b. Diabetes insipidus
c. Hypoparathyroidism
NCLEX ENDOCRINE ACTUAL EXAM
PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS
WITH RATIONALES |RATED A+
1. An agitated, confused female client arrives in the emergency
department. Her history includes type 1 diabetes mellitus, hypertension,
and angina pectoris. Assessment reveals pallor, diaphoresis, headache,
and intense hunger. A stat blood glucose sample measures 42 mg/dl, and
the client is treated for an acute hypoglycemic reaction. After recovery,
nurse Lily teaches the client to treat hypoglycemia by ingesting:
a. 2 to 5 g of a simple carbohydrate.
b. 10 to 15 g of a simple carbohydrate.
c. 18 to 20 g of a simple carbohydrate.
d. 25 to 30 g of a simple carbohydrate. - ANSWER- B.
To reverse hypoglycemia, the American Diabetes Association
recommends ingesting 10 to 15 g of a simple carbohydrate, such as
three to five pieces of hard candy, two to three packets of sugar (4 to
6 tsp), or 4 oz of fruit juice. If necessary, this treatment can be
repeated in 15 minutes. Ingesting only 2 to 5 g of a simple
carbohydrate may not raise the blood glucose level sufficiently.
Ingesting more than 15 g may raise it above normal, causing
hyperglycemia.
,2|Page
2. A female adult client with a history of chronic hyperparathyroidism
admits to being noncompliant. Based on initial assessment findings,
nurse Julia formulates the nursing diagnosis of Risk for injury. To
complete the nursing diagnosis statement for this client, which "related-
to" phrase should the nurse add?
a. Related to bone demineralization resulting in pathologic fractures
b. Related to exhaustion secondary to an accelerated metabolic rate
c. Related to edema and dry skin secondary to fluid infiltration into the
interstitial spaces
d. Related to tetany secondary to a decreased serum calcium level -
ANSWER- A.
Poorly controlled hyperparathyroidism may cause an elevated
serum calcium level. This, in turn, may diminish calcium stores in
the bone, causing bone demineralization and setting the stage for
pathologic fractures and a risk for injury. Hyperparathyroidism
doesn't accelerate the metabolic rate. A decreased thyroid hormone
level, not an increased parathyroid hormone level, may cause edema
and dry skin secondary to fluid infiltration into the interstitial
spaces. Hyperparathyroidism causes hypercalcemia, not
hypocalcemia; therefore, it isn't associated with tetany.
3. Nurse John is assigned to care for a postoperative male client who has
diabetes mellitus. During the assessment interview, the client reports that
he's impotent and says he's concerned about its effect on his marriage. In
planning this client's care, the most appropriate intervention would be to:
a. Encourage the client to ask questions about personal sexuality.
b. Provide time for privacy.
c. Provide support for the spouse or significant other.
,3|Page
d. Suggest referral to a sex counselor or other appropriate professional. -
ANSWER- D.
The nurse should refer this client to a sex counselor or other
professional. Making appropriate referrals is a valid part of
planning the client's care. The nurse doesn't normally provide sex
counseling.
4. During a class on exercise for diabetic clients, a female client asks the
nurse educator how often to exercise. The nurse educator advises the
clients to exercise how often to meet the goals of planned exercise?
a. At least once a week
b. At least three times a week
c. At least five times a week
d. Every day - ANSWER- B.
Diabetic clients must exercise at least three times a week to meet the
goals of planned exercise — lowering the blood glucose level,
reducing or maintaining the proper weight, increasing the serum
high-density lipoprotein level, decreasing serum triglyceride levels,
reducing blood pressure, and minimizing stress. Exercising once a
week wouldn't achieve these goals. Exercising more than three times
a week, although beneficial, would exceed the minimum
requirement.
5. Nurse Oliver should expect a client with hypothyroidism to report
which health concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
, 4|Page
c. Nervousness and tremors
d. Thyroid gland swelling - ANSWER- B.
Hypothyroidism (myxedema) causes facial puffiness, extremity
edema, and weight gain. Signs and symptoms of hyperthyroidism
(Graves' disease) include an increased appetite, weight loss,
nervousness, tremors, and thyroid gland enlargement (goiter).
6. A female client with hypothyroidism (myxedema) is receiving
levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should
nurse Hans recognize as an adverse drug effect?
a. Dysuria
b. Leg cramps
c. Tachycardia
d. Blurred vision - ANSWER- C.
Levothyroxine, a synthetic thyroid hormone, is given to a client with
hypothyroidism to simulate the effects of thyroxine. Adverse effects
of this agent include tachycardia. The other options aren't
associated with levothyroxine.
7. A 67-year-old male client has been complaining of sleeping more,
increased urination, anorexia, weakness, irritability, depression, and
bone pain that interferes with her going outdoors. Based on these
assessment findings, nurse Richard would suspect which of the
following disorders?
a. Diabetes mellitus
b. Diabetes insipidus
c. Hypoparathyroidism
