NCLEX Endocrine system

A client has a history of hypothyroidism. Which skin condition should the nurse expect when performing a physical assessment? A. Dry B. Moist C. Flushed D. Smooth

A. Dry

Which term should the nurse use in a report to describe the absence of menstrual periods in a 35-year-old non-pregnant client? A. Rhinorrhea B. Menopause C. Amenorrhea D. Dyspareunia

C. Amenorrhea

The anti-diuretic hormone is __________ in Diabetes Insipidus and _________ in SIADH. A. high, low B. absent, absent C. low, high D. low, low

C. low, high

A nurse is assessing the skin of a client with a cortisol deficiency. Which integumentary assessment finding will most likely be observed in this client? A. Dry skin B. Ulcerated skin C. Generalized edema D. Diminished axillary hair

D. Diminished axillary hair

What are the cardiovascular manifestations observed in a client with adrenal insufficiency? A. Fatigue B. Salt craving C. Weight loss D. Hyponatremia

D. Hyponatremia

Which hormone does the nurse state is formed from cholesterol? A. Insulin B. Cortisol C. Prolactin D. Growth hormone

B. Cortisol

A client is diagnosed with Cushing syndrome. Which clinical manifestation does the nurse expect to increase in a client with Cushing syndrome? A. Urine output B. Glucose level C. Serum potassium D. Immune response

B. Glucose level

What is the most probable cause for Conn's syndrome in an adult client? A. Genetic cause B. Adrenal adenoma C. High level of angiotensin II D. Elevated level of plasma rennin

B. Adrenal adenoma

Which clinical manifestation occurs in a client with vasopressin deficiency? A. Impotence B. Hypotension C. Amenorrhea D. Decreased libido

B. Hypotension

Which statement regarding calcitonin is correct? A. It is secreted by follicular cells. B. Its actions are opposite to that of parathyroid hormone. C. It decreases phosphorous levels by increasing bone resorption. D. It works along with thyroid hormone to maintain normal calcium levels in blood.

B. Its actions are opposite to that of parathyroid hormone.

A nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. Which statement made by the client shows that teaching was effective? A. "I should massage my feet and legs with oil or lotion." B. "I should apply heat intermittently to my feet and legs." C. "I should eat foods high in protein and carbohydrate kilocalories." D. "I should control my blood glucose with diet, exercise, and medication."

D. "I should control my blood glucose with diet, exercise, and medication."

A client with diabetes asks the nurse whether the new forearm stick glucose monitor gives the same results as a finger stick. What is the nurse's best response to this question? A. "There is no difference between readings." B. "These types of monitors are meant for children." C. "Readings are on a different scale for each monitor." D. "Faster readings can be obtained from a finger stick."

A. "There is no difference between readings."

A client with diabetic ketoacidosis who is receiving intravenous fluids and insulin reports tingling and numbness of the fingers and toes, and shortness of breath. The nurse identifies a U wave on the cardiac monitor. What should the nurse conclude is causing these clinical findings? A. Hypokalemia B. Hyponatremia C. Hyperglycemia D. Hypercalcemia

A. Hypokalemia

In the previous scenario, what medication do you expect the patient to be started on? A. IV Solu-Cortef B. PO Prednisone C. PO Declomycin D. IV Insulin

A. IV Solu-Cortef

In Cushing's Disease and Syndrome there are: A. Increased cortisol production B. Low potassium and glucose levels C. Increased production of aldosterone and cortisol D. Decreased production of cortisol and aldosterone

A. Increased cortisol production

The nurse is caring for a client with type 1 diabetes who is developing ketoacidosis. Which arterial blood gas report is indicative of diabetic ketoacidosis? A. PCO2: 49, HCO3: 32, pH: 7.50 B. PCO2: 26, HCO3: 20, pH: 7.52 C. PCO2: 54, HCO3: 28, pH: 7.30 D. PCO2: 28, HCO3: 18, pH: 7.28

D. PCO2: 28, HCO3: 18, pH: 7.28

A client with type 1 diabetes is admitted to the hospital for major surgery. Before surgery, the client's insulin requirements are elevated but well controlled. What insulin requirements will the nurse anticipate for this client postoperatively? A. Decrease B. Fluctuate C. Increase sharply D. Remain elevated

D. Remain elevated

A patient with SIADH is undergoing IV treatment of a hypertonic IV solution of 3% saline and IV Lasix. Which of the following nursing findings requires intervention? A. Assessment finding of crackles throughout the lung fields. B. Patient reports urinating more frequently. C. Potassium level of 5.0. D. Sodium level of 136.

A. Assessment finding of crackles throughout the lung fields.

Which patient is most at risk for developing Syndrome of Inappropriate Anti-diuretic Hormone (SIADH)? A. A patient diagnosed with small cell lung cancer. B. A patient whose kidney tubules are failing to reabsorb water. C. A patient with a tumor on the anterior pituitary gland. D. A patient taking Declomycin.

A. A patient diagnosed with small cell lung cancer.

You are developing a care plan for a patient with SIADH. Which of the following would be a potential nursing diagnosis for this patient? A. Fluid volume overload B. Fluid volume deficient C. Acute pain D. Impaired skin integrity

A. Fluid volume overload

A patient with Cushing's syndrome will be undergoing an adrenalectomy. Which of the following will be included in the patient's discharge teaching after the procedure? A. Glucocorticoid replacement therapy B. Avoiding avocadoes and pears C. Declomycin therapy D. Signs and symptoms of Grave's Disease

A. Glucocorticoid replacement therapy

A client with a parathyroid disorder reports nausea, vomiting, weight loss, and epigastric pain. Which electrolyte disturbance would be responsible for the client's clinical manifestations? A. Hypercalcemia B. Hypernatremia C. Hypermagnesemia D. Hyperphosphatemia

A. Hypercalcemia

Which of the following is not a typical sign and symptom of Cushing's Syndrome? A. Hyperpigmentation of the skin B. Hirsutism C. Purplish striae D. Moon Face

A. Hyperpigmentation of the skin

A nurse is assessing a client admitted to the hospital with a tentative diagnosis of a pituitary tumor. What signs of Cushing syndrome does the nurse identify? A. Retention of sodium and water B. Hypotension and a rapid, thready pulse C. Increased fatty deposition in the extremities D. Hypoglycemic episodes in the early morning

A. Retention of sodium and water

Which condition is characterized by hemorrhage after a pregnant female delivers? A. Sheehan's syndrome B. Cushing's syndrome C. Addison's syndrome D. Schwartz-Bartter syndrome

A. Sheehan's syndrome

Which of the following patients are at risk for developing Cushing's Syndrome? A. A patient with a tumor on the pituitary gland, which is causing too much ACTH to be secreted. B. A patient taking glucocorticoids for several weeks. C. A patient with a tuberculosis infection. D. A patient who is post-opt from an adrenalectomy.

B. A patient taking glucocorticoids for several weeks. (Remember that CUSHING'S DISEASE is caused by the pituitary gland producing too much ACTH which in turn increases cortisol. Cushing's SYNDROME is caused by medication therapy of glucocorticoids. An adrenalectomy is a treatment for Cushing's Disease (so this is not the answer in this case) and TB is a risk factor for developing ADDISON'S Disease.)

In the previous scenario, which drug do you anticipate the patient will be started on per doctor's order? A. Desmopressin (DDAVP) IV B. Declomycin C. Diabinese D. Stimate

B. Declomycin

What does the nurse state as the etiological factor of nephrogenic diabetes insipidus (DI)? A. Meningitis B. Lithium therapy C. Graves' disease D. Sulfonamide therapy

B. Lithium therapy

A patient with Addison's Disease should consume which of the following diets? A. High fat and fiber B. Low potassium and high protein C. High protein, carbs, and adequate sodium D. Low carbs, high protein, and increased sodium

C. High protein, carbs, and adequate sodium

A client has a tentative diagnosis of Cushing syndrome. What physical symptoms will the client exhibit? A. Fever and tachycardia B. Lethargy and constipation C. Hypertension and moon face D. Hyperactivity and exophthalmos

C. Hypertension and moon face

Where is the anti-diuretic hormone PRODUCED in the body? A. Anterior pituitary gland B. Posterior pituitary gland C. Hypothalamus D. Medulla

C. Hypothalamus

A nurse is caring for a client with type 1 diabetes who developed ketoacidosis. Which laboratory value supports the presence of diabetic ketoacidosis? A. Decreased serum glucose levels B. Decreased serum calcium levels C. Increased blood urea nitrogen levels D. Increased serum bicarbonate levels

C. Increased blood urea nitrogen levels

Addison's Disease is: A. Increased secretion of cortisol B. Increased secretion of aldosterone and cortisol C. Decreased secretion of cortisol D. Decreased secretion of aldosterone and cortisol

D. Decreased secretion of aldosterone and cortisol

Which hormonal deficiency reduces the growth of axillae and pubic hair in female clients? A. Growth hormone B. Antidiuretic hormone C. Thyroid-stimulating hormone D. Adrenocorticotropic hormone

D. Adrenocorticotropic hormone

Which hormonal deficiency causes breast atrophy in female clients? A. Growth hormone B. Luteinizing hormone C. Thyroid-stimulating hormone D. Adrenocorticotropic hormone

B. Luteinizing hormone

The nurse is caring for a client with hyperplasia of pituitary tissue. What would be the most appropriate goals of management? Select all that apply. A. To alleviate headache B. To replace lost sodium C. To eliminate visual disturbances D. To check the urine specific gravity E. To return hormone levels to normal

A. To alleviate headache C. To eliminate visual disturbances E. To return hormone levels to normal

Which condition results in elevated serum adrenocorticotropic hormone (ACTH) and urine cortisol levels? A. Diabetes insipidus B. Adrenal Cushing's syndrome C. Pituitary Cushing's syndrome D. Syndrome of inappropriate antidiuretic hormone

C. Pituitary Cushing's syndrome

Which of the following signs and symptoms is NOT expected with Diabetes Insipidus? A. Polyuria B. Polydipsia C. Polyphagia D. Extreme thirst

C. Polyphagia

The nurse is caring for a client who had a thyroidectomy. Which symptoms will the client exhibit if having a thyrotoxic crisis? A. An increased pulse deficit B. A decreased blood pressure C. A decreased heart rate and respirations D. An increased temperature and pulse rate

D. An increased temperature and pulse rate

A nurse is caring for a client who has just returned from the postanesthesia care unit after having a thyroidectomy. Which action has priority during the first 24 hours after surgery when the nurse is concerned about thyroid storm? A. Performing range-of-motion exercises B. Humidifying the room air continuously C. Assessing for hoarseness every two hours D. Checking vital signs every two hours after they stabilize

D. Checking vital signs every two hours after they stabilize

A client with hyperthyroidism asks the nurse about the tests that will be prescribed. Which diagnostic tests should the nurse include in a discussion with this client? A. Thyroxine (T4) and x-ray films B. Thyroid-stimulating hormone (TSH) assay and triiodothyronine (T3) C. Thyroglobulin level and PO2 D. Protein-bound iodine and sequential multichannel autoanalyzer (SMA)

B. Thyroid-stimulating hormone (TSH) assay and triiodothyronine (T3)

A patient is admitted to the ER. The patient is unconscious on arrival. However, the patient's family is with the patient and reports that before the patient became unconscious she was complaining of severe pain in the abdomen, legs, and back, and has been experiencing worsening confusion. In addition, they also report the patient has not been taking any medications. The patient was recently discharged from the hospital for treatment of low cortisol and aldosterone levels. On assessment, you note the patient's blood pressure is 70/45. What disorder is this patient most likely experiencing? A. Addisonian Crisis B. Cushing Syndrome C. Thyroid crisis D. Hashimoto thyroiditis

A. Addisonian Crisis

A nurse explains to a client with diabetes that self-monitoring of blood glucose is preferred to urine glucose testing. Why is blood glucose monitoring preferred? A. Blood glucose monitoring is more accurate. B. Blood glucose monitoring is easier to perform. C. Blood glucose monitoring is done by the client. D. Blood glucose monitoring is not influenced by drugs.

A. Blood glucose monitoring is more accurate.

A client reports enlargement of the hands and feet, thickened lips, and joint pains. The client's blood glucose is 250 mg/dL (13.89 mmol/L) and x-ray reports reveal increased size of the lungs. Which hormonal change does the nurse suspect in the client? A. Prolactin B. Thyrotropin C. Growth hormone D. Adrenocorticotropic hormone

C. Growth hormone

A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly "water" weight. In addition, they report the patient hasn't been able to urinate or eat within the past week as well and was recently diagnosed with small cell lung cancer. On assessment, you note the patient's HR is 115 and BP 180/92. Patient sodium level is 90. Which of the following conditions do you suspect the patient is most likely presenting with? A. SIADH B. Diabetes Insipidus C. Addison's Disease D. Fluid Volume Deficient

A. SIADH

A patient with a mild case of diabetes insipidus is started on Diabinese. What would you include in your patient teaching with this patient? A. Signs and symptoms of hypoglycemia B. Restricting foods containing caffeine C. Taking the medication on an empty stomach D. Drinking 16 oz of water when taking the medication

A. Signs and symptoms of hypoglycemia

A 24-hour urine test is prescribed for a client who has a tentative diagnosis of pheochromocytoma. What should the nurse do first? A. Start the time of the test after discarding the first voiding. B. Discard the last voiding in the 24-hour time period for the test. C. Insert a urinary retention catheter to promote the collection of urine. D. Strain the urine following each voiding before adding the urine to the container.

A. Start the time of the test after discarding the first voiding.

A patient with Addison's Disease is being discharged home on Prednisone. Which of the following statements by the patient warrants you to re-educate the patient? A. "I will notify the doctor if I become sick or experience extra stress." B. "I will take this medication as needed when symptoms present." C. "I will take this medication at the same time every day." D. "My daughter has bought me a Medic-Alert bracelet."

B. "I will take this medication as needed when symptoms present."

A nurse is caring for a client with a diagnosis of type 1 diabetes who has developed diabetic coma. Which element excessively accumulates in the blood to precipitate the signs and symptoms associated with this condition? A. Sodium bicarbonate, causing alkalosis B. Ketones as a result of rapid fat breakdown, causing acidosis C. Nitrogen from protein catabolism, causing ammonia intoxication D. Glucose from rapid carbohydrate metabolism, causing drowsiness

B. Ketones as a result of rapid fat breakdown, causing acidosis

In Cushing's disease, the _______ is secreting too much ACTH (Adrenocorticotropic hormone) which is causing an increase in cortisol production. A. Adrenal cortex B. Pituitary gland C. Thyroid gland D. Hypothalamus

B. Pituitary gland

Upon assessing a female client, the nurse discovers an abnormal endocrine finding. Which finding in the client supports the nurse's conclusion? A. Facial hair B. Protruding eyes C. Pulse of 90 beats/min D. Blood pressure of 120/80 mmHg

B. Protruding eyes

The nurse is providing care to a client being treated for bacterial cystitis. What is the goal before discharge for this client? A. Understand the need to drink 4 L of water per day, an essential measure to prevent dehydration B. Be able to identify dietary restrictions and plan menus C. Achieve relief of symptoms and maintain kidney function D. Recognize signs of bleeding, a complication associated with this type of procedure

C. Achieve relief of symptoms and maintain kidney function

What other name can the nurse use for vasopressin? A. Growth hormone B. Luteinizing hormone C. Antidiuretic hormone D. Thyroid-stimulating hormone

C. Antidiuretic hormone

A nurse is reviewing several charts. Which condition is an autoimmune disorder? A. Addison's disease B. Cushing's syndrome C. Hashimoto's disease D. Sheehan's syndrome

C. Hashimoto's disease

A nurse is assessing a client and suspects diabetic ketoacidosis (DKA). What clinical findings support this conclusion? A. Nervousness and tachycardia B. Erythema toxicum rash and pruritus C. Diaphoresis and altered mental state D. Deep respirations and fruity odor to the breath

D. Deep respirations and fruity odor to the breath

Which hormone is released from the pancreas? A. Oxytocin B. Prolactin C. Calcitonin D. Somatostatin

D. Somatostatin

An obese client is diagnosed with diabetes. What increased physiologic response should the nurse include when explaining the need for weight loss? A. Fatty acid storage B. Glucose oxidation C. Insulin requirements D. Cellular entry of glucose

C. Insulin requirements

A nurse is reviewing a client's history and finds images showing progressive development of facial changes due to acromegaly. Which diagnostic study would have confirmed this diagnosis? A. Somatotropin B. Radioactive iodine uptake C. Insulin-like growth factor 1 (IGF-1) D. Adrenocorticotropic hormone (ACTH)

C. Insulin-like growth factor 1 (IGF-1)

A client who had a subtotal thyroidectomy asks how hypothyroidism may develop when the problem was hyperthyroidism. What should the nurse consider when formulating a response? A. Hypothyroidism is a gradual slowing of the body's function. B. A decrease in pituitary thyroid-stimulating hormone (TSH) will occur. C. Less thyroid tissue is available to supply thyroid hormone after surgery. D. Atrophy of tissue remaining after surgery reduces secretion of thyroid hormones.

C. Less thyroid tissue is available to supply thyroid hormone after surgery.

Where is the anti-diuretic hormone SECRETED in the body? A. Hypothalamus B. Thyroid C. Posterior Pituitary gland D. Anterior pituitary gland

C. Posterior Pituitary gland