Endocrine NCLEX style questions

A registered nurse is providing information to a group of student nurses regarding the actions of parathyroid hormone (PTH). Which statement made by the student nurse indicates a need for further teaching? Select all that apply. A) "It activates vitamin D in the kidneys." B) "Its secretion increases serum calcium levels." C) "It allows reabsorption of phosphorus in the kidney tubules." D) "It decreases serum calcium levels by increasing bone resorption." E) "It regulates calcium and phosphorous metabolism by acting on the gastrointestinal tract."

C, D

The health care provider prescribes propylthiouracil (PTU) for a client with hyperthyroidism. What is an action of PTU that the nurse will include in teaching? A) Increases the uptake of iodine B) Causes the thyroid gland to atrophy C) Interferes with the synthesis of thyroid hormone D) Decreases the secretion of thyroid-stimulating hormone (TSH)

C

Which client response should the nurse monitor when assessing for complications of hyperparathyroidism? A) Tetany B) Seizures C) Bone pain D) Graves disease

C

Which hormonal disorder may be suspected when positive Chvostek and Trousseau signs are assessed? A) Diabetes mellitus B) Addisonian crisis C) Hypoparathyroidism D) Pheochromocytoma

C

Which hormonal imbalance causes acromegaly? A) Insulin B) Thyroxine C) Somatotropin D) Parathyroid hormone

C

A client who is on long-term corticosteroid therapy following an adrenalectomy is admitted to the surgical intensive care unit after being involved in a motor vehicle crash. What is the nurse's most important concern related to the client's history? A) The dosage of steroids may have to be tapered down slowly. B) Steroid therapy will need to be increased to avert a life-threatening crisis. C) Osteoporosis secondary to long-term corticosteroids increases fracture risk. D) The client will be at greater risk of infection secondary to immunosuppression.

B

A client, reports feeling nervous, irritable, and extremely tired. The client says to the nurse, "Although I eat a lot of food, I have frequent bouts of diarrhea and am losing weight." The nurse observes a fine hand tremor, an exaggerated reaction to external stimuli, and a wide-eyed expression. What laboratory tests may be prescribed to determine the cause of these signs and symptoms? A) Partial thromboplastin time (PTT) and prothrombin time (PT) B) T3, T4, and thyroid-stimulating hormone (TSH) C) Venereal disease research laboratory (VDRL) test and complete blood count (CBC) D) Adrenocorticotropic hormone (ACTH), antidiuretic hormone ADH, and corticotropin-releasing factor (CRF)

B

A client is diagnosed with diabetic ketoacidosis. Which insulin should the nurse expect the health care provider to prescribe? A) Insulin lispro B) Insulin glargine C) NPH insulin D) Regular insulin

D

A client tells the nurse during the admission history that an oral hypoglycemic agent is taken daily. For which condition does the nurse conclude that an oral hypoglycemic agent may be prescribed by the health care provider? A) Ketosis B) Obesity C) Type 1 diabetes D) Reduced insulin production

D

Which clinical findings should the nurse expect when assessing a client with hyperthyroidism? Select all that apply. A) Diarrhea B) Listlessness C) Weight loss D) Bradycardia E) Decreased appetite

A, C

A nurse is assessing a female client with Cushing syndrome. Which clinical findings can the nurse expect to identify? Select all that apply. A) Hirsutism B) Menorrhagia C) Buffalo hump D) Dependent edema E) Migraine headaches

A, C

A nurse is caring for a client who had a hypophysectomy. For which complication specific to this surgery should the nurse assess the client for early clinical manifestations? A) Urinary retention B) Respiratory distress C) Bleeding at the suture line D) Increased intracranial pressure

D

The nurse is providing teaching to a client who recently has been diagnosed with type 1 diabetes mellitus. The nurse reinforces the importance of monitoring for ketoacidosis. What are the signs and symptoms of ketoacidosis? Select all that apply. A) Confusion B) Hyperactivity C) Excessive thirst D) Fruity-scented breath E) Decreased urinary output

A, C, D

A client with addisonian crisis exhibits severe manifestations of glucocorticoid and mineralocorticoid deficiencies. Which responses should the nurse expect the client to exhibit? Select all that apply. A) Bradycardia B) Hypertension C) Hyperkalemia D) Hyponatremia E) Postural hypotension

C, D, E

Which instructions will be most beneficial for a client who has diabetes and renal disease? Select all that apply. A) Recommend the client drink boiled water B) Suggest the client to go for a morning walk C) Instruct the client to check blood pressure regularly D) Contact the primary healthcare provider before taking ibuprofen E) Encourage the client to undergo a microalbuminuria test yearly

C, D, E

A nurse is caring for a client admitted to the hospital for diabetic ketoacidosis. Which clinical findings related to this event should the nurse document in the client's clinical record? Select all that apply. A) Sweating B) Retinopathy C) Acetone breath D) Increased arterial bicarbonate level E) Decreased arterial carbon dioxide level

C, E

The nurse is teaching a diabetic client about the advantages of using an insulin pump. What information will the nurse include in the teaching? Select all that apply. A) It prevents ketoacidosis B) It helps cause weight loss C) It can improve hemoglobin A1c levels D) It costs less than subcutaneous injections E) It allows clients to exercise without eating more carbohydrates

C, E

A client who has type 1 diabetes is admitted to the hospital for major surgery. Before surgery the client's insulin requirements are elevated but well controlled. Postoperatively, the nurse anticipates that the client's insulin requirements will do what? A) Decrease B) Fluctuate C) Increase sharply D) Remain elevated

D

A client is diagnosed with parathyroid dysfunction. Which serum calcium concentration in the client would support the diagnosis? A) 7.8 mg/dL B) 8.9 mg/dL C) 9.7 mg/dL D) 10.2 mg/dL

A

Which clinical indicators can the nurse expect when assessing a client with Cushing syndrome? Select all that apply. A) Lability of mood B) Slow wound healing C) A decrease in the growth of hair D) Ectomorphism with a moon face E) An increased resistance to bruising

A, B

Before a client's discharge after a thyroidectomy, the nurse teaches the client to observe for signs of surgically induced hypothyroidism. What clinical indicators of hypoglycemia should the client report. Select all that apply. A) Fatigue B) Dry skin C) Insomnia D) Intolerance to heat E) Progressive weight loss

A, B Fatigue is caused by a decreased metabolic rate. Dry skin is caused by decreased glandular function associated with a decreased metabolic rate. Insomnia is caused by an increased metabolic rate associated with hyperthyroidism, not hypothyroidism. Intolerance to heat is associated with hyperthyroidism. Intolerance to cold is associated with hypothyroidism. Progressive weight loss is associated with hyperthyroidism. Progressive weight gain is associated with hypothyroidism because of the reduced metabolic rate.

A nurse is caring for a client who has had type 1 diabetes for 25 years. The client states, "I have been really bad for the last 15 years. I have not paid attention to my diet and have done little to control my diabetes." What signs of common complications of diabetes might the nurse expect to identify when assessing this client? Select all that apply. A) Leg ulcers B) Loss of visual acuity C) Thick, yellow toenails D) Increased growth of body hair E) Decreased sensation in the feet

A, B, C, E

The nurse provides education related to manifestations of hyperglycemia to a client with type 1 diabetes. Which signs and symptoms identified by the client indicate that the teaching was effective? Select all that apply. A) Thirst B) Headache C) Nervousness D) Fruity breath odor E) Excessive urination

A, D, E

A client with a diagnosis of Graves disease refuses to have radioactive iodine (RAI) therapy, and a subtotal thyroidectomy is performed. What should the nurse do postoperatively to reduce the risk of thyroid storm? A) Provide a high-calorie diet B) Prevent infection at the surgical site C) Encourage postoperative breathing exercises D) Demonstrate how to support the neck after surgery

B

A client with diabetes is self-administering insulin. Which action performed by the client indicates a need for correction? A) Inspecting the vial for crystals B) Washing the hands with hot water C) Inspecting the barrel for air bubbles D) Bringing the insulin to room temperature

B

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

A client's parathyroid glands are removed. What clinical manifestation is indicative of the fluid and electrolyte imbalance associated with this surgery? A) Constipation B) Muscle spasms C) Hypoactive reflexes D) Increased specific gravity

B

A nurse is caring for a client with an underactive thyroid gland. Which responses should the nurse expect the client to exhibit as a result of decreased levels of triiodothyronine (T3 ) and thyroxine (T4 )? Select all that apply. A) Irritability B) Tachycardia C) Weight gain D) Cold intolerance E) Profuse diaphoresis

C, D

A nurse is caring for a client with an underactive thyroid gland. Which responses should the nurse expect the client to exhibit as a result of decreased levels of triiodothyronine (T3) and thyroxine (T4)? Select all that apply. A) Irritability B) Tachycardia C) Weight gain D) Cold intolerance E) Profuse diaphoresis

C, D

A nurse is assessing a malnourished client with a history of cirrhosis. The client is experiencing nausea, ascites, and gastrointestinal bleeding. What is the primary cause of the client's ascites? A) A decrease in vitamins to maintain cell coenzyme functions B) A decrease in iron to maintain adequate hemoglobin synthesis C) A decrease in sodium to maintain its concentration in tissue fluid D) A decrease in plasma protein to maintain adequate capillary-tissue circulation

D

After reviewing the reports of four clients, the nurse suspects hyperparathyroidism in one of the clients. Which client's finding supports the nurse's suspicion? Client A: 1.8 mg/dL serum phosphate Client B: 2.4 mg/dL serum phosphate Client C: 3.9 mg/dL serum phosphate Client D: 4.2 mg/dL serum phosphate

A

A nurse is caring for a client admitted to the hospital with primary hyperparathyroidism. Which action should be included in this client's plan of care? A) Ensuring a large fluid intake B) Providing a high-calcium diet C) Instituting seizure precautions D) Encouraging complete bed rest

A

A nurse is monitoring for clinical manifestations of infection in a client with a diagnosis of Addison disease. Which body mechanism related to infectious processes does the nurse conclude is impaired as a result of this disease? A) Stress response B) Electrolyte balance C) Metabolic processes D) Respiratory function

A

An client who is obese and has type 2 diabetes asks about the intake of alcohol and special "dietetic" food in the diet. What should the nurse include in teaching? A) Alcohol can be consumed, with its calories counted in the diet. B) Unlimited amounts of sugar substitutes can be used as desired. C) Alcohol should not be used in cooking because it adds too many calories. D) Special "dietetic" foods are needed because many regular foods cannot be used.

A

A client with hyperthyroidism has been treated with radioactive iodine (131I) to destroy overactive thyroid gland cells. To reduce radiation exposure, the nurse's principles for providing care should be based on what? A) Wearing a lead-shield apron at all times B) Limiting distance and time spent with the client C) Wearing a radiation meter to measure exposure D) Remaining at least 6 feet (1.8 m) away from the client at all times

B

A nurse is assessing a client with a suspected pituitary tumor. Which assessment finding is consistent with a pituitary tumor? A) Tetany B) Seizures C) Lethargy D) Hyperreflexia

B

Propylthiouracil is prescribed for a client diagnosed with hyperthyroidism. The client asks the nurse, "Why do I have to take this medication if I am going to get radiation therapy?" What explanation does the nurse provide? A) It binds previously formed thyroid hormones. B) It decreases production of thyroid hormones. C) Vascularity of the thyroid gland is decreased. D) The need for thyroid iodine supplements is reduced.

B

The nurse is caring for a client with type 1 diabetes. Which signs or symptoms of insulin reaction should the nurse be most concerned should they occur? Select all that apply. A) Lethargy B) Headache C) Diaphoresis D) Excessive thirst E) Deep respirations

B, C

The nurse is teaching a student nurse about caring for a client with decreased bone density. Which statements made by the student nurse indicates effective learning? Select all that apply. A) "I will instruct the client to refrain from running as exercise." B) "I will instruct the client to be very careful to prevent injuries." C) "I will instruct the client to perform weight-bearing activities." D) "I will instruct the client to drink at least 2 liters of water daily." E) "I will instruct the client to change positions every 2 hours."

B, C

Which clinical findings should the nurse assess when caring for a client with hyperthyroidism? Select all that apply. A) Lethargy B) Tachycardia C) Weight gain D) Constipation E) Exophthalmos

B, E

Which metabolic manifestations are likely to be observed in a client with hypothyroidism? Select all that apply. A) Impaired memory B) Intolerance to cold C) Difficulty breathing D) Decreased blood pressure E) Decreased body temperature

B, E

A client with type 1 diabetes self-administers Novolin N insulin every morning at 8 AM. The nurse evaluates that the client understands the action of the insulin when the client says she should be alert for signs of hypoglycemia between what hours? A) 9 am and 10 am B) 10 am and 11 am C) 2 pm and 8 pm D) 8 pm and 12 noon

C

A client with hyperthyroidism refuses radioactive iodine therapy and a subtotal thyroidectomy is scheduled. The nurse reviews the preoperative plan of care and questions which prescription? A) High protein, high carbohydrate diet B) Iodine preparations C) Antithyroid drugs D) Vasoactive drugs

D

A client who is to begin continuous ambulatory peritoneal dialysis asks the nurse what this entails. What information should the nurse include when answering the client's question? A) Hemodialysis and peritoneal dialysis will be done together. B) Peritoneal dialysis is performed in an ambulatory care clinic. C) About a quarter of a liter of dialysate is maintained in the peritoneal cavity. D) Constant contact is maintained between the dialysate and the peritoneal membrane.

D

An 11-year-old client is admitted with enlarged supraclavicular lymph nodes, fatigue, and low-grade fever. She also has a persistent nonproductive cough. In light of these findings, the nurse knows to gear education toward preparation for which therapies? A) Intravenous (IV) fluids and nutritional therapy B) Bloodwork and oxygenation therapy C) IV fluids and antibiotic therapy D) Computed tomography (CT) and lymph node biopsy

D

Blood studies are being performed on a client with the potential diagnosis of hyperparathyroidism. What serum blood level should the nurse expect to be decreased when reviewing this client's hematologic studies? A) Calcium B) Chloride C) Phosphorus D) Parathormone

C

A nurse is caring for a school-aged child with type 1 diabetes. There have been problems maintaining euglycemia. What laboratory test does the nurse expect to be ordered that will reveal the effectiveness of the diabetic regimen over time? A) Serum glucose B) Glucose tolerance C) Fasting blood sugar D) Glycosylated hemoglobin

D

A nurse is developing a discharge plan for a client hospitalized with severe cirrhosis of the liver. What should be included in this plan? A) The need for a high-protein diet B) The use of a sedative for relaxation C) The need to increase fluids D) The importance of reporting personality changes to the primary healthcare provider

D

A client who is scheduled to have surgery to remove an aldosterone-secreting adenoma asks the nurse what will happen if surgery is not performed. On what information should the nurse base a response? A) The tumor must be removed to prevent heart and kidney damage. B) Surgery will prevent the tumor from metastasizing to other organs. C) Radiation therapy can be just as effective as surgery if the tumor is small. D) Chemotherapy is as reliable as surgery for the treatment of adenomas of this type in some people

A

The nurse provides a list of appropriate food choices to a client with newly diagnosed diabetes. The client reviews the list and says, "I do not like and refuse to eat asparagus, broccoli, and mushrooms." In response, the nurse teaches the client about the food exchange list. The nurse evaluates that the teaching is understood when the client states that instead of asparagus, broccoli, and mushrooms, the client can eat what? A) String beans, beets, or carrots B) Corn, lima beans, or dried peas C) Baked beans, potatoes, or parsnips D) Corn muffins, corn chips, or pretzels

A

A nurse mixes a short-acting and an intermediate-acting insulin in the same syringe to administer to a client with diabetes. List the actions in the order the nurse should perform them. A) Don a pair of clean gloves. B) Put air into the intermediate-acting insulin vial. C) Withdraw the prescribed amount of short-acting insulin. D) Put air into the short-acting insulin vial. E) Withdraw the prescribed amount of intermediate-acting insulin.

A, D, B, C, E

At 4:30 PM, a client who is receiving human insulin (Humulin N) every morning states, "I feel very nervous." The nurse observes that the client's skin is moist and cool. What is the nurse's most accurate interpretation of what the client is likely experiencing? A) Polydipsia B) Ketoacidosis C) Glycogenesis D) Hypoglycemia

D

Which electrolyte concentration has the potential to precipitate dysrhythmias and cardiac arrest in a client? A) Serum sodium of 139 mEq/L (139 mmol/L) B) Serum chloride of 100 mEq/L (100 mmol/L) C) Serum calcium of 10.2 mg/dL (2.55 mmol/L) D) Serum potassium of 7.2 mEq/L (7.2 mmol/L)

D

A nurse is providing postoperative care for a client one hour after the client had an adrenalectomy. Maintenance steroid therapy has not begun yet. The nurse should monitor the client for which complication? A) Hypotension B) Hyperglycemia C) Sodium retention D) Potassium excretion

A

A client undergoes removal of a pituitary tumor through a transsphenoidal approach. What should the nurse implement postoperatively? A) Provide oral hygiene and include brushing the teeth B) Encourage the client to deep breathe and cough frequently C) Maintain the head of the bed at a 30-degree angle continuously D) Continue giving nothing by mouth until the nasal packing is removed

C