NCLEX Endocrine Questions
Question 1 of 5.
The nurse administered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with type 1 diabetes at 1600. Which intervention should the nurse implement?
A. Ensure the client eats the bedtime snack.
B. Determine how much food the client ate at lunch.
C. Perform a glucometer reading at 0700.
D. Offer the client protein after administering insulin.
Explanation: Humulin N peaks in 4–12 hours, risking nocturnal hypoglycemia. A bedtime snack prevents this. Lunch intake is irrelevant, morning glucose checks are too late, and protein alone is insufficient.
Question 2 of 5.
The client with type 2 diabetes controlled with biguanide oral diabetic medication is scheduled for a computed tomography (CT) scan with contrast of the abdomen to evaluate pancreatic function. Which intervention should the nurse implement?
A. Provide a high-fat diet 24 hours prior to test.
B. Hold the biguanide medication for 48 hours prior to test.
C. Obtain an informed consent form for the test.
D. Administer pancreatic enzymes prior to the test.
Explanation: Biguanides (e.g., metformin) are held 48 hours before contrast CT to prevent lactic acidosis due to contrast-induced kidney injury. High-fat diets, consent, and enzymes are irrelevant.
Question 3 of 5.
The client diagnosed with type 2 diabetes is admitted to the intensive care unit (ICU) with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) coma. Which assessment data should the nurse expect the client to exhibit?
A. Kussmaul's respirations.
B. Diarrhea and epigastric pain.
C. Dry mucous membranes.
D. Ketone breath odor.
Explanation: HHNS causes severe dehydration, leading to dry mucous membranes. Kussmaul's respirations and ketone odor are DKA-specific, and diarrhea/pain are less common.
Question 4 of 5.
Which assessment data indicate the client diagnosed with diabetic ketoacidosis is responding to the medical treatment?
A. The client has tented skin turgor and dry mucous membranes.
B. The client is alert and oriented to date, time, and place.
C. The client's ABG results are pH 7.29, PaCO2 44, HCO3 15.
D. The client's serum potassium level is 3.3 mEq/L.
Explanation: Alertness and orientation indicate resolving DKA, as cerebral function improves. Persistent dehydration, acidosis (pH 7.29), and hypokalemia are not signs of improvement.
Question 5 of 5.
Which arterial blood gas results should the nurse expect in the client diagnosed with diabetic ketoacidosis?
A. pH 7.34, PaO2 99, PaCO2 48, HCO3 24.
B. pH 7.38, PaO2 95, PaCO2 40, HCO3 22.
C. pH 7.46, PaO2 85, PaCO2 30, HCO3 26.
D. pH 7.30, PaO2 90, PaCO2 30, HCO3 18.
Explanation: DKA causes metabolic acidosis (low pH 7.30, low HCO3 18) with compensatory respiratory alkalosis (low PaCO2 30). Other options show normal or alkalotic states.
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