Endocrine Disorders NCLEX Questions with Rationale
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Question 1 of 5.
The agitated client is hospitalized with tachycardia, dyspnea, and intermittent chest palpitations. The client's BP is 170/110 mm Hg, and HR is 130 bpm. The client's health history reveals thinning hair, recent 10-lb weight loss, increased appetite, fine hand and tongue tremors, hyperreflexic tendon reflexes, and smooth, moist skin. Which prescribed intervention should be the nurse's priority?
A. 12-lead electrocardiogram (ECG) and cardiac enzyme levels.
B. Obtain thyroid-stimulating hormone (TSH) and free T4 levels.
C. Propranolol 2 mg IV q15 min or until symptoms are controlled.
D. Propylthiouracil 600-mg oral loading dose; then 200 mg orally q4h.
Explanation: Propranolol provides rapid symptomatic relief of thyrotoxicosis by controlling cardiac and psychomotor manifestations.
Question 2 of 5.
The nurse is discussing the importance of exercising with a client diagnosed with type 2 diabetes whose diabetes is well controlled with diet and exercise. Which information should the nurse include in the teaching about diabetes?
A. Eat a simple carbohydrate snack before exercising.
B. Carry peanut butter crackers when exercising.
C. Encourage the client to walk 20 minutes three (3) times a week.
D. Perform warm-up and cool-down exercises.
Explanation: Warm-up and cool-down exercises prevent injury during exercise, crucial for type 2 diabetics. Pre-exercise snacks are for insulin users, peanut butter is high-fat, and walking is good but not the focus.
Question 3 of 5.
The client received 10 units of Humulin R, a fast-acting insulin, at 0700. At 1030 the unlicensed assistive personnel (UAP) tells the nurse the client has a headache and is really acting 'funny.' Which intervention should the nurse implement first?
A. Instruct the UAP to obtain the blood glucose level.
B. Have the client drink eight (8) ounces of orange juice.
C. Go to the client's room and assess the client for hypoglycemia.
D. Prepare to administer one (1) ampule 50% dextrose intravenously.
Explanation: Assessing for hypoglycemia (e.g., confusion, headache) confirms the cause, as Humulin R peaks around 3 hours. UAPs cannot check glucose, and treatment follows confirmation.
Question 4 of 5.
Which electrolyte replacement should the nurse anticipate being ordered by the health-care provider in the client diagnosed with diabetic ketoacidosis (DKA) who has just been admitted to the ICU?
A. Glucose.
B. Potassium.
C. Calcium.
D. Sodium.
Explanation: DKA causes potassium depletion due to acidosis and diuresis; replacement is anticipated to prevent arrhythmias. Glucose is not an electrolyte, and calcium/sodium are less critical.
Question 5 of 5.
The emergency department nurse is caring for a client diagnosed with HHNS who has a blood glucose of 680 mg/dL. Which question should the nurse ask the client to determine the cause of this acute complication?
A. When is the last time you took your insulin?
B. When did you have your last meal?
C. Have you had some type of infection lately?
D. How long have you had diabetes?
Explanation: Infections are a common trigger for HHNS, precipitating hyperglycemia. Insulin timing, meal timing, and diabetes duration are less directly causative.
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