Endocrine Disorders NCLEX Questions with Rationale
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Question 1 of 5.
The charge nurse of an intensive care unit is making assignments for the night shift. Which client should be assigned to the most experienced intensive care nurse?
A. The client diagnosed with respiratory failure who is on a ventilator and requires frequent sedation.
B. The client diagnosed with lung cancer and iatrogenic Cushing's disease with ABGs of pH 7.35, PaO2 88, PaCO2 44, and HCO3 22.
C. The client diagnosed with Addison's disease who is lethargic and has a BP of 80/45, P 124, and R 28.
D. The client diagnosed with hyperthyroidism who has undergone a thyroidectomy two (2) days ago and has a negative Trousseau's sign.
Explanation: Addison's with hypotension (80/45), tachycardia (124), and lethargy suggests adrenal crisis, requiring an experienced nurse. Ventilator care, stable Cushing's, and post-thyroidectomy are less acute.
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.