NCLEX Endocrine Questions
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Question 1 of 5.
The client diagnosed with type 1 diabetes mellitus received regular insulin two (2) hours ago. The client is complaining of being jittery and nervous. Which interventions should the nurse implement? List in order of priority.
- A. Call the laboratory to confirm blood glucose level.
- B. Administer a quick-acting carbohydrate.
- C. Have the client eat a bologna sandwich.
- D. Check the client's blood glucose level at the bedside.
- E. Determine if the client has had anything to eat.
- D. Check the client's blood glucose level at the bedside.
- B. Administer a quick-acting carbohydrate.
- E. Determine if the client has had anything to eat.
- C. Have the client eat a bologna sandwich.
- A. Call the laboratory to confirm blood glucose level.
Correct arrangement
Explanation: 1. Check blood glucose at bedside: Jitteriness and nervousness suggest hypoglycemia, common 2 hours post-regular insulin (peak effect). Bedside glucose testing confirms hypoglycemia quickly, guiding treatment. 2. Administer quick-acting carbohydrate: If glucose is low (<70 mg/dL), a quick-acting carbohydrate (e.g., juice) rapidly corrects hypoglycemia. 3. Determine if the client has had anything to eat: Assessing recent food intake identifies if inadequate nutrition contributed to hypoglycemia, informing prevention. 4. Have the client eat a bologna sandwich: After stabilizing glucose, a complex meal sustains normoglycemia, but it's slower-acting. 5. Call the laboratory: Lab confirmation is unnecessary and delays treatment, as bedside glucometry is standard.
Question 2 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 3 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 4 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 5 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.