NCLEX RN Questions on Endocrine System
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Question 1 of 5.
The nurse assesses clients for the risk of developing hyperosmolar hyperglycemic syndrome. Which of the following clients should the nurse consider to be at greatest risk?
A. 63-year-old with diabetes mellitus (type two) who works outdoors and recently had an increased dosage of metformin.
B. 55-year-old with diabetes mellitus (type one) who was recently hospitalized for pneumonia and occasionally forgets to take their long-acting insulin.
C. 15-year-old with diabetes mellitus (type one) who has a hemoglobin A1C of 7.6% [ < 7%] and has gained 4 lbs (1.8 kg) in the past month.
D. 45-year-old who was recently diagnosed with diabetes mellitus (type two) and was prescribed glipizide in addition to metformin.
Explanation: HHS is common in type 2 diabetes, especially in older adults. Outdoor work risks dehydration, and increased metformin may not control severe hyperglycemia, heightening HHS risk.
Question 2 of 5.
The nurse has instructed a client with diabetes mellitus (type 1) about proper exercise. Which of the following statements by the client would indicate a correct understanding of the teaching?
A. I should carry a snack rich in protein just in case I feel shaky.
B. I will not take my prescribed daily glargine insulin if I plan on exercising.
C. I can initially expect my glucose level to rise with vigorous exercise, but if I continue exercising, my levels may eventually decrease.
D. I should start my exercise near the time that my insulin peaks.
Explanation: Vigorous exercise can initially raise blood glucose due to stress hormones, but prolonged activity increases glucose uptake by muscles, lowering levels. Carrying a carbohydrate-rich snack, not protein, is best for hypoglycemia. Insulin should never be skipped, and exercising at peak insulin time risks hypoglycemia.
Question 3 of 5.
The nurse preceptor observes a newly hired nurse care for a client with a myxedema coma. It would require follow up by the nurse preceptor if the newly hired nurse is observed
A. applying a cooling blanket to the client.
B. requesting a prescription for hydrocortisone.
C. removing the water pitcher from the bedside.
D. placing an oral endotracheal tube at the bedside for potential use.
Explanation: Myxedema coma is a severe hypothyroid state with hypothermia. A cooling blanket worsens this; a warming blanket is needed. Hydrocortisone addresses adrenal insufficiency, removing water prevents dilutional hyponatremia, and an endotracheal tube is prudent for potential respiratory support.
Question 4 of 5.
The nurse is assessing a client with hyperparathyroidism. Which of the following findings would support a diagnosis of hyperparathyroidism?
A. nephrolithiasis
B. hyperphosphatemia
C. diarrhea
D. halitosis
Explanation: Hyperparathyroidism increases calcium levels, leading to kidney stones (nephrolithiasis). Phosphorus levels drop, not rise, and diarrhea and halitosis are unrelated to this condition.
Question 5 of 5.
The nurse is caring for a client eight hours postoperative following a total thyroidectomy. Which of the following assessment findings indicate that the client is developing a complication?
A. Moderate amount of dried sanguineous drainage on the dressing
B. Oral temperature of 99.2°F (37.3°C)
C. Apical pulse of 56
D. The client reports a sore throat when speaking
Explanation: Excessive drainage post-thyroidectomy may indicate hemorrhage, a serious complication. A slightly elevated temperature, mild bradycardia, and sore throat are expected or less concerning in the immediate postoperative period.
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