NCLEX RN Endocrine Questions
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Question 1 of 5.
The nurse is caring for a client with a prescribed subcutaneous (SQ) regular insulin sliding scale. The client's current blood glucose level is 360 mg/dL (19.98 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]. Which of the following actions should the nurse take? See the exhibit.
A. Notify the primary health care provider (PHCP).
B. Administer 8 units of regular insulin.
C. Administer 10 units of regular insulin.
D. Recheck the client's blood glucose in one hour.
E. Administer the insulin intravenous (IV) push.
Explanation: A blood glucose of 360 mg/dL is significantly elevated, requiring insulin per the sliding scale (e.g., 8 units for 351–400 mg/dL, depending on the exhibit) and PHCP notification for further management. IV push is inappropriate for SQ scales, and rechecking in one hour follows administration.
Question 2 of 5.
The nurse is caring for a client with Graves' disease who has exophthalmos. The nurse should recommend that the client
A. prevent eye dryness by applying artificial tears.
B. use scanning techniques to move the head from side to side.
C. take their thyroid hormone as prescribed.
D. sleep flat on your back without any pillows.
Explanation: Exophthalmos in Graves' disease causes protruding eyes, increasing the risk of dryness and irritation. Artificial tears help maintain moisture and protect the eyes. Sleeping flat may worsen eye protrusion, and thyroid hormone management is unrelated to exophthalmos directly.
Question 3 of 5.
The nurse is caring for a client who developed a thyroid storm. The nurse should obtain a prescription for
A. enalapril.
B. calcium gluconate.
C. levothyroxine.
D. propranolol.
Explanation: Thyroid storm is a life-threatening hyperthyroid state. Propranolol, a beta-blocker, reduces heart rate, blood pressure, and other hypermetabolic symptoms. Enalapril is for hypertension, calcium gluconate for hypocalcemia, and levothyroxine worsens hyperthyroidism.
Question 4 of 5.
The nurse is developing a plan of care for a client with hypothyroidism that is not controlled with medication. The nurse should recommend
A. applying lotion after a warm bath.
B. high-fiber snacks.
C. caffeinated beverages to promote energy.
D. physical activities with frequent rest breaks.
E. adding fans to the room to keep it cool.
Explanation: Hypothyroidism causes dry skin, constipation, and fatigue. Lotion hydrates skin, high-fiber snacks aid bowel movements, and rest breaks accommodate low energy. Caffeine may overstimulate, and fans are unhelpful as clients feel cold, not hot.
Question 5 of 5.
The nurse is assessing a client with a myxedema coma. Which of the following would be an expected finding?
A. Glucose 59 mg/dL (3.28 mmol/L) [70-110 mg/d, 4.0-6.0 mmol/L]
B. Sodium 155 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]
C. Serum pH 7.49 [7.35-7.45]
Explanation: Myxedema coma, a severe hypothyroid state, can cause hypoglycemia due to reduced metabolism. Hypernatremia and alkalosis are not typical; hyponatremia and acidosis are more common.
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