Endocrine Disorders NCLEX Questions with Rationale

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Question 1 of 5.

The nurse is caring for the client with type 2 DM. Which instructions should the nurse provide to the client regarding diabetes management during stress or illness? Select all that apply.

A. Notify the health care provider if unable to keep fluids or foods down.

B. Test fingerstick glucose levels and urine ketones daily and keep a record.

C. Continue to take oral hypoglycemic medications and/or insulin as prescribed.

D. Supplement food intake with carbohydrate-containing fluids, such as juices or soups.

E. When on an oral agent, administer insulin in addition to the oral agent during the illness.

F. A minor illness, such as the flu, usually does not affect the blood glucose and insulin needs.

Explanation: Notifying the HCP prevents dehydration, and continuing medications manages hyperglycemia during illness.

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.