Professional Documents
Culture Documents
NCLEX Endocrine
NCLEX Endocrine
The nurse is reinforcing instructions with a client with diabetes mellitus who is recovering from
diabetic ketoacidosis (DKA) regarding measures to prevent a recurrence. Which instruction is
important for the nurse to emphasize?
Monitor blood glucose levels frequently.
The nurse is reinforcing discharge teaching with a client who has Cushing's syndrome. Which
statement by the client indicates that the instructions related to dietary management were
understood?
"I can eat foods that contain potassium.
The nurse educator is asking the nursing student to recall the signs/symptoms of
hypothyroidism. The nurse educator determines that the student understands this disorder if
which are included in the student's response? Select all that apply.
Dry skin
Constipation
Cold intolerance
The nurse is caring for a postoperative parathyroidectomy client. Which would require the
nurse's immediate attention?
Laryngeal stridor
The nurse notes that a client with type 1 diabetes mellitus has lipodystrophy on both upper
thighs. Which further information should the nurse obtain from the client during data collection?
Plan for injection rotation
A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of
hypoglycemia. Which statement by the client indicates a correct understanding of Humulin N
insulin and exercise?
"I should not exercise in the late afternoon.
The nursing instructor asks a student to describe the pathophysiology that occurs in Cushing's
disease. Which statement by the student indicates an accurate understanding of this disorder?
Which client complaint should alert the nurse to a possible hypoglycemic reaction?
Tremors and double vision
Which nursing action would be appropriate to implement when a client has a diagnosis of
pheochromocytoma?
Monitor the client's blood pressure.
The nurse is caring for a client with pheochromocytoma. The client is scheduled for an
adrenalectomy. During the preoperative period, the priority nursing action should be to monitor
which criterion?
Vital signs
The nurse is caring for a client with pheochromocytoma. The client asks for a snack and
something warm to drink. Which is the appropriate choice for this client to meet nutritional
needs?
Graham crackers and warm milk
The nurse is caring for a client with pheochromocytoma. Which data are indicative of a potential
complication associated with this disorder?
Congestion heard on auscultation of the lungs
The nurse is caring for a client after a thyroidectomy and monitoring for signs of thyroid storm.
The nurse determines that which sign/symptom is indicative that a thyroid storm may be
occurring?
Blood pressure of 80/60 mmHg
When caring for a client who is having clear drainage from his nares after transsphenoidal
hypophysectomy, which action by the nurse is essential?
Test the drainage for glucose.
After several diagnostic tests, a client is diagnosed with diabetes insipidus. The nurse
understands that which signs/symptoms are indicative of this disorder?
Excessive thirst and urine output
Which signs/symptoms should the nurse expect to note when collecting data on a client with
Addison's disease?
Hypotension and vomiting
Which measure should the nurse anticipate being included in the plan of care for a client who
has been diagnosed with Graves' disease?
A restful environment
The nurse is preparing to reinforce instructions to a client with Addison's disease regarding diet
therapy. The nurse understands that which diet should be prescribed for this client?
High-sodium, high-carbohydrate diet
The nurse is caring for a client with a diagnosis of hypoparathyroidism. The nurse reviews the
client's laboratory results and notes that the calcium level is extremely low. The nurse should
expect to note which sign/symptom on data collection?
Positive Trousseau's sign
The nurse is providing instructions to a client newly diagnosed with diabetes mellitus. The nurse
gives the client a list of the signs of hyperglycemia. Which specific signs of this complication
should be included on the list?
Increased thirst
The nurse enters the room of a client with type 1 diabetes mellitus and finds the client difficult to
arouse. The client's skin is warm and flushed, and the pulse and respiratory rate are elevated
from the client's baseline. Which action should the nurse implement?
Check the client's capillary blood glucose.
A client with type 1 diabetes mellitus takes NPH insulin every morning and checks the blood
glucose level four times per day. The client tells the nurse that yesterday the late afternoon
blood glucose was 60 mg/dL and that she "felt funny." Which statement by the client indicates
an understanding of this occurrence?
"I forgot to take my usual mid-afternoon snack yesterday.
The nurse is reinforcing instructions to a client with diabetes mellitus about blood glucose
monitoring and monitoring for signs of hypoglycemia. The nurse should teach the client that
which result is a sign of hypoglycemia?
Less than 50 mg/dL
The nurse caring for a client scheduled for a transsphenoidal hypophysectomy to remove a
tumor in the pituitary gland assists in developing a plan of care for the client. The nurse
suggests including which specific information in the preoperative teaching plan?
Toothbrushing will not be permitted for at least 2 weeks following surgery.
Following hypophysectomy, a client complains of being very thirsty and having to urinate
frequently. Which is the initial nursing action?
Check the urine specific gravity
The nurse is reviewing a health care provider's prescriptions for a client with newly diagnosed,
untreated hypothyroidism. Which medication prescribed for the client should the nurse question
and verify?
Morphine sulfate
A client is brought to the emergency department in an unresponsive state, and a diagnosis of
hyperglycemic hyperosmolar state (HHS) is made. The nurse who is assisting with care for the
client obtains which item in preparation for the treatment of this syndrome?
Intravenous (IV) infusion of normal saline
A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency
department. Which finding should the nurse expect to note as confirming this diagnosis?
Elevated blood glucose and low plasma bicarbonate
A client is admitted to the hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial
serum glucose level was 950 mg/dL. Intravenous (IV) insulin was started along with rehydration
with IV normal saline. The serum glucose level is now 240 mg/dL. The nurse who is assisting in
caring for the client obtains which item, anticipating a health care provider's prescription?
IV infusion containing 5% dextrose
A client with diabetes mellitus is being discharged following treatment for hyperglycemic
hyperosmolar state (HHS) precipitated by acute illness. The client states to the nurse, "I will call
the doctor next time I can't eat for more than a day or so." The nurse plans care, understanding
that which statement accurately reflects this client's level of knowledge?
The client needs immediate education before discharge.
A health care provider has prescribed propylthiouracil (PTU) for a client with hyperthyroidism,
and the nurse assists in developing a plan of care for the client. Which nursing measure would
be included in the plan regarding this medication?
Signs and symptoms of hypothyroidism
The nurse is assisting in preparing a care plan for a client with diabetes mellitus who has
hyperglycemia. The nurse should focus on which potential problem for this client?
Dehydration
The nurse is assigned to care for a client at home who has a diagnosis of type 1 diabetes
mellitus. When the nurse arrives to care for the client, the client tells the nurse that she has
been vomiting and has diarrhea. Which additional statement by the client indicates a need for
further teaching?
"I need to stop my insulin.
The nurse is assigned to assist in caring for a client admitted to the emergency department with
diabetic ketoacidosis (DKA). Which is the priority nursing action for this client who is in the acute
phase?
Administer intravenous (IV) regular insulin.
A client with type 2 diabetes mellitus has a blood glucose of more than 600 mg/dL and is
complaining of polydipsia, polyuria, weight loss, and weakness. The nurse reviews the health
care provider's documentation and would expect to note which diagnosis?
Hyperglycemic hyperosmolar state (HHS)
The nurse has collected data on a client with diabetes mellitus. Findings include a fasting blood
glucose of 130 mg/dL, temperature 101 F, pulse of 88 beats per minute, respirations of 22
breaths per minute, and a blood pressure of 118/78 mm Hg. Which finding would be of concern
to the nurse?
Temperature
The nurse is collecting data from a client newly diagnosed with diabetes mellitus regarding the
client's learning readiness. Which client behavior indicates to the nurse that the client is not
ready to learn?
The client complains of fatigue whenever the nurse plans a teaching session.
A client with diabetes mellitus visits the health care clinic. The client previously had been well
controlled with glyburide (DiaBeta), but recently, the fasting blood glucose has been running 180
to 200 mg/dL. Which medication, if added to the client's regimen, may be contributing to the
hyperglycemia?
Prednisone
The nurse in an outpatient diabetes clinic is assisting in caring for a client on insulin pump
therapy. Which statement by the client indicates that a need for teaching regarding insulin pump
therapy?
"Now that I have this pump, I don't have to worry about insulin reactions or ketoacidosis
occurring again.
A client with Graves' disease has exophthalmos and is experiencing photophobia. Which
intervention would best assist the client with this problem?
Obtaining dark glasses for the client
The nurse caring for a client who has had a subtotal thyroidectomy reviews the plan of care and
determines which problem is the priority for this client in the immediate postoperative period?
Bleeding
A comatose client with an admitting diagnosis of diabetic ketoacidosis (DKA) has a blood
glucose value of 368 mg/dL, arterial pH of 7.2, arterial bicarbonate of 14 mEq/L, and is positive
for serum ketones. The diagnosis is supported by which noted data?
Fruity breath odor
The nurse is collecting data on a client admitted to the hospital with a diagnosis of myxedema.
Which data collection technique would provide data necessary to support the admitting
diagnosis?
Inspection of facial features
A client with Cushing's disease is being admitted to the hospital after a stab wound to the
abdomen. The nurse plans care and places highest priority on which potential problem?
Infection
The nurse has reinforced instructions about measuring blood glucose levels to a client newly
diagnosed with diabetes mellitus. The nurse determines that the client understands the
procedure when making which most accurate statement?
"I should check my blood glucose level before eating each meal, regardless of how much I eat."
The nurse is reinforcing dietary instructions to a client newly diagnosed with diabetes mellitus.
The nurse accurately instructs the client with which statement?
The nurse is caring for a client following an adrenalectomy and is monitoring for signs of adrenal
insufficiency. Which are signs and symptoms related to adrenal insufficiency? Select all that
apply.
Fever
Weakness
Hypotension
Mental status changes
The nurse is reinforcing home care instructions to a client with a diagnosis of Cushing's
syndrome. Which client statement reflects a need for further teaching?
I need to read the labels on any over-the-counter medications I purchase.
The nurse is reviewing a plan of care for a client with Addison's disease. The nurse notes that
the client is at risk for dehydration and suggests nursing interventions that will prevent this
occurrence. Which nursing intervention is an appropriate component of the plan of care? Select
all that apply.
Monitoring intake and output
Monitoring for changes in mental status
Encouraging fluid intake of at least 3000 mL/day
The nurse is reviewing the postoperative prescriptions for a client who had a transsphenoidal
hypophysectomy. Which health care provider's prescription noted on the record indicates the
need for clarification?
Apply a loose dressing if any clear drainage is noted.
The nurse reviews a plan of care for a postoperative client following a thyroidectomy and notes
that the client is at risk for breathing difficulty. Which nursing intervention should the nurse
include in the plan of care?
Monitor neck circumference frequently.
The nurse is monitoring a client following a thyroidectomy for signs/symptoms of hypocalcemia.
Which sign/symptom noted in the client indicates the presence of hypocalcemia?
Tingling around the mouth
The nurse is caring for a client following a thyroidectomy. The client tells the nurse that she is
concerned because of voice hoarseness. The client asks the nurse whether the hoarseness will
subside. Which statement by the nurse regarding the hoarseness is accurate?
The hoarseness is normal and will gradually subside.
The nurse is monitoring a client with Graves' disease for signs of thyrotoxic crisis (thyroid storm).
Which signs and symptoms noted in the client should alert the nurse to the presence of this
crisis? Select all that apply.
Fever
Sweating
Agitation
Which client is at risk for developing thyrotoxicosis?
A client with Graves' disease who is having surgery
The nurse is caring for a client diagnosed with hyperparathyroidism who is prescribed
furosemide (Lasix). The nurse reinforces dietary instructions to the client. Which is an
appropriate instruction?
Drink at least 2 to 3 L of fluid daily.
The nurse has reinforced instructions to the client with hyperparathyroidism regarding home
care measures related to exercise. Which statement by the client indicates a need for further
teaching? Select all that apply.
"I need to limit playing football to only the weekends.
I should exercise in the evening to encourage a good sleep pattern.
The nurse has reinforced dietary instructions to a client with a diagnosis of hypoparathyroidism.
The nurse instructs the client to include which item in the diet?
Vegetables
The nurse has reinforced home care measures to a client diagnosed with diabetes mellitus
regarding exercise and insulin administration. Which statement by the client indicates a need for
further teaching?
"I should perform my exercise at peak insulin time.
The nurse is caring for a client newly diagnosed with diabetes mellitus. The client asks the nurse
whether eating at a restaurant will affect the diabetic control and whether this is allowed. Which
nursing response is appropriate?
"You should order a half-portion meal and have fresh fruit for dessert.
A client who is managing diabetes mellitus with insulin injections asks the nurse for information
about any necessary changes in her diet to avoid hyperinsulinism. Which diet would be
appropriate for the client?
Small frequent meals with protein, fat, and carbohydrates at each meal
A client has an endocrine system dysfunction of the pancreas. The nurse anticipates that the
client will exhibit impaired secretion of which substance?
Insulin
The nurse is reinforcing discharge instructions to a client who had a unilateral adrenalectomy.
Which information should be a component of the instructions?
Instructions about early signs of a wound infection
The nurse is caring for a client experiencing thyroid storm. Which should be a priority concern
for this client?
Potential for cardiac disturbances
The nurse is collecting data on a client with hyperparathyroidism. Which question would elicit
accurate information about this condition from the client?
"Are you experiencing pain in your joints?
A client is in metabolic acidosis caused by diabetic ketoacidosis (DKA). The nurse prepares for
the administration of which medication as a primary treatment for this problem?
Regular insulin
The nurse is caring for a postoperative adrenalectomy client. Which finding does the nurse
specifically monitor for in this client?
The possibility of injury as a result of decreased sensation in the legs and feet
The nurse is monitoring the results of periodic serum laboratory studies drawn on a client with
diabetic ketoacidosis (DKA) receiving an insulin infusion. The nurse determines that which value
needs to be reported?
Potassium 3.1 mEq/L
The wife of a client with diabetes mellitus who takes insulin calls the nurse in a health care
provider's office about her husband. She states that her husband is sleepy and that his skin is
warm and flushed. She adds that his breathing is faster than normal and his pulse rate seems
fast. Which action should the nurse tell the wife to do first?
Check his blood glucose level.
A client recently diagnosed with diabetes mellitus requiring insulin tells the clinic nurse that he is
traveling by air throughout the next week. The client asks the nurse for any suggestions about
managing the disorder while traveling. Which action should the nurse tell the client to do?
Keep snacks in carry-on luggage to prevent hypoglycemia during the flight.
A client scheduled for a thyroidectomy says to the nurse, "I am so scared to get cut in my neck."
Based on the client's statement, the nurse determines that the client is experiencing which
problem?
Fear about impending surgery
The nurse is caring for a client with Addison's disease. The nurse checks the client's vital signs
and determines that the client has orthostatic hypotension. The nurse determines that this
finding relates to which factor?
A decreased secretion of aldosterone
Which nursing measure would be effective in preventing complications in a client with Addison's
disease?
Monitoring the blood glucose
The nurse is collecting data on a client with a diagnosis of hypothyroidism. Which of these
behaviors, if present in the client's history, should the nurse determine as being likely related to
the symptoms of this disorder?
Depression
While collecting data on a client being prepared for an adrenalectomy, the nurse obtains a
temperature reading of 100.8 F. The nurse analyzes this temperature reading as which?
A finding that needs to be reported immediately
The anticipated intended effect of fludrocortisone acetate (Florinef) for the treatment of
Addison's disease is which?
Promote electrolyte balance.
The nurse is caring for a client with hypothyroidism who is overweight. Which food items should
the nurse suggest to include in the plan?
Skim milk, apples, whole-grain bread, and cereal
A client has a blood glucose level drawn for suspected hyperglycemia. After interviewing the
client, the nurse determines that the client ate lunch approximately 2 hours before the blood
specimen was drawn. The laboratory reports the blood glucose to be 180 mg/dL, and the nurse
analyzes this result as indicative of which interpretation?
Elevated from the normal value
In planning nutrition for the client with hypoparathyroidism, which diet would be appropriate?
High in calcium and low phosphorous
The nurse is caring for a client with type 1 diabetes mellitus who is hyperglycemic. Which
problem should the nurse consider first, when planning care for this client?
Signs of dehydration
A preoperative client is scheduled for adrenalectomy to remove a pheochromocytoma. The
nurse should most closely monitor which assessment in the preoperative period?
Vital signs
The nurse working on an endocrine nursing unit understands that which correct concept is used
in planning care?
Clients who have hyperparathyroidism should be protected against falls.
Glucagon hydrochloride injection would most likely be prescribed for which disorder?
Type 1 diabetes mellitus
The nurse is caring for a child with a diagnosis of diabetes insipidus. The nurse anticipates that
the health care provider will prescribe which medications?
Desmopressin acetate (DDAVP)
When caring for a client diagnosed with pheochromocytoma, which information should the nurse
know when assisting with planning care?
Excessive catecholamines are released.
A client with pheochromocytoma is scheduled for surgery and says to the nurse, "I'm not sure
that surgery is the best thing to do." Which response by the nurse is appropriate?
"You have concerns about the surgical treatment for your condition?
A client with Cushing's syndrome verbalizes concern to the nurse regarding the appearance of
the buffalo hump that has developed. Which response by the nurse is appropriate?
"Usually, these physical changes slowly improve following treatment.
A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the
treatment of hyperglycemia. Which intervention would be appropriate to decrease the client's
anxiety?
Convey empathy, trust, and respect toward the client.
The nurse is collecting data from a client with type 2 diabetes mellitus. Which statement by the
client indicates an understanding of the medication regimen?
"The medication that I am taking helps release the insulin I already make.
The nurse is collecting data from a client who is being admitted to the hospital for a diagnostic
workup for primary hyperparathyroidism. The nurse understands that which client complaint
would be characteristic of this disorder?
Polyuria
The nurse is preparing to discharge a client who has had a parathyroidectomy. When reinforcing
instructions to the client about the prescribed oral calcium supplement, which information should
the nurse include?
Take the calcium 30 to 60 minutes following a meal.
A client is brought to the emergency department with suspected diabetic ketoacidosis (DKA).
Which finding should the nurse note as being consistent with this diagnosis?
High serum glucose level and low serum bicarbonate level
A client is admitted with a diagnosis of pheochromocytoma. The nurse should monitor which
parameter to detect the most common sign of pheochromocytoma?
Blood pressure elevation
During data collection on a postoperative client who has undergone hypophysectomy, the client
complains of thirst and frequent urination. Knowing the expected complication of this surgery,
the nurse should check which parameter next?
Urine specific gravity
A client with diabetes mellitus is scheduled to have a fasting blood glucose level determined in
the morning. The nurse tells the client not to eat or drink after midnight. When the client asks for
further information, the nurse clarifies by stating that which should be acceptable to take before
the test?
Water
A client with a pituitary tumor will undergo transsphenoidal hypophysectomy. The nurse
reinforces which information in the preoperative teaching plan for the client?
Blowing the nose following surgery is prohibited.
A client who returned to the nursing unit 8 hours ago after hypophysectomy has clear drainage
saturating the nasal dressing. The nurse should take which action?
Test the drainage for glucose.
A client with newly diagnosed Cushing's syndrome expresses concern about personal
appearance, specifically about the "buffalo hump" that has developed at the base of the neck.
When counseling the client about this symptom, the nurse should incorporate which knowledge?
It may slowly improve with treatment of the disorder.
A client has just been admitted with a diagnosis of myxedema coma. If all of the following
interventions were prescribed, the nurse should place highest priority on completing which
action first?
Administering oxygen
The nurse has just supervised a newly diagnosed diabetes mellitus client self-inject NPH insulin
at 7:30 . The nurse reviews the time frames for peak insulin action with the client, telling the
client to be especially watchful for a hypoglycemic reaction between which time frame?
1:30 and 7:30
The nurse is discussing foot care with a diabetic client and the spouse. The nurse includes
which instruction during this informational session?
The toenails should be cut straight across.
The nurse has provided diabetic teaching with the family of a client newly diagnosed with
diabetes. The nurse determines that the family understands the reason for having glucagon on
hand for emergency home use if the family indicates that the purpose of the medication is to
treat which condition?
Hypoglycemia from insulin overdose
After receiving furosemide (Lasix) 40 mg slow intravenous push for chest pain related to
shortness of breath and generalized edema, the client responds poorly. The client has no relief
of the chest pain, shortness of breath, or edema and only minimal urine output (less than 40 mL
of urine). The health care provider is notified, and after reviewing the chart, suspects the client
has syndrome of inappropriate antidiuretic hormone (SIADH). Which findings would lead to this
specific diagnosis? Refer to chart.
Minimal responsiveness to furosemide (Lasix) and small cell lung cancer