Nclex-Rn Practice Questions-Care Of Adult - Endocrine Disorders Part 3
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Question 1 |
A client is in diabetic ketoacidosis, secondary to infection. As the condition progresses, which symptoms might the nurse see?
A | Kussmaul’s respirations and a fruity odor on the breath |
B | Shallow respirations and severe abdominal pain |
C | Decreased respirations and increased urine output |
D | Cheyne-Stokes respirations and foul-smelling urine |
Question 2 |
An attack of pancreatitis has been brought on by gallstones and gallbladder disease. The client will require reinforcement about the need to follow which type of diet?
A | High-calorie, high-protein diet |
B | High-fiber diet, encouraging fluid intake |
C | Low-fat diet, avoiding heavy meals |
D | Diet high in protein, calcium, and vitamin D |
Question 3 |
The nurse is modifying the plan of care for a client who is recovering from acute pancreatitis. Which of these measures would be the most appropriate to include in the care plan?
A | Eat small, frequent meals that are bland, high carbohydrate, high protein, and low fat. |
B | Consume no more than one alcoholic drink per day and limit coffee to three cups per day. |
C | Include fruits and vegetables that are high in vitamin C and K and increase fiber. |
D | Maintain a diet that is low residue, low protein, and high in calcium. |
Question 4 |
Which test should a nurse expect to be ordered for a client with severe abdominal pain in the midepigastric region, back tenderness, nausea, and vomiting?
A | Amylase |
B | C-peptide |
C | Stool culture |
D | Colonoscopy |
Question 5 |
After undergoing a thyroidectomy, a client develops a positive Trousseau’s sign and muscle hyperexcitability, which can lead to tetany. These signs are caused by which of the following?
A | Hyperkalemia |
B | Hypercalcemia |
C | Hypokalemia |
D | Hypocalcemia |
Question 6 |
After undergoing a thyroidectomy, a client develops hypocalcemia and tetany caused by inadvertent damage to the parathyroid glands. Which medication should the nurse anticipate administering?
A | Calcium gluconate |
B | Potassium chloride |
C | Sodium bicarbonate |
D | Sodium phosphorus |
Question 7 |
The nurse is reviewing a client’s chart and notes a low serum calcium level. The nurse assesses the client and notes development of a carpopedal spasm when blood flow in the arm is occluded for a few minutes with a blood pressure cuff. The nurse interprets this as which sign?
A | Negative Chvostek’s sign |
B | Positive Chvostek’s sign |
C | Negative Trousseau’s sign |
D | Positive Trousseau’s sign |
Question 8 |
A client is diagnosed with a somatotrophin-secreting tumor that could lead to development of acromegaly, Cushing’s syndrome, and hypopituitarism. Which gland is related to this tumor?
A | Adrenal gland |
B | Hypothalamus |
C | Pituitary gland |
D | Thyroid gland |
Question 9 |
A nurse is providing teaching to a client with hypoparathyroidism. Which vitamin therapy should she include in her teaching?
A | Vitamin A |
B | Vitamin C |
C | Vitamin D |
D | Vitamin E |
Question 10 |
Clients with insulin-dependent diabetes mellitus may require which change to their daily routine during periods of infection?
A | No changes |
B | Less insulin |
C | More insulin |
D | Oral antidiabetic agents |
Question 11 |
The nurse admits a client whose initial laboratory tests reveal hyperphosphatemia and hypocalcemia. The nurse suspects which of the following disorders?
A | Cushing’s syndrome |
B | Graves’ disease |
C | Hypoparathyroidism |
D | Hypothyroidism |
Question 12 |
The nurse is providing education to a client who has been diagnosed with hyperparathyroidism. The nurse determines further teaching is necessary when the client states that they will continue to take:
A | acetaminophen. |
B | aspirin. |
C | potassium-wasting diuretics. |
D | thiazide diuretics. |
Question 13 |
The nurse is caring for a middle-aged athletic client with hyperparathyroidism. The client has been further diagnosed with kidney stones. The client is currently showing signs of apathy and depression, and despite the client’s athleticism, the nurse’s assessment finds flabby musculature. Based on the diagnosis and signs and symptoms, the nurse suspects which of the following conditions?
A | Hypercalcemia |
B | Hypocalcemia |
C | Hypernatremia |
D | Hyponatremia |
Question 14 |
The nurse is preparing an insulin infusion for a client in diabetic ketoacidosis (DKA). Which of the following would be the appropriate type of insulin to use for I.V. infusion?
A | Lantus |
B | NPH |
C | Humalog |
D | Regular |
Question 15 |
The nurse and a nursing student are caring for a client who is diagnosed with hyperglycemic hyperosmolar state (HHS). The student asks the nurse how HHS differs from diabetic ketoacidosis (DKA). Which is the correct reply by the nurse?
A | HHS displays little or no ketones. |
B | HHS has no potential for hypokalemia. |
C | HHS presents with lower blood glucose than DKA. |
D | HHS presents with normal hydration. |
Question 16 |
Which nursing diagnosis would have the highest priority for a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS)?
A | Risk for infection |
B | Risk for acute confusion |
C | Deficient fluid volume |
D | Impaired skin integrity |
Question 17 |
The nurse is preparing to administer I.V. insulin to a client diagnosed with diabetic ketoacidosis. The client is at risk for which conditions?
A | Hypokalemia and hypoglycemia |
B | Hypocalcemia and hyperkalemia |
C | Hyperkalemia and hyperglycemia |
D | Hypernatremia and hypercalcemia |
Question 18 |
The nurse is admitting a client with the diagnosis of diabetic ketoacidosis (DKA). The nurse should anticipate administration of which of the following treatments?
A | Glucagon and I.V. fluids |
B | Blood products |
C | Glucocorticoids |
D | Insulin and I.V. fluids |
Question 19 |
The nurse is caring for a client with type 1 diabetes mellitus. At 3:00 a.m., the nurse finds the client manifesting mild confusion and diaphoresis and complaining of palpitations. Which of the following should the nurse do first?
A | Give 10 to 15 g of carbohydrate orally. |
B | Call the physician for additional insulin order. |
C | Administer 1 mg of glucagon subcutaneously. |
D | Check blood glucose level. |
Question 20 |
The nurse is providing education about sick-day rules to a group of clients with type 1 diabetes mellitus. Which of the following information is appropriate to include?
A | Monitor blood glucose at least once a day. |
B | Do not take insulin until you feel well. |
C | Drink 8 to 12 oz of fluid each waking hour. |
D | If nauseated, cease all oral intakes. |
Question 21 |
The home health nurse is visiting a new type 1 diabetic client and finds the client lethargic with very deep, rapid respirations. The client reports nausea and abdominal pain. The nurse observes dehydration, dry skin, and weight loss. The nurse suspects which of the following diabetic complications?
A | Hypoglycemia |
B | Diabetes insipidus |
C | Myxedema |
D | Ketoacidosis |
Question 22 |
The nurse is caring for a client who was admitted with a diagnosis of diabetic ketoacidosis (DKA). The nurse is aware of possible complications related to fluid and electrolyte imbalances. Which of the following laboratory tests would be the priority to monitor as the client receives initial treatment of insulin and I.V. fluids?
A | Serum potassium |
B | A1C |
C | Serum calcium |
D | Serum nitrogen |
Question 23 |
A nurse is preparing to administer “Regular insulin 4 units subcutaneously” to a client with type 1 diabetes mellitus. Which equipment does the nurse need to perform the injection?
A | 27-gauge, ½″ needle |
B | 22-gauge, ½″ needle |
C | 27-gauge, 1″ needle |
D | 22-gauge, 1″ needle |
Question 24 |
The nurse checks on a diabetic client and finds the client lethargic, difficult to arouse, and profusely diaphoretic. The nurse immediately checks the client’s blood glucose and finds it to be 40 mg/dl. Which of the following interventions is the priority?
A | Obtain a urine sample and assess for ketones. |
B | Give 10 to 15 g of carbohydrate orally. |
C | Give 1 mg of glucagon subcutaneously. |
D | Call the physician for addition insulin order. |
Question 25 |
The nurse is caring for a 47-year-old client admitted with joint pain and weakness. The client describes a gradual coarsening of facial features and enlargement of hands and feet over the past year. The nurse is aware that these are early clinical manifestations of which condition?
A | Acromegaly |
B | Cushing’s syndrome |
C | Graves’ disease |
D | Pheochromocytoma |
Question 26 |
A 48-year-old client has been admitted with complaints of acute abdominal pain in the midepigastric region, back tenderness, nausea, and vomiting. The nurse recognizes these findings to be associated with which condition?
A | Acute pancreatitis |
B | Crohn’s disease |
C | Hypophysectomy |
D | Pheochromocytoma |
Question 27 |
A 55-year-old client is admitted with hyperthyroidism. What is the most important nursing intervention?
A | Keeping the client warm |
B | Encouraging the client to increase activity |
C | Providing a calm, restful environment |
D | Placing the client in high Fowler’s position |
Question 28 |
The serum calcium level of a client with hyperparathyroidism is 14.6 mg/dl. Which treatment should the nurse anticipate?
A | Withholding fluids |
B | Starting oral calcium supplements |
C | Giving vitamin D supplements |
D | Administering I.V. fluids at 200 ml/hour |
Question 29 |
A client is exhibiting Kussmaul’s respirations, abdominal discomfort, and lethargy. If random serum glucose is 325 mg/dl, which additional test should be conducted?
A | Complete blood count (CBC) |
B | Serum ketones |
C | Blood urea nitrogen (BUN)/creatinine |
D | Liver enzymes |
Question 30 |
The nurse is caring for a client admitted to the emergency department with weakness, thirst, and an inability to concentrate. Laboratory results show a serum glucose of 712 mg/dl, urine negative for ketones, and minimal electrolyte imbalance. For which diabetic complication should the client be evaluated?
A | Hypoglycemia |
B | Diabetes insipidus |
C | Diabetic ketoacidosis (DKA) |
D | Hyperglycemic hyperosmolar state (HHS) |
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