Nclex-Rn Practice Questions-Care of Adults Endocrine Management
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Question 1 |
The nurse determined that the client’s fluid volume deficit from HHNS has resolved. Which serum laboratory finding led to the nurse’s conclusion?
A | Decreased glucose |
B | Decreased sodium |
C | Decreased osmolality |
D | Decreased potassium |
Question 2 |
The nurse is caring for the client who is experiencing symptoms associated with pheochromocytoma. Which intervention should be included in the plan of care for this client?
A | Offer distractions such as television or music. |
B | Encourage family and friends to visit often. |
C | Assist with ambulation at least three times a day. |
D | Administer nicardipine for hypertension. |
Question 3 |
The nurse is preparing to discharge the client following a unilateral adrenalectomy to treat hyperal- dosteronism caused by an adenoma. Which instruction should be included in this client’s discharge teaching?
A | Avoid foods high in potassium |
B | Self—monitor blood pressure daily |
C | Stop drugs taken before adrenalectomy |
D | Carry epinephrine for emergency use |
Question 4 |
The nurse is caring for the client admitted in Addisonian crisis. Which medication, if prescribed, should the nurse plan to administer?
A | Regular insulin |
B | Ketoconazole |
C | Sodium nitroprusside |
D | Hydrocortisone |
Question 5 |
The nurse is preparing to care for the stable client with Addison’s disease. Which skin appearance should the nurse expect when performing an assessment?
A | Very white, dry, and scaly |
B | Bronzed and suntanned hue |
C | Diaphoretic and cyanotic |
D | Puffy and butterfly-like rash |
Question 6 |
The nurse is teaching the client who lacks parathyroid hormone (PTH) about foods to consume. Which items should be included on a list of appropriate foods for the client?
A | Dark green vegetables, soybeans, and tofu |
B | Spinach, strawberries, and yogurt |
C | Whole grain bread, milk, and liver |
D | Rhubarb, yellow vegetables, and fish |
Question 7 |
The nurse is caring for the client newly diagnosed with hypothyroidism. Which problem should the nurse include in the plan of care?
A | Diarrhea due to gastrointestinal (GI) hypennotility |
B | Imbalanced nutrition due to insufficient calorie intake |
C | Activity intolerance due to increased metabolic rate |
D | Anxiety due to forgetfulness and slowed speech |
Question 8 |
The nurse is caring for the client with elevated growth hormone (GH) levels. Which problem should the nurse exclude from the plan of care?
A | Fluid volume deficit due to polyuria |
B | Insomnia due to soft tissue swelling |
C | Impaired communication due to speech difficulties |
D | Altered body image due to undersized hands, feet, and jaw |
Question 9 |
The nurse is planning to address diabetic meal planning with the client recently diagnosed with type 1 DM. Which action should the nurse take first?
A | Encourage use of non-nutritive sweeteners that contain no calories. |
B | Emphasize the importance of keeping regular mealtimes every day. |
C | Teach the client how to count the carbohydrates in meals and snacks. |
D | Ask the client to identify favorite foods and the client’s usual mealtimes. |
Question 10 |
A friend brings the older adult homeless client to a free health screening clinic. The friend is unable to continue administering the client’s morning and evening insulin dose for treating type 1 DM. When advocating for this client, which action by the nurse is most appropriate?
A | Notify Adult Protective Services about the client’s condition and living situation. |
B | Ask where the client lives and whether someone else could administer the insulin. |
C | Arrange with a local homeless shelter to have someone give the insulin injections. |
D | Have the client return to the screening clinic morning and evening to receive the injections. |
Question 11 |
The clinic nurse is evaluating the client with type 1 DM who intends to enroll in a tennis class. Which statement made by the client indicates that the client understands the effects of exercise on insulin demand?
A | “I will carry a high-fat, high-calorie food, such as a cookie.” |
B | “I Will administer 1 unit of lispro insulin prior to playing tennis.” |
C | “I will eat a 15-grarn carbohydrate snack before playing tennis.” |
D | “I Will need to rest for a While during tennis if l feel sweaty or shaky.” |
Question 12 |
The nurse is reviewing information for the client with type 1 DM.The nurse concludes that the client may be experiencing the Somogyi phenomenon, as evidenced by which finding?
A | 02.00 blood glucose between 80—1 10 mg/dL and morning levels between 80—100 mg/dL |
B | 0200 blood glucose between 50—60 mg/dL and morning levels between 48—62 mg/dL |
C | 0200 blood glucose between 130—140 mg/dL and morning levels between 180—200 mg/dL |
D | 0200 blood glucose between 45—62 mg/dL and morning levels between 200—3 05 ing/dL |
Question 13 |
The client with type 1 DM is scheduled for major surgery in the morning. The nurse on the night shift observes that the client’s daily insulin dose remains the same as previously given. Which nursing action is most appropriate?
A | Notify the prescribing HCP about the client’s surgery and ask about any insulin changes. |
B | Write an order to decrease the morning insulin dose by one-half of the prescribed dose. |
C | Do nothing; the HCP would want the client to receive the usual insulin dose prior to surgery. |
D | Have the day shift nurse check a mooring glucose level and, if normal, hold the insulin dose. |
Question 14 |
The nurse is teaching the client newly diagnosed with type 2 DM. Which information should the nurse emphasize in the session?
A | Use the arm when self-administering insulin. |
B | Exercise for 30 minutes daily, preferably after a meal. |
C | Consume 30% of the daily calorie intake from protein foods. |
D | Eat a 30-gram carbohydrate snack prior to strenuous activity. |
Question 15 |
The nurse is interviewing four clients. Which client is at the greatest risk for developing type 2 DM?
A | 56-year-old Hispanic female |
B | 40-year—old Asian American female |
C | 25-year-old obese Caucasian male |
D | 38-year-old Native American male |
Question 16 |
The client with type 2 DM is scheduled for cardiac rehabilitation exercises (cardiac rehab). The nurse notes that the client’s blood glucose level is 300 mg/dL and that the urine is positive for ketones. How should the nurse proceed?
A | Send the client to cardiac rehab; exercise will lower the client’s glucose level. |
B | Give insulin; send the client for exercises with a 15-gram carbohydrate snack. |
C | Delay cardiac rehab; blood glucose levels will decrease too much with exercise. |
D | Cancel cardiac rehab; blood glucose levels will increase further with exercise. |
Question 17 |
The client residing in a long-term care facility has type 2 DM and is sick with the stomach flu. The client’s blood glucose is 245 mg/dL. Which action should the nurse take next?
A | Have the client void and check the urine for ketones. |
B | Keep the client NPO until blood glucose levels decline. |
C | Immediately contact the client’s health care provider. |
D | Continue to monitor blood glucose levels every 6 hours. |
Question 18 |
The nurse administers a usual morning dose of 4 units of regular insulin and 8 units of NPH insulin at 7:30 am. to the client with a blood glucose level of 110 mg/dL. Which statements regarding the client’s insulin are correct?
A | The onset of the regular insulin will be at 7:45 am. and the peak at 1:00 pm. |
B | The onset of the regular insulin will be at 8:00 am. and the peak at 10:00 am. |
C | The onset of the NPH insulin will be at 8:00 am. and the peak at 10:00 am. |
D | 6. The onset of the NPH insulin will be at 12:30 pm. and the peak at 11:30 pm. |
Question 19 |
The nurse assesses that the client diagnosed with Cushing’s syndrome has an irregular HR, right arm ecchymosis, 4+ pitting edema in the legs, and a blood glucose of 140 mg/dL. Which action should be the nurse’s priority?
A | Weigh the client again |
B | Administer insulin as prescribed |
C | Notify the health care provider |
D | Measure the client’s abdominal girth |
Question 20 |
The nurse reviews the HCP’s orders for the newly admitted client diagnosed with DKA. Which order should the nurse question?
A | Administer D5W intravenously (TV) at 125 mL per hour |
B | Administer KCL 10 mEq in 100 mL NaCl IV now |
C | Give sodium bicarbonate IV per pharmacy dosing if arterial pH is less than 7.0 |
D | Start regular insulin infusion per protocol; titrate based on hourly glucose level |
Question 21 |
The female client is to be treated with radioactive iodine (RAI) therapy for an enlarged thyroid gland. The client asks if there are any precautions that are needed. during RAI therapy. Which is the nurse’s best response?
A | “No precautions are necessary. The radiation in the form of an oral capsule will target and destroy thyroid tissue only.” |
B | “Use contraceptives or abstain from sexual intercourse to avoid conceiving during and for6 months after treatment.” |
C | “Discontinue taking the antithyroid medication and propranolol; results are seen immediately with RA] therapy.” |
D | “Some people need a thyroid hormone replacement, but it is not necessary when the thyroid gland is enlarged.” |
Question 22 |
The nurse is caring for multiple clients with DM. It is most important for the nurse to initiate a referral to a diabetes educator for which client?
A | The client who states diabetes is well controlled with diet and exercise; Hgb Alc is 11%. |
B | The client requesting diabetes information; fingerstick glucose is 132 mg/dL, Hgb Alc is 5.6%. |
C | The client who states perfect compliance with diet, exercise, and meds; Hgb A1c is 7%. |
D | The client with short-term memory loss; fingerstick glucose is 110 mg/dL, Hgb A1C is 4.5%. |
Question 23 |
The nurse is reviewing the serum laboratory report for the hospitalized client who has adrenocortical insufficiency. The nurse should immediately notify the HCP about which value?
A | WBC 11,000/mm3 |
B | Glucose 138 mg/dL |
C | Sodium 148 mEq/L |
D | Potassium 6.2 mEq/L |
Question 24 |
The nurse observes a colleague caring for the client who had a hypophysectomy via the transsphenoidal approach 12 hours ago. Which action would require the observing nurse to intervene?
A | Elevates the head of the client’s bed to 30 degrees |
B | Gathers supplies to replace the bloody nasal packing |
C | Moisturizes the client’s oral mucous membranes |
D | Places a cold washcloth over the client’s swollen eyes |
Question 25 |
The nurse administers 15 units of glargine insulin at 2100 hours to the client when the client’s fingerstick blood glucose reading is 110 mg/dL. At 2300, an NA reports that an evening snack was not given because the client was sleeping. Which instruction by the nurse is most appropriate?
A | “You will need to wake the client to check the blood glucose and then give a snack. All diabetics get a snack at bedtime.” |
B | “It is not necessary for this client to have a snack; glargine insulin is absorbed over 24 hours and doesn’t have a peak.” |
C | “The next time the client wakes up, check a blood glucose level and then give a 15-gram carbohydrate snack.” |
D | “I will notify the HCP; a snack at this time will affect the next blood glucose level and dose of glargine insulin.” |
Question 26 |
The nurse is caring for the client with Addisonian crisis. Which clinical change should indicate to the nurse that the therapy is effective?
A | Increase of 25 mm Hg in the client’s blood pressure |
B | Decrease of 25 mm Hg in the systolic blood pressure |
C | Increase in serum potassium from 3.4 to 5.8 mEq/dL |
D | Decrease in serum sodium from 146 to 136 mEq/LThe nurse is admitting the client tentatively diagnosed with possible hyperaldosteronism. What should be the nurse’s priority? |
E | C |
Question 27 |
The nurse evaluates the client who is being treated for DKA. Which finding indicates that the client is responding to the treatment plan?
A | Eyes sunken and skin flushed |
B | Skin moist with rapid elastic recoil |
C | Serum potassium level is 3.3 mEq/L |
D | ABG results are pH 7.25. Paco2 30. HCO; 17 |
Question 28 |
The nurse obtains a fingerstick blood glucose reading of 48 mg/dL for the client with type 1 DM. The client is to receive 6 units of regular and 10 units of NPH insulin now. Which is the nurse’s best immediate intervention?
A | Administer the insulin that is due now. |
B | Call the lab for a STAT serum glucose level. |
C | Have the client choose foods for a meal now. |
D | Provide juice with 15 grams of carbohydrates. |
Question 29 |
Two hours after taking a regular morning dose of regular insulin, the client presents to a clinic with diaphoresis, tremors, palpitations, and tachycardia. Which nursing action is most appropriate?
A | Check pulse oxirnetry; if 94% or less, start oxygen at 2 L per nasal cannula. |
B | Give a baby aspirin and one nitroglycerin tablet; obtain an electrocardiogram. |
C | Check blood glucose level; provide carbohydrates if less than 70 mg/dL (3.8 mmol/L). |
D | Check heart rate; if the HR is above 120 beats per minute, give aten010125 mg orally. |
Question 30 |
The client develops SIADH secondary to a pituitary tumor. The client’s assessment findings include thirst, weight gain, fatigue, and a serum sodium of 127 mEq/L. Which intervention, if prescribed, should the nurse implement to treat SIADH?
A | Elevate the head of the bed 30 degrees |
B | Administer vasopressin intravenously (IV) |
C | Restrict fluids to 800 to 1000 ml. per day |
D | Give 0.3% sodium chloride IV infusion |
Question 31 |
The agitated client is hospitalized with tachycardia, dyspnea, and intermittent chest palpitations. The client’s BP is 170/110 mm Hg, and HR is 130 bpm. The client’s health history reveals thinning hair, recent 10-lb weight loss, increased appetite, fine hand and tongue tremors, hyperreflexic tendon reflexes, and smooth, moist skin. Which prescribed intervention should be the nurse’s priority?
A | 12-lead electrocardiogram (ECG) and cardiac enzyme levels. |
B | Obtain thyroid-stimulating hormone (TSH) and free T4 levels. |
C | Propranolol 2 mg IV q15 min or until symptoms are controlled. |
D | Propylthiouracil 600-mg oral loading dose; then 200 mg orally q4h. |
Question 32 |
The client taking NPH insulin at 0800 reports feeling anxious and shaky in the midafternoon. Which intervention is best for the nurse to initiate?
A | Have the client rate the level of anxiety. |
B | Give the client’s prn dose of lorazepam. |
C | Check the client’s fingerstick blood glucose level. |
D | Advise the client to sit in a recliner to relax. |
Question 33 |
The nurse completes teaching the client with Cushing’s disease- Which statement demonstrates that the client understands measures to prevent bone resorption from corticosteroid therapy?
A | “I will increase calcium in my diet to 3000 mg daily.” |
B | “1 should participate in daily weight-bearing exercises.” |
C | “I should limit my dietary intake of sodium and vitamin D.” |
D | “I plan to rise slowly from a bed or chair to avoid falling.” |
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