MSNCB Endocrine Nursing 2 — Questions and Answers
Question 1: A patient with type 1 diabetes presents with blood glucose of 42 mg/dL, diaphoresis, and confusion. Which intervention should the nurse perform FIRST?
- Administer 1 mg glucagon IM
- Give 15-20g of fast-acting carbohydrate orally (Correct answer)
- Start an IV and administer 50% dextrose
- Notify the physician immediately
Correct answer: Give 15-20g of fast-acting carbohydrate orally
If the patient can swallow safely, oral fast-acting carbohydrates (15-20g) are the first-line treatment for mild-to-moderate hypoglycemia.
Question 2: Which laboratory finding is MOST consistent with primary hypothyroidism?
- Low TSH and low T4
- High TSH and low T4 (Correct answer)
- High TSH and high T4
- Low TSH and high T4
Correct answer: High TSH and low T4
Primary hypothyroidism is characterized by elevated TSH (pituitary compensation) and low T4 due to inadequate thyroid gland function.
Question 3: A patient post-thyroidectomy develops perioral tingling and a positive Chvostek's sign. The nurse should anticipate administering:
- Potassium chloride IV
- Magnesium sulfate IV
- Calcium gluconate IV (Correct answer)
- Sodium bicarbonate IV
Correct answer: Calcium gluconate IV
Positive Chvostek's sign with perioral tingling indicates hypocalcemia, a common complication after thyroidectomy due to inadvertent parathyroid removal.
Question 4: When teaching a patient about metformin therapy for type 2 diabetes, the nurse should instruct the patient to withhold the medication before:
- Blood glucose monitoring
- Iodinated contrast dye procedures (Correct answer)
- Routine physical therapy
- Ophthalmology appointments
Correct answer: Iodinated contrast dye procedures
Metformin should be held 48 hours before iodinated contrast procedures due to the risk of contrast-induced nephropathy leading to lactic acidosis.
Question 5: A patient with Cushing's syndrome would be expected to exhibit which combination of findings?
- Hypotension, weight loss, and hyperpigmentation
- Hypertension, central obesity, and purple striae (Correct answer)
- Hypoglycemia, muscle weakness, and bronze skin
- Bradycardia, hair loss, and dry skin
Correct answer: Hypertension, central obesity, and purple striae
Cushing's syndrome is caused by excess cortisol and presents with hypertension, central obesity, moon face, buffalo hump, and purple striae.
Question 6: Which electrolyte imbalance is MOST commonly associated with hyperaldosteronism (Conn's syndrome)?
- Hyperkalemia and hyponatremia
- Hypokalemia and hypernatremia (Correct answer)
- Hyperphosphatemia and hypocalcemia
- Hypomagnesemia and hyperchloremia
Correct answer: Hypokalemia and hypernatremia
Excess aldosterone promotes sodium retention and potassium excretion, resulting in hypokalemia and hypernatremia with resultant hypertension.
Question 7: A patient with DKA has an arterial blood gas showing pH 7.18, PaCO2 28 mmHg, HCO3 10 mEq/L. The nurse recognizes this as:
- Metabolic alkalosis with respiratory compensation
- Respiratory acidosis with metabolic compensation
- Metabolic acidosis with respiratory compensation (Correct answer)
- Combined respiratory and metabolic alkalosis
Correct answer: Metabolic acidosis with respiratory compensation
DKA causes metabolic acidosis (low pH, low HCO3); the low PaCO2 reflects respiratory compensation (Kussmaul respirations blowing off CO2).
MSNCB Endocrine Nursing 2
A patient with type 1 diabetes presents with blood glucose of 42 mg/dL, diaphoresis, and confusion.
Which intervention should the nurse perform FIRST?