MSNCB Endocrine Nursing 3 — Questions and Answers
Question 1: A patient with SIADH would be expected to have which serum sodium level?
- 148 mEq/L
- 140 mEq/L
- 122 mEq/L (Correct answer)
- 135 mEq/L
Correct answer: 122 mEq/L
SIADH causes water retention without sodium retention, diluting serum sodium below 135 mEq/L, often significantly lower.
Question 2: Which intervention is the PRIORITY for a patient in thyroid storm (thyrotoxic crisis)?
- Administer radioactive iodine therapy
- Apply warming blankets to treat hypothermia
- Administer propylthiouracil (PTU) and propranolol (Correct answer)
- Prepare patient for immediate thyroidectomy
Correct answer: Administer propylthiouracil (PTU) and propranolol
Thyroid storm treatment prioritizes blocking new thyroid hormone synthesis with PTU and controlling sympathetic symptoms with propranolol.
Question 3: A patient with type 2 diabetes is ordered a fasting lipid panel. The nurse knows the patient's LDL target should be less than:
- 130 mg/dL
- 100 mg/dL (Correct answer)
- 160 mg/dL
- 200 mg/dL
Correct answer: 100 mg/dL
ADA guidelines recommend LDL <100 mg/dL for most patients with diabetes, or <70 mg/dL for those with cardiovascular disease.
Question 4: Which sign/symptom is MOST specific to a pheochromocytoma?
- Persistent hypertension unresponsive to medication
- Episodic hypertension with headache, diaphoresis, and palpitations (Correct answer)
- Orthostatic hypotension with tachycardia
- Hypertension with bilateral leg edema
Correct answer: Episodic hypertension with headache, diaphoresis, and palpitations
Pheochromocytoma classically presents with paroxysmal episodes of hypertension, severe headache, diaphoresis, and palpitations due to catecholamine surges.
Question 5: A nurse is caring for a patient receiving insulin glargine. Which statement about this insulin is CORRECT?
- It has a peak action at 4-6 hours after injection
- It can be mixed with regular insulin in the same syringe
- It provides a steady, peakless 24-hour basal coverage (Correct answer)
- It must be administered 30 minutes before meals
Correct answer: It provides a steady, peakless 24-hour basal coverage
Insulin glargine (Lantus) is a long-acting basal insulin with no pronounced peak, providing approximately 24 hours of steady glucose control.
Question 6: A patient with adrenal insufficiency (Addison's disease) is scheduled for surgery. The nurse should anticipate which perioperative intervention?
- Administering mineralocorticoid supplements only
- Withholding all steroids to prevent infection risk
- Providing stress-dose corticosteroid coverage (Correct answer)
- Restricting IV fluid administration preoperatively
Correct answer: Providing stress-dose corticosteroid coverage
Patients with adrenal insufficiency cannot mount a normal cortisol stress response, requiring supraphysiologic 'stress-dose' steroids during surgical stress.
Question 7: Which instruction is MOST important for a patient newly diagnosed with diabetes insipidus being discharged on desmopressin (DDAVP)?
- Take the medication with a full glass of orange juice
- Monitor daily weight and report gains of more than 2 lbs (Correct answer)
- Increase sodium intake to compensate for urinary losses
- Avoid all physical activity while on this medication
Correct answer: Monitor daily weight and report gains of more than 2 lbs
DDAVP can cause fluid retention and dilutional hyponatremia; daily weight monitoring helps detect early signs of water intoxication.
MSNCB Endocrine Nursing 3
A patient with SIADH would be expected to have which serum sodium level?