NCLEX Medical-Surgical: Endocrine Disorders

Question 1

A patient is admitted with diabetic ketoacidosis (DKA). Which combination of lab findings confirms this diagnosis?

Accepted Answer

Blood glucose 380 mg/dL, pH 7.24, serum ketones positive, anion gap 18

Answer

Blood glucose 600 mg/dL, pH 7.39, serum osmolality 330 mOsm/kg

Answer

Blood glucose 250 mg/dL, pH 7.32, bicarbonate 22 mEq/L

Answer

Blood glucose 180 mg/dL, pH 7.42, HbA1c 9%

Question 2

A patient with hypothyroidism is started on levothyroxine (Synthroid). Which instruction should the nurse include?

Accepted Answer

Take the medication 30–60 minutes before breakfast on an empty stomach for best absorption

Answer

Take the medication with breakfast to prevent GI upset

Answer

Take the medication at bedtime to coincide with thyroid hormone production

Answer

Take the medication with calcium supplements to enhance absorption

Question 3

A patient is admitted in an Addisonian crisis. Which nursing intervention is the highest priority?

Accepted Answer

Administer IV hydrocortisone and IV normal saline immediately

Answer

Restrict fluids until blood pressure stabilizes

Answer

Administer mineralocorticoid replacement as the sole treatment

Answer

Obtain cortisol level and wait for results before starting treatment

Question 4

A nurse is teaching a patient with type 2 diabetes about metformin. Which laboratory value requires immediate provider notification before administering metformin?

Accepted Answer

eGFR of 25 mL/min/1.73m²

Answer

HbA1c of 8.2%

Answer

Fasting glucose of 185 mg/dL

Answer

Triglycerides of 220 mg/dL

Question 5

A patient is admitted with a serum calcium level of 13.2 mg/dL (normal 8.5–10.5 mg/dL). Which set of symptoms would the nurse expect?

Accepted Answer

Bone pain, constipation, polyuria, confusion, and muscle weakness

Answer

Tetany, muscle cramps, and positive Chvostek's sign

Answer

Hyperreflexia, carpopedal spasms, and laryngospasm

Answer

Bradycardia with peaked T waves on ECG

Question 6

A patient undergoes a total thyroidectomy. Postoperatively, which assessment is the priority?

Accepted Answer

Monitoring for hypocalcemia symptoms: perioral tingling, muscle cramps, positive Chvostek's sign

Answer

Blood glucose monitoring every 2 hours

Answer

Assessing for weight gain and cold intolerance

Answer

Monitoring for adrenal insufficiency

Question 7

A patient with Cushing's syndrome is being assessed. Which cluster of findings is most consistent with this diagnosis?

Accepted Answer

Central obesity, moon face, buffalo hump, purple striae, and hyperglycemia

Answer

Weight loss, hyperpigmentation, and hypotension

Answer

Exophthalmos, heat intolerance, and tachycardia

Answer

Myxedema, constipation, and bradycardia

Question 8

A patient with type 1 diabetes has a blood glucose of 52 mg/dL and is conscious and able to swallow. What is the priority intervention?

Accepted Answer

Give 15 g of fast-acting carbohydrate orally and recheck glucose in 15 minutes (Rule of 15)

Answer

Administer 1 mg glucagon IM

Answer

Start a 10% dextrose IV infusion immediately

Answer

Administer 50 mL of 50% dextrose IV push

Question 9

A patient with SIADH (syndrome of inappropriate antidiuretic hormone) has a serum sodium of 118 mEq/L. Which intervention should the nurse anticipate?

Accepted Answer

Fluid restriction, monitoring neurological status, and possibly hypertonic saline (3% NaCl)

Answer

Encourage liberal fluid intake to dilute the excess sodium

Answer

Administer IV potassium replacement as the priority

Answer

Initiate diuretic therapy to eliminate excess fluid rapidly

Question 10

A patient presents with pheochromocytoma. Which vital sign finding is most characteristic?

Accepted Answer

Severe paroxysmal hypertension (BP >200/120) with headache, diaphoresis, and palpitations

Answer

Persistent low-grade fever with sinus bradycardia

Answer

Orthostatic hypotension with reflex tachycardia

Answer

Fixed hypertension without variation throughout the day