Endocrine System Disorders Quiz: NCLEX Review and Practice

1. An agitated. confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus. hypertension. and angina pectoris. Assessment reveals pallor. diaphoresis. headache. and intense hunger. A stat blood glucose sample measures 42 mg/dl. and the client is treated for an acute hypoglycemic reaction. After recovery. the nurse teaches the client to treat hypoglycemia by ingesting:

2 to 5 g of a simple carbohydrate.

10 to 15 g of a simple carbohydrate.

18 to 20 g of a simple carbohydrate.

25 to 30 g of a simple carbohydrate.

To reverse hypoglycemia. the American Diabetes Association recommends ingesting 10 to 15 g of a simple carbohydrate. such as three to five pieces of hard candy. two to three packets of sugar (4 to 6 tsp). or 4 oz of fruit juice. If necessary. this treatment can be repeated in 15 minutes. Ingesting only 2 to 5 g of a simple carbohydrate may not raise the blood glucose level sufficiently. Ingesting more than 15 g may raise it above normal. causing hyperglycemia.

Explanation

To reverse hypoglycemia. the American Diabetes Association recommends ingesting 10 to 15 g of a simple carbohydrate. such as three to five pieces of hard candy. two to three packets of sugar (4 to 6 tsp). or 4 oz of fruit juice. If necessary. this treatment can be repeated in 15 minutes. Ingesting only 2 to 5 g of a simple carbohydrate may not raise the blood glucose level sufficiently. Ingesting more than 15 g may raise it above normal. causing hyperglycemia.

2. When caring for a male client with diabetes insipidus. nurse Juliet expects to administer:

Vasopressin (Pitressin Synthetic).

Furosemide (Lasix).

Regular insulin.

10% dextrose.

Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production. the nurse should expect to administer synthetic vasopressin for hormone replacement therapy. Furosemide. a diuretic. is contraindicated because a client with diabetes insipidus experiences polyuria. Insulin and dextrose are used to treat diabetes mellitus and its complications. not diabetes insipidus.

Explanation

Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production. the nurse should expect to administer synthetic vasopressin for hormone replacement therapy. Furosemide. a diuretic. is contraindicated because a client with diabetes insipidus experiences polyuria. Insulin and dextrose are used to treat diabetes mellitus and its complications. not diabetes insipidus.

3. During a class on exercise for diabetic clients. a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise?

At least once a week

At least three times a week

At least five times a week

Every day

Diabetic clients must exercise at least three times a week to meet the goals of planned exercise — lowering the blood glucose level. reducing or maintaining the proper weight. increasing the serum high-density lipoprotein level. decreasing serum triglyceride levels. reducing blood pressure. and minimizing stress. Exercising once a week wouldn’t achieve these goals. Exercising more than three times a week. although beneficial. would exceed the minimum requirement.

Explanation

Diabetic clients must exercise at least three times a week to meet the goals of planned exercise — lowering the blood glucose level. reducing or maintaining the proper weight. increasing the serum high-density lipoprotein level. decreasing serum triglyceride levels. reducing blood pressure. and minimizing stress. Exercising once a week wouldn’t achieve these goals. Exercising more than three times a week. although beneficial. would exceed the minimum requirement.

4. A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client. nurse Sharmaine would be most accurate in stating:

“The test needs to be repeated following a 12-hour fast.”

“It looks like you aren’t following the prescribed diabetic diet.”

“It tells us about your sugar control for the last 3 months.”

“Your insulin regimen needs to be altered significantly.”

The glycosylated Hb test provides an objective measure of glycemic control over a 3-month period. The test helps identify trends or practices that impair glycemic control. and it doesn’t require a fasting period before blood is drawn. The nurse can’t conclude that the result occurs from poor dietary management or inadequate insulin coverage.

Explanation

The glycosylated Hb test provides an objective measure of glycemic control over a 3-month period. The test helps identify trends or practices that impair glycemic control. and it doesn’t require a fasting period before blood is drawn. The nurse can’t conclude that the result occurs from poor dietary management or inadequate insulin coverage.

5. Nurse Joey is assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview. the client reports that he's impotent and says he's concerned about its effect on his marriage. In planning this client's care. the most appropriate intervention would be to:

Encourage the client to ask questions about personal sexuality.

Provide time for privacy.

Provide support for the spouse or significant other.

Suggest referral to a sex counselor or other appropriate professional.

The nurse should refer this client to a sex counselor or other professional. Making appropriate referrals is a valid part of planning the client’s care. The nurse doesn’t normally provide sex counseling.

Explanation

The nurse should refer this client to a sex counselor or other professional. Making appropriate referrals is a valid part of planning the client’s care. The nurse doesn’t normally provide sex counseling.

6. A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings. the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client. which "related-to" phrase should the nurse add?

Related to bone demineralization resulting in pathologic fractures

Related to exhaustion secondary to an accelerated metabolic rate

Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces

Related to tetany secondary to a decreased serum calcium level

Poorly controlled hyperparathyroidism may cause an elevated serum calcium level. This. in turn. may diminish calcium stores in the bone. causing bone demineralization and setting the stage for pathologic fractures and a risk for injury. Hyperparathyroidism doesn’t accelerate the metabolic rate. A decreased thyroid hormone level. not an increased parathyroid hormone level. may cause edema and dry skin secondary to fluid infiltration into the interstitial spaces. Hyperparathyroidism causes hypercalcemia. not hypocalcemia; therefore. it isn’t associated with tetany.

Explanation

Poorly controlled hyperparathyroidism may cause an elevated serum calcium level. This. in turn. may diminish calcium stores in the bone. causing bone demineralization and setting the stage for pathologic fractures and a risk for injury. Hyperparathyroidism doesn’t accelerate the metabolic rate. A decreased thyroid hormone level. not an increased parathyroid hormone level. may cause edema and dry skin secondary to fluid infiltration into the interstitial spaces. Hyperparathyroidism causes hypercalcemia. not hypocalcemia; therefore. it isn’t associated with tetany.

7. Nurse Oliver should expect a client with hypothyroidism to report which health concerns?

Increased appetite and weight loss

Puffiness of the face and hands

Nervousness and tremors

Thyroid gland swelling

Hypothyroidism (myxedema) causes facial puffiness. extremity edema. and weight gain. Signs and symptoms of hyperthyroidism (Graves’ disease) include an increased appetite. weight loss. nervousness. tremors. and thyroid gland enlargement (goiter).

Explanation

Hypothyroidism (myxedema) causes facial puffiness. extremity edema. and weight gain. Signs and symptoms of hyperthyroidism (Graves’ disease) include an increased appetite. weight loss. nervousness. tremors. and thyroid gland enlargement (goiter).

8. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid). 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect?

Dysuria

Leg cramps

Tachycardia

Blurred vision

Levothyroxine. a synthetic thyroid hormone. is given to a client with hypothyroidism to simulate the effects of thyroxine. Adverse effects of this agent include tachycardia. The other options aren’t associated with levothyroxine.

Explanation

Levothyroxine. a synthetic thyroid hormone. is given to a client with hypothyroidism to simulate the effects of thyroxine. Adverse effects of this agent include tachycardia. The other options aren’t associated with levothyroxine.

9. The nurse is aware that the following is the most common cause of hyperaldosteronism?

Excessive sodium intake

A pituitary adenoma

Deficient potassium intake

An adrenal adenoma

An autonomous aldosterone-producing adenoma is the most common cause of hyperaldosteronism. Hyperplasia is the second most frequent cause. Aldosterone secretion is independent of sodium and potassium intake as well as of pituitary stimulation.

Explanation

An autonomous aldosterone-producing adenoma is the most common cause of hyperaldosteronism. Hyperplasia is the second most frequent cause. Aldosterone secretion is independent of sodium and potassium intake as well as of pituitary stimulation.

10. A 67-year-old male client has been complaining of sleeping more. increased urination. anorexia. weakness. irritability. depression. and bone pain that interferes with her going outdoors. Based on these assessment findings. nurse Richard would suspect which of the following disorders?

Diabetes mellitus

Diabetes insipidus

Hypoparathyroidism

Hyperparathyroidism

Hyperparathyroidism is most common in older women and is characterized by bone pain and weakness from excess parathyroid hormone (PTH). Clients also exhibit hypercalciuria-causing polyuria. While clients with diabetes mellitus and diabetes insipidus also have polyuria. they don’t have bone pain and increased sleeping. Hypoparathyroidism is characterized by urinary frequency rather than polyuria.

Explanation

Hyperparathyroidism is most common in older women and is characterized by bone pain and weakness from excess parathyroid hormone (PTH). Clients also exhibit hypercalciuria-causing polyuria. While clients with diabetes mellitus and diabetes insipidus also have polyuria. they don’t have bone pain and increased sleeping. Hypoparathyroidism is characterized by urinary frequency rather than polyuria.

Endocrine System Disorders Quiz: NCLEX Review And Practice