Endocrine System Disorders | NCLEX Quiz 100

1. A clinical instructor teaches a class for the public about diabetes mellitus. Which individual does the nurse assess as being at highest risk for developing diabetes?

The 50-year-old client who does not get any physical exercise

The 56-year-old client who drinks three glasses of wine each evening

The 42-year-old client who is 50 pounds overweight

The 38-year-old client who smokes one pack of cigarettes per day

Obesity increases the likelihood of developing diabetes mellitus due to over stimulation of the endocrine system. Exercise is important. but lack of exercise is not as big a risk factor as obesity. Smoking is a serious health concern but is not a specific risk factor for diabetes. Consuming alcohol is associated with liver disease but is not as high a risk factor for diabetes as obesity.

Explanation

Obesity increases the likelihood of developing diabetes mellitus due to over stimulation of the endocrine system. Exercise is important. but lack of exercise is not as big a risk factor as obesity. Smoking is a serious health concern but is not a specific risk factor for diabetes. Consuming alcohol is associated with liver disease but is not as high a risk factor for diabetes as obesity.

2. A client diagnosed with type 1 diabetes receives insulin. He asks the nurse why he can't just take pills instead. What is the best response by the nurse?

“Insulin must be injected because it needs to work quickly.”

“Insulin can’t be in a pill because it is destroyed in stomach acid.”

“Have you talked to your doctor about taking pills instead?”

“I know it is tough. but you will get used to the shots soon.”

Insulin must be injected because it is destroyed in the stomach acid if taken orally. Telling he will get used to shots does not answer his question and is condescending. Insulin must be injected because it is destroyed in stomach acid if taken orally; the onset of action is not the issue here. The nurse should answer the client’s question. not refer him back to the physician.

Explanation

Insulin must be injected because it is destroyed in the stomach acid if taken orally. Telling he will get used to shots does not answer his question and is condescending. Insulin must be injected because it is destroyed in stomach acid if taken orally; the onset of action is not the issue here. The nurse should answer the client’s question. not refer him back to the physician.

3. Serge who has diabetes mellitus is taking oral agents. and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of the nurse with regard to giving the client his oral medications?

Administer the oral agents immediately after the test.

Notify the the diagnostic department and request orders.

Notify the physician and request orders.

Administer the oral agents with a sip of water before the test.

It is best to notify the client’s physician and request orders. The client should not receive the medication during NPO status unless directed by the physician. The medications should not be given upon return unless the physician orders this; the client may still need to be NPO. The radiologist in the diagnostic department might give orders. but it would be best to check with the client’s physician first.

Explanation

It is best to notify the client’s physician and request orders. The client should not receive the medication during NPO status unless directed by the physician. The medications should not be given upon return unless the physician orders this; the client may still need to be NPO. The radiologist in the diagnostic department might give orders. but it would be best to check with the client’s physician first.

4. Steven John has type 1 diabetes mellitus and receives insulin. Which laboratory test will the nurse assess?

Potassium

AST (aspartate aminotransferase)

Serum amylase

Sodium

Insulin causes potassium to move into the cell and may cause hypokalemia. There is no need to monitor the sodium. serum amylase. and AST levels.

Explanation

Insulin causes potassium to move into the cell and may cause hypokalemia. There is no need to monitor the sodium. serum amylase. and AST levels.

5. Ben injects his insulin as prescribed. but then gets busy and forgets to eat. What will the best assessment of the nurse reveal?

The client will be very thirsty.

The client will complain of nausea.

The client will need to urinate.

The client will have moist skin.

Moist skin is the sign of hypoglycemia. which the client would experience if he injected himself with insulin and did not eat. Thirst. nausea. and increased urination are signs of hyperglycemia.

Explanation

Moist skin is the sign of hypoglycemia. which the client would experience if he injected himself with insulin and did not eat. Thirst. nausea. and increased urination are signs of hyperglycemia.

6. Marlisa has been diagnosed with diabetes mellitus type 1. She asks Nurse Errol what this means. What is the best response by the nurse? Select all that apply.

“Your alpha cells should be able to secrete insulin. but cannot.”

“The exocrine function of your pancreas is to secrete insulin.”

“Without insulin. you will develop ketoacidosis (DKA).”

“The endocrine function of your pancreas is to secrete insulin.”

“It means your pancreas cannot secrete insulin.”

One function of your pancreas is to secrete insulin. The endocrine function of the pancreas is to secrete insulin. The endocrine. not the exocrine. function of the pancreas is to secrete insulin. Insulin is secreted by the beta. not the alpha. cells of the pancreas. A consequence of diabetes mellitus type 1 is that without insulin. severe metabolic disturbances. such as ketoacidosis (DKA) will result.

Explanation

One function of your pancreas is to secrete insulin. The endocrine function of the pancreas is to secrete insulin. The endocrine. not the exocrine. function of the pancreas is to secrete insulin. Insulin is secreted by the beta. not the alpha. cells of the pancreas. A consequence of diabetes mellitus type 1 is that without insulin. severe metabolic disturbances. such as ketoacidosis (DKA) will result.

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7. Dr. Shrunk orders intravenous (IV) insulin for Rita. a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select all that apply.

The nurse could have given the insulin subcutaneously.

The nurse should have contacted the physician.

The nurse should have used regular insulin (Humulin R).

The nurse used the correct insulin.

Regular insulin is the only insulin that can be given intravenously (IV). The nurse did not use correct insulin as it was not regular insulin. Contact the provider to clarify the order. regular insulin is the only insulin that can be given intravenously (IV). The nurse cannot give the insulin subcutaneously when it is ordered to be given intravenously (IV).

Explanation

Regular insulin is the only insulin that can be given intravenously (IV). The nurse did not use correct insulin as it was not regular insulin. Contact the provider to clarify the order. regular insulin is the only insulin that can be given intravenously (IV). The nurse cannot give the insulin subcutaneously when it is ordered to be given intravenously (IV).

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8. Nurse Andy has finished teaching a client with diabetes mellitus how to administer insulin. He evaluates the learning has occurred when the client makes which statement?

“I should check my blood sugar immediately prior to the administration.”

“I should provide direct pressure over the site following the injection.”

“I should use the abdominal area only for insulin injections.”

“I should only use calibrated insulin syringe for the injections.”

To ensure the correct insulin dose. a calibrated insulin syringe must be used. Insulin injections should be rotated to the arm and thigh. not just the abdominal area. There is no need to apply direct pressure over the site following an insulin injection. There is no need to check blood glucose immediately prior to the injection.

Explanation

To ensure the correct insulin dose. a calibrated insulin syringe must be used. Insulin injections should be rotated to the arm and thigh. not just the abdominal area. There is no need to apply direct pressure over the site following an insulin injection. There is no need to check blood glucose immediately prior to the injection.

9. Serafica who has diabetes mellitus type 1 is found unresponsive in the clinical setting. Which nursing action is a priority? arrange from 1 to 4 (1. Treat the client for hypoglycemia. 2. Call the physician STAT. 3. Assess the vital signs. 4. Call a code.)

1. 2. 3. 4

1. 3. 2. 4

3. 1. 2. 4

4. 3. 2. 1

When a patient with diabetes mellitus type 1 is unresponsive. the nurse should focus on and treat for hypoglycemia. as this is more likely than hyperglycemia. This is an emergency situation where the nurse must act before calling the physician. Vital signs should be taken after the client is treated for hypoglycemia. Assessment for ABCs should precede calling a code; there is no information that the client is not breathing.

Explanation

When a patient with diabetes mellitus type 1 is unresponsive. the nurse should focus on and treat for hypoglycemia. as this is more likely than hyperglycemia. This is an emergency situation where the nurse must act before calling the physician. Vital signs should be taken after the client is treated for hypoglycemia. Assessment for ABCs should precede calling a code; there is no information that the client is not breathing.

10. Jansen is receiving metformin (Glucophage). What will be the best plan of the nurse with regard to patient education with this drug? Select all that apply.

It stimulates the pancreas to produce more insulin.

It must be taken with meals.

It decreases sugar production in the liver.

It inhibits absorption of carbohydrates.

It reduces insulin resistance.

Metformin (Glucophage) reduces insulin resistance. decreases sugar production in the liver. and should be taken with meals for the best absorption and effect. It does not stimulate the pancreas to produce more insulin and does not inhibit the absorption of carbohydrates.

Explanation

Metformin (Glucophage) reduces insulin resistance. decreases sugar production in the liver. and should be taken with meals for the best absorption and effect. It does not stimulate the pancreas to produce more insulin and does not inhibit the absorption of carbohydrates.

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