Endocrine

Question 1

Fill in the gaps in the following statement:
Type I (insulin dependant) diabetes is characterised by almost no __________ secretion. This contributes to a build up of __________ in the blood stream. If exogenous insulin is not administered __________ and __________ will develop
A. Insulin, glucose, hyperglycaemia and ketoacidosis
B. Glucose, insulin, hyperglycaemia and ketoacidosis
C. Glucose, insulin, hypoglycaemia, and unconsciousness
D. Insulin, hormones, ketoacidosis and unconsciousness

Answer 1

A. Insulin, glucose, hyperglycaemia and ketoacidosis

Question 2

When describing the effects of insulin on the body to a patient newly diagnosed with diabetes mellitus, the best explanation by the nurse is?
A. Insulin promotes the breakdown of fatty tissue into triglycerides, which can be used for energy
B. When proteins are taken into the body, insulin promotes their breakdown and conversion to fats
C. Insulin stimulates the conversion of stored sugars into blood glucose and the conversion of proteins into glucose
D. When carbohydrates, fats, and proteins are eaten, insulin promotes cellular transport and storage of all these nutrients

Answer 2

D. When carbohydrates, fats, and proteins are eaten, insulin promotes cellular transport and storage of all these nutrients

Question 3

Before beginning a diabetic education programme for your new patient, what should you first do?
A. Assess their level of understand of diabetes
B. Obtain pamphlets about diabetes that are bi lingual
C. Negotiate a time when whanau (family) can be present
D. Contact the diabetic education nurse

Answer 3

A. Assess their level of understand of diabetes

Question 4

How will you know if Tui understands the diabetic education you provided?
A. He repeats the information in his own words
B. He demonstrates use of the equipment ??
C. He has seen the Māori nurse educator
D. He has his whanau with him

Answer 4

A. He repeats the information in his own words

Question 5

Oral hypoglycaemic agents are effective and short acting. Their specific action is?
A. As an oral form of insulin
B. To increase the output of insulin
C. To control the islets of Langerhans
D. To decrease the output of insulin

Answer 5

B. To increase the output of insulin

Question 6

Individuals whose diabetes is not well controlled are vulnerable to several complications, which of the following are they least likely to develop?
A. Atherosclerosis
B. Cataracts
C. Lymphadenopathy
D. Nephropathy

Answer 6

A. Atherosclerosis

Question 7

Hypertension, oedema and proteinuria syndrome commonly occur in women who?
A. Have essential hypertension
B. Have diabetes mellitus
C. Are primigravids
D. All of the above

Answer 7

B. Have diabetes mellitus

Question 8

The risk factors of type 1 diabetes include all of the following expect?
A. Diet
B. Genetics
C. Autoimmune
D. Environment

Answer 8

A. Diet

Question 9

Untreated diabetes may result in all of the following expect?
A. Blindness
B. Cardiovascular disease
C. Kidney disease
D. Tinnitus

Answer 9

D. Tinnitus

Question 10

The nurse is developing a teaching plan for a client prescribed liraglutide as an adjunct to insulin to treat type 1 diabetes mellitus (DM). Which instruction should the nurse include in the education?
A. “If you miss a meal, take half of your regular dose.”
B. “Consume a high carbohydrate diet.”
C. “Contact your healthcare provider if you experience changes in your voice.”
D. “Liraglutide causes an increase in appetite.”

Answer 10

C. “Contact your healthcare provider if you experience changes in your voice.”

Question 11

A client arrives at the emergency department stating, “My glucometer is reading greater than 14.4 mmol and I haven’t felt like myself all day.” The healthcare provider suspects hyperglycaemic. Which initial finding(s) should the nurse associate with this diagnosis? Select all that apply.
A. Respiratory rate 21/min
B. Oxygen saturation 95% on room air
C. Blood pressure 90/48 mmHg
D. Heart rate 111/min
E. Temperature: 37.5°C (99.6°F)

Answer 11

A. Respiratory rate 21/min
C. Blood pressure 90/48 mmHg
D. Heart rate 111/min
E. Temperature: 37.5°C (99.6°F)

Question 12

The student nurse is reviewing the assessment findings of a client diagnosed with hyperosmolar hyperglycaemic state (HHS) with the nursing instructor. The student asks the instructor, “Which of my assessments are correlated with HHS?” Which finding(s) should the nursing instructor include in the response? Select all that apply.
A. Polydipsia
B. Confusion
C. Hyperactivity
D. Dry mouth
E. Cold clammy skin

Answer 12

A. Polydipsia
B. Confusion
D. Dry mouth

Question 13

The nurse is providing discharge teaching for a client following a new diagnosis of chronic primary adrenal insufficiency. Which information should the nurse include regarding hormone replacement therapy?
A. “You will be required to take this medication for the next five days.”
B. “You will be required to take this medication for the rest of your life.”
C. “You will be required to take this medication for the next 30 days.”
D. “You will be required to take this medication for the next five years.”

Answer 13

B. “You will be required to take this medication for the rest of your life.”

Question 14

The nurse in the community health clinic is caring for a client diagnosed with hypothyroidism who was prescribed levothyroxine six weeks ago. Which client statement indicates that medication dosing may need to be decreased?
A. “I’ve lost three pounds since starting this medication.”
B. “I don’t think I need a stool softener anymore, I keep having diarrhea.”
C. “My skin looks pink and my tongue doesn’t feel swollen.”
D. “I am feeling so sluggish and tired, I thought I’d feel better by now.”

Answer 14

B. “I don’t think I need a stool softener anymore, I keep having diarrhea.”

Question 15

A client diagnosed with hypothyroidism is being evaluated by the emergency department nurse. The client recently underwent a dental procedure and states, “Ever since my surgery, I haven’t felt right.” Which clinical manifestation is a possible sign of myxedema coma and should be reported to the healthcare provider immediately?
A. Respiratory rate 14/min
B. Blood glucose 90 mg/dL
C. Temperature 96°F (35.6°C)
D. Lactate dehydrogenase (LDH) 88 U/L

Answer 15

C. Temperature 96°F (35.6°C)

Clients diagnosed with hypothyroidism are at risk of developing the complication of myxedema coma. Hypothermia is a symptom of this complication and needs to be reported to the healthcare team first. Normal temperature is 98.6°F (37°C).

Question 16

The nurse is planning to educate a group of clients who have been newly diagnosed with hyperthyroidism. Which statement(s) should the nurse include about the cause(s) of hyperthyroidism? All apply except?
A. “Elevated calcium can contribute to hyperthyroidism.”
B. “Hyperthyroidism can be classified as primary or secondary.”
C. “Hyperthyroidism can develop related to thyroid cancer.”
D. “Graves disease is an autoimmune cause of hyperthyroidism.”
E. “Pituitary dysfunction can cause hyperthyroidism.”
F. “Treatment for hypothyroidism can cause hyperthyroidism.”

Answer 16

A. “Elevated calcium can contribute to hyperthyroidism.”

Question 17

A client with type II diabetes and whom is taking metformin is scheduled for a computed tomography (CT) exam with contrast dye. Which action should the nurse plan to take?
A. Hold the metformin for 48 hours before the procedure.
B. Hold the metformin for 24 hours after the procedure.
C. Administer the metformin if the hemoglobin A1C is above 5.0%.
D. Instruct the client to take their medication as prescribed.

Answer 17

A. Hold the metformin for 48 hours before the procedure.

This action should be part of the care plan to prevent acute kidney injury and lactic acidosis.

Question 18

A client diagnosed with type 2 diabetes mellitus (DM) is prescribed sitagliptin. This client has a history of renal impairment with a glomerular filtration rate (GFR) of 35 mL/min/1.73m2. Due to the client’s impaired kidney function, the healthcare provider prescribed half of the standard dose, which is normally 100 mg. The tablets come prepared in a 50 mg formulation. How many tablet(s) should the nurse administer per dose?

Answer 18

1 tablet

Question 19

The nurse is caring for a client recently diagnosed with type 2 diabetes mellitus (DM). The client states, “I never had any symptoms. I think the doctor must have made a mistake.” Which is the best response by the nurse?
A. “Only clients diagnosed with type 1 diabetes typically show symptoms.”
B. “More often than not, people with type 2 diabetes have no symptoms at all.”
C. “You’re right, I will contact the provider and double check the results.”
D. “Symptoms of type 2 diabetes only show up after years of having the disease.”

Answer 19

B. “More often than not, people with type 2 diabetes have no symptoms at all.”

Clients diagnosed with type 2 DM may present with symptomatic hyperglycemia but are more often asymptomatic, and their condition is detected only during routine testing.

Question 20

post-adrenalectomy. Which statement by the client indicates further education is required?
A. “If I get sick, I will call my doctor right away.”
B. “I will need cortisol replacement therapy.”
C. “I can take off the adhesive strips before I take a shower.”
D. “I will avoid temperature extremes.”

Answer 20

C. “I can take off the adhesive strips before I take a shower.”

Question 21

After conducting a physical assessment of a client, the healthcare provider suspects the client has Cushing syndrome. Which test should the nurse anticipate will be performed to confirm the suspected diagnosis?
A. A 24-hour urine sample
B. Magnetic resonance imaging (MRI)
C. Computed tomography (CT) scan
D. Radioactive scan of the thyroid

Answer 21

A. A 24-hour urine sample

Question 22

The nurse is caring for a client with diabetes who was recently prescribed dapagliflozin. Which type of diabetes is treated with this medication?
A. Type 1 diabetes mellitus (DM)
B. Type 2 diabetes mellitus (DM)
C. Gestational diabetes
D. Prediabetes

Answer 22

B. Type 2 diabetes mellitus (DM)

Question 23

The nurse is caring for a client currently being treated for diabetic ketoacidosis (DKA) who is asking for a lunch tray. The client is currently receiving a continuous insulin infusion. The most recent glucose level is 11.7 mmol/L. What is the most appropriate action by the nurse?
A. Administer a subcutaneous injection of rapid-acting insulin and allow the client to eat.
B. Keep the client NPO until glucose is less than 150mg/dL
C. Administer a bolus of IV insulin and allow the client to eat
D. Administer a subcutaneous injection of long-acting insulin and discontinue the insulin infusion.

Answer 23

A. Administer a subcutaneous injection of rapid-acting insulin and allow the client to eat.

Question 24

The nurse has been assigned to care for a client with diabetic ketoacidosis (DKA). Which assessment findings should the nurse anticipate?
A. Oral temperature 102.2°F, photophobia, neck pain
B. Dizziness, headache, pH 7.5
C. Ammonia level of 66 µ/dL, distended abdomen, slurred speech
D. Respiratory rate of 28 breaths per minute, bilious emesis, confusion

Answer 24

D. Respiratory rate of 28 breaths per minute, bilious emesis, confusion

Question 25

Which statement by a client with Type 1 diabetes mellitus (DM) indicates that the client may be experiencing diabetic ketoacidosis (DKA)? Select all that apply.
A. “I don’t know why, I just have no energy at all. My body just doesn’t want to move.”
B. “It burns when I urinate, and it feels like I still have to go even after I think I’m finished.”
C. “I have stomach pain that won’t go away and feel like I’m going to vomit”
D. “People have been telling me that my breath smells weird, almost like nail polish remover.”

Answer 25

A. “I don’t know why, I just have no energy at all. My body just doesn’t want to move.”
C. “I have stomach pain that won’t go away and feel like I’m going to vomit”
D. “People have been telling me that my breath smells weird, almost like nail polish remover.”

Question 26

The nurse is performing an assessment on a client diagnosed with type 2 diabetes mellitus (DM). Which statement indicates the development of a possible long-term complication of type 2 DM?
A. “I feel so thirsty; I keep drinking water, but I never feel satisfied.”
B. “I have been losing my hair for the last year.”
C. “My dentist told me I need a root canal this year. I’ve never needed one before.”
D. “I’ve had to get a new prescription for my glasses twice this year.”

Answer 26

D. “I’ve had to get a new prescription for my glasses twice this year.”

Question 27

The nurse is reviewing the list of clients on the unit who have type 1 diabetes mellitus (DM). Which client requires close monitoring for hypoglycemia after the administration of insulin?
A. A client scheduled for an electrocardiogram (ECG)
B. A client scheduled for an appendectomy
C. A febrile client receiving antibiotics for the treatment of pneumonia
D. A client receiving intravenous fluid replacement for vomiting

Answer 27

D. A client receiving intravenous fluid replacement for vomiting

Question 28

The nurse has provided education to a client prescribed insulin for the treatment of type 1 diabetes mellitus (DM). Which statement made by the client indicates further teaching is required?
A. “If I experience dizziness, I will immediately check my blood sugar.”
B. “I will store my opened vial of insulin at room temperature.”
C. “I do not need to monitor my blood glucose if I feel well.”
D. “I will rotate my injection site with each new injection.”

Answer 28

C. “I do not need to monitor my blood glucose if I feel well.”

Question 29

Type 1 diabetes differs from type 2 diabetes in that:
A. Type 2 diabetes only affects the adult population
B. Insulin is never required for type 2 diabetes
C. Type 1 diabetes is an autoimmune disease
D. Type 1 diabetes is only acquired in childhood

Answer 29

C. Type 1 diabetes is an autoimmune disease