Saunders NCLEX Endocrine Test
Questions with Answers
The nurse has documented the problem of body image distortion for a client with a
diagnosis of Cushing's syndrome. The nurse identifies nursing interventions related to
this problem and includes these interventions in the plan of care. Which nursing
intervention is inappropriate?
1.
Encourage the client's expression of feelings.
2.
Assess the client's understanding of the disease process.
3.
Encourage family members to share their feelings about the disease process.
4.
Encourage the client to recognize that the body changes need to be dealt with. -
Answer-Encourage the client to recognize that the body changes need to be dealt with.
Encouraging the client to understand that the body changes that occur in this disorder
need to be dealt with is an inappropriate nursing intervention. This option does not
address the client's feelings. The remaining options are appropriate because they
address the client and family feelings regarding the disorder.
The nurse is caring for a client who has had an adrenalectomy and is monitoring the
client for signs of adrenal insufficiency. Which signs and symptoms indicate adrenal
insufficiency in this client?
1.
Hypotension and fever
2.
Mental status changes and hypertension
3.
Subnormal temperature and hypotension
4.
Complaints of weakness and hypertension - Answer-Hypotension and fever
The nurse should be alert to signs and symptoms of adrenal insufficiency after
adrenalectomy. These signs and symptoms include weakness, hypotension, fever, and
mental status changes. The remaining options are incorrect.
,The nurse is providing home care instructions to the client with a diagnosis of Cushing's
syndrome and prepares a list of instructions for the client. Which instructions should be
included on the list? Select all that apply.
1.
The signs and symptoms of hypoadrenalism
2.
The signs and symptoms of hyperadrenalism
3.
Instructions to take the medications exactly as prescribed
4.
The importance of maintaining regular outpatient follow-up care
5.
A reminder to read the labels on over-the-counter medications before purchase -
Answer-1.
The signs and symptoms of hypoadrenalism
2.
The signs and symptoms of hyperadrenalism
3.
Instructions to take the medications exactly as prescribed
4.
The importance of maintaining regular outpatient follow-up care
The client with Cushing's syndrome should be instructed to take the medications exactly
as prescribed. The nurse should emphasize the importance of continuing medications,
consulting with the health care provider (HCP) before purchasing any over-the-counter
medications, and maintaining regular outpatient follow-up care. The nurse also should
instruct the client in the signs and symptoms of both hypoadrenalism and
hyperadrenalism.
The nurse is developing a plan of care for a client with Addison's disease. The nurse
has identified a problem of risk for deficient fluid volume and identifies nursing
interventions that will prevent this occurrence. Which nursing interventions should the
nurse include in the plan of care? Select all that apply.
1.
Monitor for changes in mentation.
2.
Encourage an intake of low-protein foods.
3.
Encourage an intake of low-sodium foods.
4.
Encourage fluid intake of at least 3000 mL per day.
5.
,Monitor vital signs, skin turgor, and intake and output. - Answer-1.
Monitor for changes in mentation.
4.
Encourage fluid intake of at least 3000 mL per day.
5.
Monitor vital signs, skin turgor, and intake and output.
The client at risk for deficient fluid volume should be encouraged to eat regular meals
and snacks and to increase intake of sodium, protein, and complex carbohydrates and
fluids. Oral replacement of sodium losses is necessary, and maintenance of adequate
blood glucose levels is required. Mentation, vital signs, skin turgor and intake and output
should be monitored for signs of fluid volume deficit.
The nurse is reviewing the postoperative prescriptions for a client who had a
transsphenoidal hypophysectomy. Which health care provider's (HCP's) prescriptions, if
noted on the record, would indicate the need for clarification?
1.
Assess vital signs and neurological status.
2.
Instruct the client to avoid blowing his nose.
3.
Apply a loose dressing if any clear drainage is noted.
4.
Instruct the client about the need for a MedicAlert bracelet. - Answer-Apply a loose
dressing if any clear drainage is noted.
A client is brought to the emergency department in an unresponsive state, and a
diagnosis of hyperosmolar hyperglycemic syndrome is made. The nurse would
immediately prepare to initiate which anticipated health care provider's prescription?
1.
Endotracheal intubation
2.
100 units of NPH insulin
3.
Intravenous infusion of normal saline
4.
Intravenous infusion of sodium bicarbonate - Answer-Intravenous infusion of normal
saline
The primary goal of treatment in hyperosmolar hyperglycemic syndrome (HHS) is to
rehydrate the client to restore fluid volume and to correct electrolyte deficiency.
Intravenous (IV) fluid replacement is similar to that administered in diabetic ketoacidosis
(DKA) and begins with IV infusion of normal saline. Regular insulin, not NPH insulin,
, would be administered. The use of sodium bicarbonate to correct acidosis is avoided
because it can precipitate a further drop in serum potassium levels. Intubation and
mechanical ventilation are not required to treat HHS.
An external insulin pump is prescribed for a client with diabetes mellitus. When the
client asks the nurse about the functioning of the pump, the nurse bases the response
on which information about the pump?
1.
It is timed to release programmed doses of either short-duration or NPH insulin into the
bloodstream at specific intervals.
2.
It continuously infuses small amounts of NPH insulin into the bloodstream while
regularly monitoring blood glucose levels.
3.
It is surgically attached to the pancreas and infuses regular insulin into the pancreas.
This releases insulin into the bloodstream.
4.
It administers a small continuous dose of short-duration insulin subcutaneously. The
client can self-administer an additional bolus dose from the pump before each meal. -
Answer-It administers a small continuous dose of short-duration insulin subcutaneously.
The client can self-administer an additional bolus dose from the pump before each
meal.
An insulin pump provides a small continuous dose of short-duration (rapid- or short-
acting) insulin subcutaneously throughout the day and night. The client can self-
administer an additional bolus dose from the pump before each meal as needed. Short-
duration insulin is used in an insulin pump. An external pump is not attached surgically
to the pancreas.
A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the
emergency department. Which findings support this diagnosis? Select all that apply.
1.
Increase in pH
2.
Comatose state
3.
Deep, rapid breathing
4.
Decreased urine output
5.
Elevated blood glucose level - Answer-2.
Comatose state
3.
Deep, rapid breathing
Questions with Answers
The nurse has documented the problem of body image distortion for a client with a
diagnosis of Cushing's syndrome. The nurse identifies nursing interventions related to
this problem and includes these interventions in the plan of care. Which nursing
intervention is inappropriate?
1.
Encourage the client's expression of feelings.
2.
Assess the client's understanding of the disease process.
3.
Encourage family members to share their feelings about the disease process.
4.
Encourage the client to recognize that the body changes need to be dealt with. -
Answer-Encourage the client to recognize that the body changes need to be dealt with.
Encouraging the client to understand that the body changes that occur in this disorder
need to be dealt with is an inappropriate nursing intervention. This option does not
address the client's feelings. The remaining options are appropriate because they
address the client and family feelings regarding the disorder.
The nurse is caring for a client who has had an adrenalectomy and is monitoring the
client for signs of adrenal insufficiency. Which signs and symptoms indicate adrenal
insufficiency in this client?
1.
Hypotension and fever
2.
Mental status changes and hypertension
3.
Subnormal temperature and hypotension
4.
Complaints of weakness and hypertension - Answer-Hypotension and fever
The nurse should be alert to signs and symptoms of adrenal insufficiency after
adrenalectomy. These signs and symptoms include weakness, hypotension, fever, and
mental status changes. The remaining options are incorrect.
,The nurse is providing home care instructions to the client with a diagnosis of Cushing's
syndrome and prepares a list of instructions for the client. Which instructions should be
included on the list? Select all that apply.
1.
The signs and symptoms of hypoadrenalism
2.
The signs and symptoms of hyperadrenalism
3.
Instructions to take the medications exactly as prescribed
4.
The importance of maintaining regular outpatient follow-up care
5.
A reminder to read the labels on over-the-counter medications before purchase -
Answer-1.
The signs and symptoms of hypoadrenalism
2.
The signs and symptoms of hyperadrenalism
3.
Instructions to take the medications exactly as prescribed
4.
The importance of maintaining regular outpatient follow-up care
The client with Cushing's syndrome should be instructed to take the medications exactly
as prescribed. The nurse should emphasize the importance of continuing medications,
consulting with the health care provider (HCP) before purchasing any over-the-counter
medications, and maintaining regular outpatient follow-up care. The nurse also should
instruct the client in the signs and symptoms of both hypoadrenalism and
hyperadrenalism.
The nurse is developing a plan of care for a client with Addison's disease. The nurse
has identified a problem of risk for deficient fluid volume and identifies nursing
interventions that will prevent this occurrence. Which nursing interventions should the
nurse include in the plan of care? Select all that apply.
1.
Monitor for changes in mentation.
2.
Encourage an intake of low-protein foods.
3.
Encourage an intake of low-sodium foods.
4.
Encourage fluid intake of at least 3000 mL per day.
5.
,Monitor vital signs, skin turgor, and intake and output. - Answer-1.
Monitor for changes in mentation.
4.
Encourage fluid intake of at least 3000 mL per day.
5.
Monitor vital signs, skin turgor, and intake and output.
The client at risk for deficient fluid volume should be encouraged to eat regular meals
and snacks and to increase intake of sodium, protein, and complex carbohydrates and
fluids. Oral replacement of sodium losses is necessary, and maintenance of adequate
blood glucose levels is required. Mentation, vital signs, skin turgor and intake and output
should be monitored for signs of fluid volume deficit.
The nurse is reviewing the postoperative prescriptions for a client who had a
transsphenoidal hypophysectomy. Which health care provider's (HCP's) prescriptions, if
noted on the record, would indicate the need for clarification?
1.
Assess vital signs and neurological status.
2.
Instruct the client to avoid blowing his nose.
3.
Apply a loose dressing if any clear drainage is noted.
4.
Instruct the client about the need for a MedicAlert bracelet. - Answer-Apply a loose
dressing if any clear drainage is noted.
A client is brought to the emergency department in an unresponsive state, and a
diagnosis of hyperosmolar hyperglycemic syndrome is made. The nurse would
immediately prepare to initiate which anticipated health care provider's prescription?
1.
Endotracheal intubation
2.
100 units of NPH insulin
3.
Intravenous infusion of normal saline
4.
Intravenous infusion of sodium bicarbonate - Answer-Intravenous infusion of normal
saline
The primary goal of treatment in hyperosmolar hyperglycemic syndrome (HHS) is to
rehydrate the client to restore fluid volume and to correct electrolyte deficiency.
Intravenous (IV) fluid replacement is similar to that administered in diabetic ketoacidosis
(DKA) and begins with IV infusion of normal saline. Regular insulin, not NPH insulin,
, would be administered. The use of sodium bicarbonate to correct acidosis is avoided
because it can precipitate a further drop in serum potassium levels. Intubation and
mechanical ventilation are not required to treat HHS.
An external insulin pump is prescribed for a client with diabetes mellitus. When the
client asks the nurse about the functioning of the pump, the nurse bases the response
on which information about the pump?
1.
It is timed to release programmed doses of either short-duration or NPH insulin into the
bloodstream at specific intervals.
2.
It continuously infuses small amounts of NPH insulin into the bloodstream while
regularly monitoring blood glucose levels.
3.
It is surgically attached to the pancreas and infuses regular insulin into the pancreas.
This releases insulin into the bloodstream.
4.
It administers a small continuous dose of short-duration insulin subcutaneously. The
client can self-administer an additional bolus dose from the pump before each meal. -
Answer-It administers a small continuous dose of short-duration insulin subcutaneously.
The client can self-administer an additional bolus dose from the pump before each
meal.
An insulin pump provides a small continuous dose of short-duration (rapid- or short-
acting) insulin subcutaneously throughout the day and night. The client can self-
administer an additional bolus dose from the pump before each meal as needed. Short-
duration insulin is used in an insulin pump. An external pump is not attached surgically
to the pancreas.
A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the
emergency department. Which findings support this diagnosis? Select all that apply.
1.
Increase in pH
2.
Comatose state
3.
Deep, rapid breathing
4.
Decreased urine output
5.
Elevated blood glucose level - Answer-2.
Comatose state
3.
Deep, rapid breathing
