NCLEX Endocrine Latest Exam Questions with Answers Provided
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Course
NCLEX
Institution
NCLEX
NCLEX Endocrine Latest Exam Questions with Answers Provided
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...
NCLEX Endocrine Latest Exam Questions with
Answers Provided
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
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.
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
2.Comatose state
3.Deep, rapid breathing
5.Elevated blood glucose level
Because of the profound deficiency of insulin associated with DKA, glucose cannot be used for energy and the
,body breaks down fat as a secondary source of energy. Ketones, which are acid byproducts of fat metabolism,
build up and the client experiences a metabolic ketoacidosis. High serum glucose contributes to an osmotic
diuresis and the client becomes severely dehydrated. If untreated, the client will become comatose due to severe
dehydration, acidosis, and electrolyte imbalance. Kussmaul's respirations, the deep rapid breathing associated
with DKA, is a compensatory mechanism by the body. The body attempts to correct the acidotic state by
blowing off carbon dioxide (CO2), which is an acid. In the absence of insulin, the client will experience severe
hyperglycemia. Option 1 is incorrect because in acidosis the pH would be low. Option 4 is incorrect because a
high serum glucose will result in an osmotic diuresis and the client will experience polyuria.
The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis.
The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if
which symptom or symptoms develop? Select all that apply.
Shakiness, palpitations, and lightheadedness are signs/symptoms of hypoglycemia and would indicate the need
for food or glucose. Polyuria, blurred vision, and a fruity breath odor are manifestations of hyperglycemia.
A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of
hyperglycemia. What is the appropriate intervention to decrease the client's anxiety?
1. Administer a sedative.
2. Convey empathy, trust, and respect toward the client.
3. Ignore the signs and symptoms of anxiety, anticipating that they will soon disappear.
4. Make sure that the client is familiar with the correct medical terms to promote understanding of what
is happening.
Convey empathy, trust, and respect toward the client.
Anxiety is a subjective feeling of apprehension, uneasiness, or dread. The appropriate intervention is to
address the client's feelings related to the anxiety. Administering a sedative is not the most appropriate
intervention and does not address the source of the client's anxiety. The nurse should not ignore the client's
anxious feelings.
Anxiety needs to be managed before meaningful client education can occur.
The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse
recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client makes which
statement?
1. "I will stop taking my insulin if I'm too sick to eat."
2. "I will decrease my insulin dose during times of illness."
3. "I will adjust my insulin dose according to the level of glucose in my urine."
4. "I will notify my health care provider (HCP) if my blood glucose level is higher than 250 mg/dL
, (14.2 mmol/L)."
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