NCLEX RN Endocrine Questions

NCLEX RN Endocrine Questions Related

Review NCLEX RN Endocrine Questions related questions and content

The following scenario applies to the next 1 items
The nurse in the emergency department cares for a 45-year-old female
Nurses’ Note
The client reports significant fatigue that has worsened over the past eight weeks. Additionally, the client reports constipation, hair loss, and a 3-kilogram (6.6 pounds) weight gain. She reports missing work because of difficulty concentrating and persistent fatigue.

The client is alert and fully oriented. She appears fatigued and reports dizziness when she moves quickly. Periorbital edema, various bruises, and facial swelling were noted on assessment. Peripheral pulses were intact and weak. The client denies any pain.

Vital Signs
Oral temperature 97 F (36.1o C); Pulse 51/minute; Respirations 15/minute.
BP 93/61 mm Hg; Oxygen saturation 95% on room air.

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress.

  • A. Obtain a prescription for levothyroxine, Obtain a prescription for methimazole, Have the client complete a blood transfusion consent, Obtain an order for a urine cortisol level, Initiate fall precautions.
  • B. Vital Signs, Serum TSH/T3/T4 levels, Intake and Output, Cortisol Level, BUN and Creatinine.
  • C. Graves' disease, Cushing's syndrome, Hypothyroidism, Systemic Lupus Erythematosus, Adrenal Insufficiency.
Correct Answer: C, A, E, B

Rationale: Fatigue, weight gain, and bradycardia suggest hypothyroidism. Levothyroxine treats it, fall precautions address dizziness, and TSH/T3/T4 and vital signs monitor progress.

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The nurse is caring for a client who is receiving newly prescribed prednisone. Which of the following medications should the client avoid while receiving this medication?

  • A. valsartan
  • B. naproxen
  • C. omeprazole
  • D. acetaminophen
Correct Answer: B

Rationale: Naproxen, an NSAID, should be avoided with prednisone due to increased risk of gastrointestinal bleeding and ulceration. Valsartan, omeprazole, and acetaminophen are generally safe with prednisone, though monitoring is needed.

The following scenario applies to the next 1 items.
The nurse is caring for a client in the emergency department (ED) with an altered level of consciousness
Item 1 of 1
History and Physical
A 53-year-old male presented to the emergency department (ED) with his wife because the client had become quite tired over the past several days. Today, he was difficult to arouse and spoke incoherently. The client responded to his name during the assessment but did not answer any other questions. Peripheral pulses were thready. Obvious tenting was noted in the skin, which was warm and quite dry. No facial drooping was observed, and when asked to hold out his arms, he could not perform the task. In fact, he did not have many purposeful movements during the exam. The client has a medical history of gout, bipolar disorder, and hypothyroidism, for which he takes levothyroxine, allopurinol, and quetiapine. She reports that he has been taking his medications as prescribed. However, she noted he was recently placed on Prednisone 20 mg PO BID for a gout flare. He self-discontinued the drug after taking it for two weeks and feeling better, and he did not taper as directed.

Vital Signs

Temperature 98.0° F (37° C)
Pulse 121/minute
Respirations 16/minute
Blood Pressure 90/60 mm Hg
Pulse oximetry 95% on room air

Diagnostics
12-lead electrocardiogram: sinus tachycardia with peaked T waves

Complete the sentence below by dragging one (1) condition and one (1) assessment finding. The client is at highest risk for............. related to the client's...........

  • A. myxedema coma
  • B. catatonia
  • C. adrenal crisis
  • D. cessation of prednisone
  • E. lack of purposeful movement
  • F. history of hypothyroidism
Correct Answer: C, D

Rationale: Abrupt cessation of prednisone in a client on chronic steroids can precipitate adrenal crisis due to suppressed adrenal function. Altered consciousness, thready pulses, and dehydration support this risk.

The nurse is planning a staff education program about conditions that increase cortisol levels. Which of the following conditions should the nurse include?

  • A. Addison's disease
  • B. Congestive heart failure (CHF)
  • C. Renal failure
  • D. Cushing's disease
Correct Answer: D

Rationale: Cushing's disease increases cortisol due to excess ACTH. Addison's reduces cortisol, and CHF and renal failure do not directly elevate cortisol levels.

This nurse is caring for a client who is receiving prescribed sitagliptin. Which assessment findings indicate the client is experiencing a severe adverse effect?

  • A. Nasal stuffiness
  • B. Abdominal pain
  • C. Headache
  • D. Occasional dry cough
Correct Answer: B

Rationale: Abdominal pain may indicate pancreatitis, a rare but severe sitagliptin adverse effect, requiring immediate attention. Nasal stuffiness, headache, and dry cough are less severe.

The nurse is caring for a client with a prescribed subcutaneous (SQ) regular insulin sliding scale. The client's current blood glucose level is 360 mg/dL (19.98 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]. Which of the following actions should the nurse take? See the exhibit.

  • A. Notify the primary health care provider (PHCP).
  • B. Administer 8 units of regular insulin.
  • C. Administer 10 units of regular insulin.
  • D. Recheck the client's blood glucose in one hour.
  • E. Administer the insulin intravenous (IV) push.
Correct Answer: A,B

Rationale: A blood glucose of 360 mg/dL is significantly elevated, requiring insulin per the sliding scale (e.g., 8 units for 351–400 mg/dL, depending on the exhibit) and PHCP notification for further management. IV push is inappropriate for SQ scales, and rechecking in one hour follows administration.

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