Endocrine RN NCLEX Questions Related

The nurse observes the newly hired registered nurse prepare to administer neutral protamine hagedorn (NPH) insulin to a client. Which action by the newly hired nurse requires follow-up?

• A. asks the client which site the insulin was last injected.
• B. checks the client's blood glucose levels prior to administering the insulin injection.
• C. shakes the insulin vial before withdrawing insulin.
• D. reminds the client to report symptoms of clammy skin and disorientation.

The nurse is caring for a client experiencing an adrenal crisis (Addisonian crisis). The nurse should be prepared to administer which intravenous fluid?

• A. Lactated Ringers (LR)
• B. 0.9% saline
• C. Dextrose 5% in water (D5W)
• D. Dextrose 5% in water and Lactated Ringers (D5LR)

The nurse is counseling a client who has prediabetes. The nurse understands that the client is meeting the treatment goal, as evidenced by

• A. total cholesterol of 215 mg/dL (5.55 mmol/L) [ < 200 mg/dL, < 5.2 mmol/L]
• B. hemoglobin A1C of 5.4% [ < 6.4%]
• C. fasting blood glucose 128 mg/dL (7.10 mmol/L) [70-110 mg/dL, 4.0-6.0 mmol/L]
• D. random blood glucose of 210 mg/dL (11.66 mmol/L) [70-110 mg/dL, 4.0-6.0 mmol/L]

The following scenario applies to the next 6 items
The nurse in the clinic is caring for a 32-year-old female client.
Item 1 of 6
Nurses' Notes
1559: Client reports to the outpatient clinic with reports of persistent fatigue, weakness, lethargy, and lower back pain over the last 8 months. She is also concerned because she has gained 24 pounds (10.9 kg) over the past 4 months. She stated that the weight gain has been so significant that she developed reddened streaks on her abdomen from the weight gain. The client is concerned because, over the past month, she has noticed she has been drinking more often and has had increased hunger. She has also noticed she is urinating more frequently. She went to urgent care one week ago and tested negative for urinary tract infection. She also noticed that her menstrual cycle has been irregular. She is not on birth control and took a home pregnancy test, which was negative. During the assessment, the client was fully alert and oriented. Clear lung sounds bilaterally. Skin was dry. Excessive facial hair was noted. 1+ pedal and ankle edema bilaterally. Peripheral pulses palpable, 2+, and regular. Body mass index (BMI) of 32. Vital signs: T 97.5° F (36.4° C), P 93, RR 18, BP 145/93, pulse oximetry reading 96% on room air. She is currently taking escitalopram for persistent depressive disorder.

Laboratory Results
Capillary Blood Glucose
1613: 254 mg/dL [70-110 mg/dL]

Select the client findings that require follow-up.

• A. Capillary blood glucose
• B. Peripheral pulse findings
• C. Blood pressure
• D. Not taking birth control

The following scenario applies to the next 1 items
The emergency department (ED) nurse is caring for a 66-year-old male client
Item 1 of 1


History and Physical
2000: 66-year male arrives at the emergency department (ED) following a recommendation by his primary healthcare provider (PHCP). The client called his PHCP in the morning, reporting a headache, feeling unwell, fatigue, and thirst. He could not check his blood glucose because he reports being out of testing supplies for two weeks. He also reports being unable to take his prescribed antihypertensive and antidiabetic medications for one week because he lost his job. On exam, the client reports feeling fatigued and thirsty. He is alert and completely oriented. His physical exam was within normal limits except for a thready pulse with a rate of 119/minute.

The client has a medical history of type II diabetes mellitus, congestive heart failure (CHF), hypertension, and hyperlipidemia. He is prescribed atorvastatin, metformin, and lisinopril.

Vital Signs
Oral Temperature 98o F (36.7o C)
Pulse 119/minute
Respirations 19/minute
Blood pressure 98/52 mm Hg
Oxygen saturation 96% on room air

Physician Orders
Obtain intravenous (IV) access
Five units of regular insulin via intravenous push (IVP)
Infuse two liters of 0.9% saline over one hour
Obtain capillary blood glucose (CBG) every two hours
Potassium chloride 20 mEq by mouth x 1 dose
Implement seizure precautions

The nurse reviews laboratory work ordered by the primary healthcare provider (PHCP). The nurse obtains physician orders for this client with hyperosmolar hyperglycemic state (HHS) . The nurse is preparing to implement the physician's orders. Which order should the nurse clarify with the physician?

• A. Infuse two liters of 0.9% saline over one hour
• B. Obtain capillary blood glucose every two hours
• C. Potassium chloride 20 mEq by mouth
• D. Implement seizure precautions