NCLEX RN Questions on Endocrine System

NCLEX RN Questions on Endocrine System Related

Review NCLEX RN Questions on Endocrine System related questions and content

The following scenario applies to the next 1 items
The nurse in the medical-surgical unit is caring for a 59-year-old female
Item 1 of 1
Nurses' Notes
0845: Morning capillary blood glucose obtained of 189 mg/dL (10.4 mmol/L). 4 units of lispro insulin administered per sliding scale. Vancomycin infusion started at this time in left peripheral vascular access device that was patent with positive blood return. Call bell placed within reach.

0950: The client alerted RN that they 'didn't feel good.' The client appeared pale, diaphoretic, and lethargic. The client's words became slurred, and she was disoriented, asking, "where am I?" 'The client's breakfast tray appeared untouched. The client's capillary blood glucose was obtained at 41 mg/dL (2.2 mmol/L). Glasgow coma scale: 13. Vital signs: T 98° F (36.7° C), P 108, RR 22, BP 150/86, pulse oximetry reading 95%. A rapid response was called because of the client's condition change.

1000: Rapid response team arrived at the bedside. Report was given to the rapid response nurse.

Medical History
• Diabetes mellitus, type I
• Hyperlipidemia
• Pericarditis
• Asthma
Orders
0700:
• Admit to medical/surgical for cellulitis
• vancomycin 1 g, IV, every 12 hours
• Resume all home medications
• Insulin lispro, sliding scale, before meals
• Consistent carbohydrate diet
• Daily labs: complete blood count and comprehensive metabolic panel

The rapid response nurse receives report from the primary nurse and reviews the medical record. 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. Keep the client NPO until mental status improves, Administer glucagon 1 mg intramuscular (IM), Have the client drink 8 ounces (240 mL) of skim milk, Stop the vancomycin infusion.
  • B. Creatinine, Glasgow coma scale, Capillary blood glucose, Urinary ketones.
  • C. Cerebrovascular accident, Diabetic ketoacidosis (DKA), Hypoglycemia, Vancoymycin infusion reaction.
Correct Answer: C, B, C, B

Rationale: Low glucose (41 mg/dL), pallor, and disorientation indicate hypoglycemia. Administer glucagon for rapid correction, monitor glucose and Glasgow coma scale to assess recovery.

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The nurse has provided education to a client newly prescribed glipizide. Which of the following statements by the client would indicate a correct understanding of the teaching?

  • A. I will need to take this medication 30 minutes before a meal.
  • B. I can expect to lose weight while taking this medication.
  • C. I should not take this medication if I had a procedure involving contrast dye.
  • D. This medication may cause me to develop vitamin B12 deficiency.
Correct Answer: A

Rationale: Glipizide, a sulfonylurea, should be taken 30 minutes before meals to enhance insulin secretion during eating. It may cause weight gain, not loss, and is not affected by contrast dye or linked to B12 deficiency.

The nurse is teaching a client who has Graves' disease about self-management. Which of the following should the nurse include in the teaching plan?

  • A. Stool softeners can be taken daily to prevent constipation.
  • B. Thyroid replacement should be taken first thing in the morning.
  • C. Report any significant weight gain while taking the antithyroid medication.
  • D. Maintain the prescribed fluid restriction to prevent fluid overload.
Correct Answer: C

Rationale: In Graves' disease, antithyroid meds control hyperthyroidism; significant weight gain may signal overtreatment, needing reporting. Stool softeners, thyroid replacement, and fluid restriction are for hypothyroidism or other conditions.

The nurse is caring for a client eight hours postoperative following a total thyroidectomy. Which of the following assessment findings indicate that the client is developing a complication?

  • A. Moderate amount of dried sanguineous drainage on the dressing
  • B. Oral temperature of 99.2°F (37.3°C)
  • C. Apical pulse of 56
  • D. The client reports a sore throat when speaking
Correct Answer: A

Rationale: Excessive drainage post-thyroidectomy may indicate hemorrhage, a serious complication. A slightly elevated temperature, mild bradycardia, and sore throat are expected or less concerning in the immediate postoperative period.

The nurse is educating a group of students on the effects of corticosteroids. It would be appropriate for the nurse to identify the following adverse effects associated with corticosteroids.

  • A. Mood lability
  • B. Immunosuppression
  • C. Hypoglycemia
  • D. Hyperkalemia
  • E. Weight gain
Correct Answer: A, B, E

Rationale: Corticosteroids cause mood changes, suppress immunity, and promote weight gain via fluid retention and fat redistribution. They cause hyperglycemia, not hypoglycemia, and hypokalemia, not hyperkalemia.

The nurse is teaching a client about newly prescribed insulin glargine. The nurse recognizes the need for further instruction when the client makes the following statement?

  • A. I will take this insulin right before my meals.
  • B. I should roll this vial of insulin before removing it with the syringe.
  • C. This insulin will help control my glucose for 24 hours.
  • D. I can only inject this insulin into my abdomen.
  • E. I'm glad to know I can mix this with my regular insulin.
Correct Answer: A,B,D,E

Rationale: Insulin glargine is a long-acting insulin taken once daily, not before meals, provides 24-hour coverage, and should not be mixed with other insulins. It is clear and does not require rolling, and can be injected in multiple sites, not just the abdomen. Only the statement about 24-hour control is correct.

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