ENDOCRINE TEST
SITUATION 1
1. The endocrine system is a glandular tissue that produces, stores, and secretes hormone. Which of the
following are the UNIQUE characteristics of all hormones?
A. Circulate into the blood for metabolic processes.
B. Enter cells to after genetic development.
C. Influence cellular activity of specific target tissues.
D. Most hormones can damage the pituitary gland.
2. Acromegaly is most frequently diagnosed in:
A. Middle-aged adults
B. Newborns (DWARFISM)
C. Children 2 to 5 (HYPOTHYROIDISM)
D. Adults aged 85 and older ( DEGENERATIVE PROCESS)
3. Which of the following is related to acromegaly?
A. Do you use 3 pillows during sleep?
B. Are you saying that you want to hurt yourself?
C. Has the patient’s pulse increased?
D. Are you buying larger size of shoes?
4. Which test is not related to acromegaly?
A. Blood sugar
B. Growth factor
C. CT Scan
D. MRI
E. Sodium level
5. The appropriate
A. Trans labyrinth
B. Transsphenoidal hypophysectomy
C. Craniotomy
D. Decompressive brain surgery
6. What is hormone secreted from the posterior lobe of the pituitary gland?
A. LH
B. MSH
C. ADH
D. GNRH
7. Hormone accelerates the anabolism and catabolism regulation.
Which of the following tests is related to DI?
A. ECG C. Urine Test
B. EMG – brain activity D. EMG- muscle activity
8. A female patient with a suspected DI is to provide a clean-catch urine specimen for urine testing. To obtain the
specimen the nurse will:
a. have the patient empty the bladder completely, then obtain the next urine specimen that the patient can avoid.
b. teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile
specimen.
c. insert a short sterile “mini” catheter attached to a collecting container into the urethra and bladder to obtain the
specimen.
d. clean the area around the meatus with a povidone-iodine(Betadine) swab, and then have the patient void into a
sterile container.
9. Which of the following is a PRIORITY goal of the health care team when a patient is
afflicted with DI?
A. Maintenance of fluid and electrocyte balance.
B. Maintenance of glucose level.
C. Docu
D. Administer
10. When caring for a male client with diabetes insipidus, the nurse expects to administer:
A. Vasopressin
B. Furosemide
C. Regular insulin
D. 10%
11. A male patient in the clinic provides a urine sample that is red orange in color.
Which action should the nurse take first?
a. Notify the patient’s health care provider.
b. Teach correct midstream urine collection.
c. Ask the patient about current medications.
RIFAMPICIN
RED ORANDE URINE
PYRIDIUM
d. Questions the patient about urinary tract infection (UTI) risk factors.
12. A patient with DI is treated with nasal desmopressin. The nurse recognizes that the drug is not having an adequate
therapeutic effect if patient experiences
a. headache and weight gain
b. nasal irritation and nausea
c. a urine specific gravity of 1.002
d. an oral intake greater than urinary output.
13. Which a priority nursing diagnosis for a patient receiving desmopressin in
(DDAVP-Deamino-8 D-Argenine VasoPressin)?
A. Risk for injury
B. Acute pain
C. Excess fluid volume.
D. Deficient knowledge regarding Medication.
14. When discharging patient with diabetes insipidus. Which of the following is the BEST instruction to be given to the
patient?
a. Know the steps in self CPR
b. Always carry his emergency meds.
c. Carry the names of his attending physician.
d. Written instruction.
15. Which of the following may cause SIADH?
A. Lung cancer
B. PPG tumor
C. Stress
D. All these.
16. Which of the following laboratory result is related to SIADH?
A. K+5.5
B. Na+ 148
C. Hematocrit 55%
D. RBC 6M
E. Na+ 130 SODIUM HYPONATREMIA
17. The urine of client with SIADH will show a urine:
A. that is diluted
B. with a high specific gravity
C. that is cloudy
D. that is full of bubbles.
18. Which of the following dugs maybe prescribed for clients with SIADH?
A. Haldol
B. Lithium
C. Prozac
D. MAOI
Situation-Thyroid Gland
19. Grave’s disease is:
a. The most common cause of hypothyroidism MYXEDEMA
b. The most common cause of hyperparathyroidism TUMOR
c. The most common cause of hyperthyroidism
d. The most common cause of adrenal insufficiency ADDISON’S
20. When conducting physical assessment of patients with endocrine disorders, the nurse is guided that the ONLY
endocrine organ that can be done by palpation is the
A. Pituitary gland
B. Adrenal gland
C. Thyroid gland
D. Parathyroid gland
21. The patient asks you about goiter. You describe this disorders as
a. A condition produced by excessive endogenous or exogenous thyroid hormone.
b. The enlargement of the thyroid gland and usually caused by an iodine-deficit diet.
c. None of the choices.
d. Inflammation of the thyroid gland that may lead to chronic hypothyroidism or resolve spontaneously.
22. The patient asks what is normal thyroid state? The BEST response is:
A. Euthyroid
B. Hyperthyroid
C. Parathyroid
D. Panthyroid
23. The client has a tentative diagnosis of thyrotoxicosis. With the increase thyroid hormone that stimulates metabolic rate
in this condition, which of the following NOT expected by the patient to manifest?
A. Hyper
B. Increase
C. Cold intolerance
D. Palpitation
24. PRIOR to thyroid scanning procedure, the patient must avoid:
A. Bread
B. Pasta
C. Rice
D. Water
E. Seafood
25. Which of the following interventions is APPROPRIATE to protect the eye of the patient from injury and maintain visual
acuity?
a. Report to the ENT for check up.
b. Bright eyeglasses as protective mechanism.
c. Artificial tears as need to moisten the dry eyes.
d. Clear eyeglasses when doing outdoor activities.
26. A patient with hyperthyroidism is taking propylthiouracil (PTU).
The nurse will monitor the effectivity by checking the
A. gingival hyperplasia
B. dyspnea and a dry cough.
C. blurred vision and nystagmus.
D. decreased in pulse rate
27. Of what instruction should a client receiving radioactive iodine-131 be told?
A. Drink plenty of fluids, especially those high in calcium
B. Flush the toilet 2-3x.
C. Be aware of the symptoms of tachycardia, increased metabolic rate, and anxiety.
D. Wear a mask if around children or pregnant women.
28. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds nurse, Then assesses the
client, who now has a nausea, a temperature of 106* F (40.5*C), tachycardia and extreme restlessness. What is the
most likely cause of these signs?
a. Diabetic ketoacidosis
b. Thyroid storm
c. Hypoglycemia
d. Tetany
29. Primary hypothyroidism in adults is more common among?
a. newborns
b. school aged children
c. elderly
d. early to middle adulthood
30. The nurse has identified the nursing diagnosis of fatigue for a patient who is hypothyroid. What should the nurse do
while caring for this patient?
a. Monitor for changes in orientation, cognition, and behavior.
b. Monitor vital signs and cardiac rhythm, response to activity.
c. Monitor bowel movement frequent
d. Provide balanced meal to the client
31. A physician prescribes levothyroxine (Synthroid), 0.15 mg orally daily, for a client with hypothyroidism. The nurse will
prepare to administer this medication in the:
a. Morning
b. After meals
c. At bedtime
d. With meal
e.
32. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily.
a. Dysuria
b. Leg cramps
c. Dysrhythmia
d. Blurred vision
33. A female adult client with history of chronic hyperparathyroidism admits to being noncompliance. Based on initial
assessment findings, the nurse formulates the nursing diagnosis of Risk of injury. To complete the nursing diagnosis
statement for this client, which “related to” phrase should the nurse add?
a. Related to bone demineralization resulting in pathologic fractures.
b. Related to exhaustion secondary to an accelerated metabolic rate
c. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces.
d. Related to tetany secondary to a medical diagnosis: decreased serum calcium level.
Situation - Adrenal glands
34. The most common cause of Cushing’s Disease is:
A. Lung cancer
B. Excess steroids
C. Cigarette smoking
D. Hereditary
35. Which one is common in Cushing’s?
A. Pink striations in the abdomen (purple, red striae)
B. Linea nigra
C. Spider Angiomas
D. Visible peristaltic wave
36. Which of the following is not included in the management of Cushing’s?
A. Check VS
B. Urine output, input, weight monitoring
C. Stress management
D. High protein diet
E. Steroid therapy
37. Which of the following patients are at risk for developing Addison’s Disease?
a. A patient with tumor on the pituitary gland, which is causing too much GH to be secreted.
b. A patient taking glucocorticoids for several weeks.
c. A client with recent PTB infection.
d. A patient who is post-opt from an appendectomy.
e.
38. The nurse’s is aware that the most appropriate NANDA for a client with Addison’s Disease?
a. Fluid volume deficit
b. Excessive fluid volume
c. Urinary retention related to oliguria
d. Hyperglycemia related excessive sugar intake
39. Regarding question above, you are also educating the patient about post-op care for bilateral adrenalectomy. Which
statement by the patient indicates they understood your instruction?
A. “I will have to take mineralocorticoids daily for 2 years”.
B. “I will have to take glucocorticoids and mineralocorticoids daily for 2 years”.
C. When I experience signs of stress, “I will have to take mineralocorticoids as needed”.
D. “I will have to take glucocorticoids and mineralocorticoids daily for life”
40. A 54-year old patient admitted with type 2 asks the nurse “type 2” means. What is the appropriate response by the
nurse?
a. “With type 2 diabetes, the body of the pancreas becomes inflamed”.
b. “With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased."
c. “With type 2 diabetes, the patient is totally dependent on an outside source of insulin."
d. “With type 2 diabetes, the body produces autoantibodies that destroy β-cells in the pancreas."
e.
41. The nurse is evaluating a 45-year-old patient diagnosed with type 2 diabetes mellitus. Which symptom reported by the
patient is considered one of the classic clinical manifestations of diabetes?
POLYURIA, POLYDIPSIA, POLYPHAGIA
A. Excessive thirst
B. Gradual weight gain
C. Overwhelming fatigue
D. Recurrent blurred vision
42. Polydipsia and polyuria related to diabetes mellitus are primarily due to:
a. the release of ketones from cells during fat metabolism
b. fluid shifts resulting from the osmotic effect of hyperglycemia
c. damage to the kidneys from exposure to high levels of glucose.
d. changes in RBCs resulting from attachment of excessive glucose to hemoglobin.
43. A patient, who is admitted with diabetes mellitus, has a glucose level of 380 mg/dL and a moderate level of ketones in the
urine. As the nurse assesses for signs of ketoacidosis, which respiratory pattern would the nurse expect to find?
a. Central apnea
b. Hypoventilation
c. Kussmaul respirations
d. Cheyne-Stokes respirations
44. Which electrolyte replacement should the nurse anticipate being ordered by the health-care provider in the client
diagnosed with DKA who has just been admitted to the ICU?
A. Glucose
B. Potassium
C. Calcium
D. Sodium
45. Which arterial blood gas results should the nurse expect in the client diagnosed with diabetic keto acidosis?
a. pH-7.34, PaO2-99, PaCO2-48, HCO3-24
b. pH-7.38, PaO2-95, PaCO2-40, HCO3-22
c. pH-7.46, PaO2-85, PaCO2-30, HCO3-26
d. pH-7.30, PaO2-90, PaCO2-30, HCO3-18
46. Which assessment data indicate the client diagnosed with diabetic keto acidosis is responding to the medical treatment?
a. The client has tented skin turgor and dry mucous membranes
b. The client is alert and oriented to date, time, and place
c. The client's ABG results are pH-7.29, PaCO2-44, HCO3-15
d. The client's serum potassium level is 3.3 mEq/L
47. The client diagnosed with type 2 diabetes is admitted to the intensive care unit with hyperosmolar hyperglycemic nonketotic
syndrome (HHNS) coma. Which assessment data should the nurse expect the client to exhibit?
a. Kussmaul's respiration's
b. Diarrhea and epigastric
c. Dry mucous membranes
d. Ketone breath odor
48. The elderly client is admitted to the intensive care department diagnosed with severe NKS. Which collaborative intervention
should the nurse include in the plan of care?
a. Infuse 0.9% normal saline intravenously.
b. Administer intermediate-acting insulin.
c. Perform blood glucometer checks daily.
d. Monitor arterial blood gas results. DKA
49. The nurse caring for a patient hospitalized with diabetes mellitus would look for which laboratory test result to obtain
information on the patient's past glucose control?
MOST ACCURATE TEST THAT DETERMINES THE BLOOD GLUCOSE CONTROL
A. Prealbumin level
B. Urine ketone level
C. Fasting glucose level
D. Glycosylated hemoglobin level (60-120 DAYS)
50. The client diagnosed with type 1 diabetes has a glycosylated hemoglobin (A1c) of 8.1%.
Which interpretation should the nurse make based on this result?
Normal <5.7%
Prediabetic 5-7-6.4%
Diabetic 6.5 and up
A. This result is below normal levels
B. This result tis within acceptable levels
C. This result is above recommended levels
D. This result is dangerously high (12-13%)
51. Ideally, the goal of patient diabetes education is to:
A. Make all patients responsible for the management of their disease.
B. Involve the patient's family and significant others in the care of the patient.
C. Enable the patient to become the most active participant in the management of the diabetes.
D. Provide the patient with as much information as soon as possible to prevent complications of diabetes.
52. The nurse is developing a care plan for the client diagnosed with type diabetes. The nurse identifies the problem "high risk
for hyperglycemia related to noncompliance with the medication regimen." Which statement is an appropriate short-term goal
for the client?
A. The client will have a blood glucose level between 90 and 140 mg/Dl
B. The client will demonstrate appropriate insulin injection technique
C. The nurse will monitor the client's blood glucose levels four (4) times a day.
D. The client will maintain normal kidney function with 30 mL/hr urine output
53. The nurse teaches a 38-year-old man who was recently diagnosed with type 1 diabetes mellitus about insulin administration.
Which statement by the patient requires an intervention by the nurse?
a. "I will discard any insulin bottle that is cloudy in appearance."
b. "The best injection site for insulin administration is in my abdomen."
c. "I can wash the site with soap and water before insulin administration."
d. "I may keep my insulin at room temperature (75F) for up to a month.”
54. The nurse has been teaching a patient with diabetes mellitus how to perform self-monitoring of blood glucose (SMBG).
During evaluation of the patient's technique, the nurse identifies a need for additional teaching when the patient does what?
a. Chooses a puncture site in the center of the finger pad.
b. Washes hands with soap and water to cleanse the site to be used.
c. Warms the finger before puncturing the finger to obtain a drop of blood.
d. Tells the nurse that the result of 110 mg/dL indicates good control of diabetes.
55. The nurse is beginning to teach a diabetic patient about vascular complications of diabetes. What information is appropriate
for the nurse to include?
a. Macroangiopathy does not occur in type 1 diabetes but rather in type 2 diabetics who have severe disease.
b. Microangiopathy is specific to diabetes and most commonly affects the capillary membranes of the eyes, kidneys,
and skin.
c. Renal damage resulting from changes in large- and medium-sized blood vessels can be prevented by careful
glucose control.
d. Macroangiopathy causes slowed gastric emptying and the sexual impotency experienced by a majority of
patients with diabetes.
56. The nurse is teaching a 60-year-old woman with type 2 diabetes mellitus
how to prevent diabetic nephropathy. Which statement made by the
patient indicates that teaching has been successful?
a. "Smokeless tobacco products decrease the risk of kidney damage."
b. "I can help control my blood pressure by avoiding foods high in salt."
c. "I should have yearly dilated eye examinations by an ophthalmologist."
d. "I will avoid hypoglycemia by keeping my blood sugar above 180 mg/dL."
57. The nurse has taught a patient admitted with diabetes, cellulitis, and osteomyelitis about the principles of foot care. The
nurse evaluates that the patient understands the principles of foot care if the patient makes what statement?
a. "I should only walk barefoot in nice dry weather."
b. "I should look at the condition of my feet every day."
c. "I am lucky my shoes fit so nice and tight because they give me firm support."
d. "When I am allowed up out of bed, I should check the shower water with my toes."
58. The nurse instructs a 22-year-old female patient with diabetes mellitus about a healthy eating plan. Which statement made
by the patient indicates that teaching was successful?
a. "I plan to lose 25 pounds this year by following a high-protein diet."
b. "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach."
c. "I should include more fiber in my diet than a person who does not have diabetes."
d. "If I use an insulin pump, I will not need to limit the amount of saturated fat in my diet."
59. The newly diagnosed patient with type 2 diabetes has been prescribed metformin (Glucophage). What should the
nurse tell the patient to best explain how this medication works?
METFORMIN = ANTIDIABETIC DRUG
a. Increases insulin production from the pancreas.
b. Slows the absorption of carbohydrate in the small intestine.
c. Reduces glucose production by the liver and enhances insulin sensitivity.
d. Increases insulin release from the pancreas, inhibits glucagon secretion, and decreases gastric emptying.
60. The nurse is assessing the feet of a client with long-term type 2 diabetes.
Which assessment data warrant immediate intervention by the nurse?
A. The client has crumbling toenails
B. The client has athlete's foot
C. The client has a necrotic big toe
D. The client has thickened toenails
