endocrine nclex questions

Caring for patients with endocrine disorders is a challenge for nurses, especially since there are various symptoms that can be life-threatening for patients and need immediate care or attention.

This practice test, therefore, aims to test nurses with knowledge and skills in caring for patients with endocrine disorders. Included in this practice test are items related to the most commonly-asked endocrine disorders in the NCLEX-RN and their care using both the usual multiple-choice question formats and innovative items.

Read each item carefully, analyzing what is asked from the question, and choose the best response/responses from the options provided. Note the time it takes for you to complete this rest, simulating how the NCLEX-RN and other examinations are given. Try to answer each question in 1 minute. Correct answers and rationale are provided at the end of the test.

Endocrine NCLEX Practice Questions

1. The nurse is caring for a patient after hypophysectomy and notes clear nasal drainage from the patient’s nostril. The nurse should take which initial action?

A. Lower the head of the bed.
B. Test the drainage for glucose.
C. Obtain a culture of the drainage.
D. Continue to observe the drainage.

2. The nurse is admitting a patient who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which health care provider prescriptions should the nurse anticipate receiving? Select all that apply.

A. Initiate an infusion of 3% NaCl.
B. Administer intravenous furosemide.
C. Restrict fluids to 800 mL over 24 hours.
D. Elevate the head of the bed to high Fowler’s.
E. Administer a vasopressin antagonist as
prescribed.

3. A patient is admitted to an emergency department, and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out initially?

A. Warm the patient.
B. Maintain a patent airway.
C. Administer thyroid hormone.
D. Administer fluid replacement.

4. The nurse is completing an assessment on a patient who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which patient complaint would be characteristic of this disorder? Select all that apply.

A. Polyuria
B. Headache
C. Bone pain
D. Nervousness
E. Weight gain

5. The nurse is teaching a patient with hyperparathyroidism how to manage the condition at home. Which response by the patient indicates the need for additional teaching?

A. “I should limit my fluids to 1 liter per day.”
B. “I should use my treadmill or go for walks daily.”
C. “I should follow a moderate-calcium, high fiber diet.”
D. “My alendronate helps to keep calcium from coming out of my bones.”

6. The nurse is monitoring a patient diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the intensive care unit. Which findings should alert the nurse to the presence of a possible postoperative complication? Select all that apply.

A. Anxiety
B. Leukocytosis
C. Chvostek’s sign
D. Urinary output of 800 mL/hour
E. Clear drainage on nasal dripper pad

7. In a patient with central diabetes insipidus, administration of aqueous vasopressin during a water deprivation test will result in a

A. decrease in body weight
B. increase in urinary output
C. decrease in blood pressure
D. increase in urine osmolality

8. Preoperative instructions for the patient scheduled for a subtotal thyroidectomy includes teaching the patient

A. how to support the head with the hands when moving
B. that coughing should due avoided to prevent pressure on the incision
C. that the head and neck will need to remain immobile until the incision heals
D. that any tingling around the lips or in the fingers after surgery is expected and
temporary

9. When providing discharge instructions to a patient following a subtotal thyroidectomy, the nurse advises the patient to

A. never miss a daily dose of thyroid replacement therapy
B. avoid regular exercise until thyroid function is normalized
C. avoid eating foods such as soybeans, turnips, and rutabagas
D. use warm salt water gargles several times a day to relieve throat pain

10. A patient is admitted to the hospital with a diagnosis of Cushing syndrome. On physical assessment of the patient, the nurse would expect to find

A. hypertension, peripheral edema, and petechiae
B. weight loss, buffalo hump, and moon face with acne
C. abdominal and buttock striae, truncal obesity, and hypotension
D. anorexia, signs of dehydration, and hyperpigmentation of the skin

11. A patient with Addison’s disease comes to the emergency department with complaints of nausea, vomiting, diarrhea, and fever. The nurse would expect collaborative care to

Include

A. parenteral injections of ACTH
B. IV administration of vasopressors
C. IV administration of hydrocortisone
D. IV administration of D5W with 20mEq of KCl

12. The most important nursing intervention during the medical and surgical treatment of the patient with a pheochromocytoma is

A. administering IV fluids
B. monitoring blood pressure
C. monitoring I&O and daily weights
D. administering B-adrenergic blocking agents

13. During a follow-up visit to the physician, a patient with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and:

A. magnesium
B. phosphorus
C. sodium
D. potassium

14. While assessing a patient with hypoparathyroidism, the nurse taps the patient’s facial nerve and observes twitching of the mouth and tightening of the jaw. The nurse would document this finding as to which of the following?

A. Positive Trousseau’s sign
B. Positive Chvostek’s sign
C. Tetany
D. Hyperactive deep tendon reflex

15. Before discharge, what should a nurse instruct a patient with Addison’s disease to do when exposed to periods of stress?

A. Perform capillary blood glucose monitoring four times daily.
B. Drink 8 oz of fluids.
C. Administer hydrocortisone I.M.
D. Continue to take his usual dose of hydrocortisone.

16. The nurse is educating a couple who has had difficulty with conception. The patient asks about the hormone, which is responsible for the production of eggs. The nurse answers that this hormone is called:

A. Melanocyte-stimulating hormone
B. Luteinizing hormone (LH)
C. Follicle-stimulating hormone (FSH)
D. Interstitial cell-stimulating hormone (ICSH)

17. The nurse is caring for a patient admitted with suspected hyperparathyroidism. Because of the potential effects of this disease on electrolyte balance, the nurse should assess this patient for which of the following manifestations?

A. Neurologic irritability
B. Declining urine output
C. Lethargy and weakness
D. Hyperactive bowel sounds

18. The nurse is providing discharge instructions to a patient with diabetes insipidus. Which of the following instructions regarding desmopressin acetate (DDAVP) would be most appropriate?

A. The patient can expect to experience weight loss resulting from increased diuresis.
B. The patient should alternate nostrils during administration to prevent nasal irritation.
C. The patient should monitor for symptoms of hypernatremia as a side effect of this drug.
D. The patient should report any decrease in urinary elimination to the health care
provider.

19. A patient has been taking oral prednisone for the past several weeks after having a severe reaction to poison ivy. The nurse has explained the procedure for gradual reduction rather than sudden cessation of the drug. What is the rationale for this approach to drug administration?

A. Prevention of hypothyroidism
B. Prevention of diabetes insipidus
C. Prevention of adrenal insufficiency
D. Prevention of cardiovascular complications

20, When instructing a patient regarding a urine study for free cortisol, it is most important for the nurse to tell the patient to

A. Save the first voided urine in the am.
B. Maintain a high-sodium diet 3 days before collection.
C. Try to avoid stressful situations during the collection period.
D. Complete at least 30 minutes of strenuous exercise before collecting the urine
sample.

21. Laboratory results are back for a 54-year-old patient with a 15-year history of diabetes. Which of the following results follows the expected pattern accompanying macrovascular disease as a complication of diabetes?

A. Increased triglyceride levels
B. Decreased low-density lipoproteins
C. Increased high-density lipoproteins
D. Decreased very-low-density lipoproteins

22. A daily dose of prednisone is prescribed for a patient. The nurse provides instructions to the patient regarding the administration of the medication and should instruct the patient that which time is best to take this medication?

A. At noon
B. At bedtime
C. Early morning
D. Anytime, at the same time each day

23. A patient with thyrotoxicosis says to the nurse, “I am so irritable. I am having problems at work because I lose my temper very easily.” Which of the following responses by the nurse would give the patient the most accurate explanation of her behavior?

A. “Your behavior is caused by temporary confusion brought on by your illness.”
B. “Your behavior is caused by the excess thyroid hormone in your system.”
C. “Your behavior is caused by your worrying about the seriousness of your illness.”
D. “Your behavior is caused by the stress of trying to manage a career and cope with illness.”

24. A patient with Graves’ disease is treated with radioactive iodine (RAI) in the form of sodium iodide 131I. Which of the following statements by the nurse will explain to the patient how the drug works?

A. “The radioactive iodine stabilizes the thyroid hormone levels before a thyroidectomy.”
B. “The radioactive iodine reduces uptake of thyroxine and thereby improves your condition.”
C. “The radioactive iodine lowers the levels of thyroid hormones by slowing your body’s production of them.”
D. “The radioactive iodine destroys thyroid tissue so that thyroid hormones are no longer produced.”

25. A patient expresses concern about how a hypophysectomy will affect his sexual function. Which of the following statements provides the most accurate information about the physiologic effects of hypophysectomy?

A. Removing the source of excess hormone should restore the patient’s libido, erectile function, and fertility.
B. Potency will be restored, but the patient will remain infertile.
C. Fertility will be restored, but impotence and decreased libido will persist.
D. Exogenous hormones will be needed to restore erectile function after the adenoma is removed.

26. The patient’s wife asks the nurse whether the I.V. infusion is meeting her husband’s nutritional needs because he has vomited several times. The nurse’s response should be based on the knowledge that 1 L of 5% dextrose in normal saline solution delivers:

A. 170 calories.
B. 250 calories.
C. 340 calories.
D. 500 calories.

27. A patient with Addison’s disease is admitted to the medical unit. The nurse diagnoses the patient with Deficient fluid volume related to inadequate fluid intake and to fluid loss secondary to inadequate adrenal hormone secretion. As the patient’s oral intake increases, which of the following fluids would be most appropriate?

A. Milk and diet soda.
B. Water and eggnog.
C. Bouillon and juice.
D. Coffee and milkshakes.

28. A patient with Cushing’s disease tells the nurse that the physician said the morning serum cortisol level was within normal limits. The patient asks, “How can that be? I’m not imagining all these symptoms!” The nurse’s response will be based on which of the following concepts?

A. Some patients are very sensitive to the effects of cortisol and develop symptoms even with normal levels.
B. A single random blood test cannot provide reliable information about endocrine levels.
C. The excessive cortisol levels are seen in Cushing’s disease commonly result from loss of the normal diurnal secretion pattern.
D. Tumors tend to secrete hormones irregularly, and the hormones are generally not present in the blood.

29. The patient with Cushing’s disease needs to modify dietary intake to control symptoms. In addition to increasing protein, which strategy would be most appropriate?

A. Increase calories.
B. Restrict sodium.
C. Restrict potassium.
D. Reduce fat to 10%.

30. The patient who has undergone a bilateral adrenalectomy is ready to return home. She tells the nurse that she is concerned about persistent body changes and the fact that her moods are still so unpredictable. She says, “I thought surgery was supposed to fix all that.” The nurse should tell the patient that:

A. The body changes are permanent and the patient will not be the same as before this condition.
B. The body and mood will gradually return to normal.
C. The physical changes are permanent, but the mood swings will disappear.
D. The physical changes are temporary, but the mood swings are permanent.

31. After a bilateral adrenalectomy for Cushing’s disease, the patient will receive periodic testosterone injections. The expected outcome of these injections is:

A. Balanced reproductive cycle.
B. Restored sodium and potassium balance.
C. Stimulated protein metabolism.
D. Stabilized mood swings.

32. The patient with pheochromocytoma is scheduled for surgical resection of the tumor in the adrenal medulla. The nurse should monitor the patient postoperatively for which of the following potential complications?

A. Orthostatic hypotension.
B. Hemorrhage.
C. Hypoglycemia.
D. Hypertensive crisis

33. The patient with pheochromocytoma should be instructed to avoid activities that precipitate hypertensive crises or paroxysms, such as:

A. Jogging.
B. The Valsalva maneuver.
C. Anxiety.
D. Hypoglycemia.

34. A patient with diabetes mellitus comes to the clinic for a regular 3-month follow-up appointment. The nurse notes several small bandages covering cuts on the patient’s hands. The patient says, “I’m so clumsy. I’m always cutting my finger cooking or burning myself on the iron.” Which of the following responses by the nurse would be most appropriate?

A. “Wash all wounds in isopropyl alcohol.”
B. “Keep all cuts clean and covered.”
C. “Why don’t you have your children do the cooking and ironing?”
D. “You really should be fine as long as you take your daily medication.”

35. The patient with diabetes mellitus says, “If I could just avoid what you call carbohydrates in my diet, I guess I would be okay.” The nurse should base the response to this comment on the knowledge that diabetes affects the metabolism of which of the following?

A. Carbohydrates only.
B. Fats and carbohydrates only.
C. Protein and carbohydrates only.
D. Proteins, fats, and carbohydrates.

Answers and Rationale

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Nhiña Sandeep de Rosas, MAN, DIH, DSHRM, RN currently works for the Department of Health CHD Mimaropa as a Training Specialist. She is also a Nurse Licensure Exam and NCLEX-RN reviewer on her free time. She has her USRN licenses in New York and Vermont, having passed the NCLEX-RN in 2007.Since 2006, she has been a nurse educator and worked as a clinical instructor and classroom lecturer for Unciano Colleges (College of Nursing) in Antipolo City. She has earned her Master’s Degree in Nursing and Diploma in International Health at the University of the Philippines Open University; and her Diploma in Strategic Human Resource Management at the Ateneo de Manila University.

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