NCLEX : Endocrine Conditions

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #21 : Endocrine Conditions

A 50-year-old female client is seen in the clinic for her recent diagnosis of hypothyroidism. Which of the following instructions should be included in the nurse's teaching plan?

Possible Answers:

High fiber, low calorie diet, and 5-6 small meals per day

The use of antiglycemic medications

High protein, low carbohydrate diet and replacement hydrocortisone

Explain the outcomes expected with removal of the thyroid gland

Obtain a hemoglobin A1C test

Correct answer:

High fiber, low calorie diet, and 5-6 small meals per day

Explanation:

Hypothyroidism usually involves weight gain so a lower calorie diet with frequent small meals are recommended. High fiber, low calorie diets and stool softeners will help to alleviate these symptoms. Antiglycemics and hemoglobin A1C tests are indicated for diabetics.

Example Question #22 : Endocrine Conditions

A middle-aged female client has just underwent a thyroidectomy for treatment of Graves' disease. The nurse caring for this client is aware she may need to monitor the client for what possible complication?

Possible Answers:

Bone pain

Tetany

Goiter

Oliguria

Tetanus

Correct answer:

Tetany

Explanation:

Tetany is a complication due to hypocalcemia which can occur if the parathyroid glands which control calcium balance are accidentaly injured during thyroidectomy. Tetany is associated with nerve excitability and sustained muscle contractions, or spasms. Tetanus, bone pain, and oliguria are not associated with complications of a thyroidectomy. Goiter is a manifestation of an overactive thyroid. 

Example Question #23 : Endocrine Conditions

A 45-year-old female client with Addison's disease has presented to the client for instruction on her medication regiment The nurse understands that the patient may require lifelong corticosteroid replacement. It will be necessary to educate the client about possible side effects of this type of therapy. 

Which of the following should a nurse include in his/her teaching plan about corticosteroid therapy?

Possible Answers:

Monitor glucose with finger sticks to check for hypoglycemia.

The medications should be taken on a empty stomach in the morning to avoid nausea if taken with food. 

Increase calcium intake to at least  with vitamin D, to help to prevent steroid induced osteoporosis. 

Incease intake of folic acid and B12 to prevent neurological side effects such as paresthesias of the hands and feet.

Increase sodium intake to prevent hypotension due to edema. 

Correct answer:

Increase calcium intake to at least  with vitamin D, to help to prevent steroid induced osteoporosis. 

Explanation:

Corticosteroids may lead to bone loss, especially after long term treatment (over 3 months). Calcium and vitamin D supplementation can help prevent these side effects. The client should also be advised to start a low impact exercise regimine if possible, and if necessary take a bisphosphonate drug. 

Example Question #432 : Conditions And Treatments

You are caring for a patient who is started on clindamycin, ketorolac, prednisone, lisinopril, and simvastatin. After receiving multiple doses of each of these medications, you notice that the patient's blood glucose is . Which of these medications is known to cause hyperglycemia?

Possible Answers:

Ketorolac

Simvastatin

Prednisone

Lisinopril

Clindamycin

Correct answer:

Prednisone

Explanation:

The correct answer is prednisone. Of all the medications listed, prednisone is the only medication that is known to cause hyperglycemia. 

Prednisone has a number of side effects including hyperglycemia, acne, headache, restlessness, insomnia, nausea, vomiting, and weight gain, among others. 

Clindamycin's side effects include diarrhea (including Clostridium difficile), and less commonly nausea, vomiting, and abdominal pain, among others, but not hyperglycemia.

Ketorolac's side effects include renal toxicity, tinnitus, heartburn, diarrhea, and abdominal pain, among others, but not hyperglycemia.

Lisinopril's side effects include hypotension, lightheadedness, angioedema, and barky cough, among others, but not hyperglycemia.

Simvastatin's side effects include muscle pains/aches, muscle weakness, and less frequently confusion, and electrolyte disturbances, but not hyperglycemia.

Example Question #432 : Conditions And Treatments

You are the nurse taking care of a patient with type two diabetes mellitus. The patient is hospitalized for pneumonia and switched from his home medication, metformin, to sliding-scale insulin, while inpatient. You explain to the patient that the specific reason is which of the following? 

Possible Answers:

To prevent depression while hospitalized 

To prevent stroke while hospitalized

To prevent lactic acidosis while hospitalized

To prevent headache while hospitalized

To prevent myocardial infarction while hospitalized

Correct answer:

To prevent lactic acidosis while hospitalized

Explanation:

The correct answer is "to prevent lactic acidosis while hospitalized." This is the correct answer because a known side effect of metformin use is development of lactic acidosis (a form of metabolic acidosis). Patients who are hospitalized, especially if hospitalized for infections, like pneumonia, are independently at an elevated risk of developing a lactic acidosis. As such, to minimize the risk of lactic acidosis, a modifiable risk factor, metformin use, is frequently temporarily discontinued while inpatient. Patients on metformin are frequently switched to sliding-scale insulin as inpatients, as this allows for adequate glycemic monitoring, titration, and control. Once they are stable for discharge and the cause of their hospitalization is addressed and treated, most can be safely discharged home on metformin without issue.

While numerous measures are carried out while patients are hospitalized to prevent myocardial infarction, stroke, headache, and depression, the switching of metformin to sliding-scale insulin is not performed specifically for any of those reasons.

Example Question #24 : Endocrine Conditions

Which of the following is true of type I diabetes?

Possible Answers:

Patients typically present in diabetic ketoacidosis

Patients are typically overweight adults

Patients develop insulin resistance

Patients do not require treatment with insulin

Correct answer:

Patients typically present in diabetic ketoacidosis

Explanation:

Type I diabetes is an autoimmune process that typically presents in young children in the form of DKA (diabetic ketoacidosis). This potentially life threatening condition is treated with IV insulin. Type II diabetes is insulin resistance, and is found in older adults (typically those who are overweight).

Example Question #1 : Symptoms And Tests For Endocrine Conditions

The nurse is caring for a patient who is to receive a fasting blood glucose test. The nurse does all of the following to prepare the patient except __________.

Possible Answers:

Stops the patient's D5 0.45 IV maintenance fluid

Instructs the patient to refrain from the use of hard candy

Instructs the patient not to use any gum or breath mints

Marks the patient NPO 2 hours before the test

Restricts meals 4-8 hours before the test

Correct answer:

Marks the patient NPO 2 hours before the test

Explanation:

The patient should refrain from ingesting any material that may contain sugar prior to a fasting blood glucose. However, is not necessary for a patient to be labeled NPO as they are still able to ingest water. All other preparations should be made.

Example Question #1241 : Nclex

The nurse cares for a patient newly diagnosed with systemic lupus erythematosus (SLE). Which of the following is a characteristic sign of SLE?

Possible Answers:

Lesions on extremities

Blood in urine

Arthritis and joint swelling

Butterfly rash across bridge of nose and cheeks

Pain during exposure to cold

Correct answer:

Butterfly rash across bridge of nose and cheeks

Explanation:

The most characteristic sign of SLE is a butterfly rash across the bridge of nose and cheeks. The others listed are also signs and symptoms of SLE, but the most well-known sign that is specific to SLE is the butterfly rash. Arthritis and joint swelling, hematuria, lesions on extremities, and pain during exposure to cold (Raynaud’s phenomenon) may be signs of other diseases 

Example Question #2 : Symptoms And Tests For Endocrine Conditions

The nurse reviews lab results for a patient with hyperparathyroidism. Which of the following changes in lab findings would the nurse expect?

Possible Answers:

Low vitamin D level

Low serum calcium level

High serum calcium level

Normal vitamin D level

Low parathyroid hormone level

Correct answer:

High serum calcium level

Explanation:

The nurse should know the parathyroid glands regulate serum calcium levels; in hyperparathyroidism, serum calcium levels are elevated. Parathyroid hormones are not low in hyperparathyroidism due to the overactivity of the parathyroid glands. Urine calcium may be elevated due to spilling of the high serum calcium level into the urine. Vitamin D levels should be low, as the body will increase vitamin D in the blood to lower the calcium level.

Example Question #1 : Endocrine Condition Follow Up

What type of thyroid cancer has the worst prognosis?

Possible Answers:

Medullary carcinoma

Anaplastic carcinoma

Follicular carcinoma

Papillary carcinoma

Correct answer:

Anaplastic carcinoma

Explanation:

The 5 year survival rate for aplastic carcinoma of the thyroid is 7-14%. The 5 year survival rates of papillary, medullary, and follicular thyroid carcinomas are close to 100% for stage I cancers. Survival rates decrease to approximately 50% for stage IV papillary and follicular carcinomas and 28% for stage IV medullary carcinoma. 

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