NCLEX-PN : Conditions and Treatments

Study concepts, example questions & explanations for NCLEX-PN

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Example Questions

Example Question #12 : Endocrine Conditions

Which of the following genetic condition increases risk for development of diabetes?

Possible Answers:

Turner syndrome

All of these

Down's syndrome

Kleinfelter's syndrome

Correct answer:

All of these

Explanation:

All of these symptoms are associated with a higher risk of developing diabetes. Turner syndrome is also know as XO, where the individual is a female, and is monosomic for the X-chromosome. Individuals with Turner syndrome are also at higher risk of heart disease, and hypothyroidism, and they are sterile. Down's syndrome is caused by trisomy of chromosome 21, and involves elevated risks for mental impairment, heart disease, and certain cancers. Kleinfelter's syndrome patients have the XXY-chromosomal expression. They are at a higher risk than the classically male or female public for osteoporosis, hypogonadism, and cardiovascular disorders.

Example Question #13 : Endocrine Conditions

What is the most common cause of Cushing's disease?

Possible Answers:

Corticosteroid use

Paraneoplastic syndrome

Pituitary adenoma

Renal adenoma

Correct answer:

Pituitary adenoma

Explanation:

80% of cases of Cushing's disease are caused by adrenocorticotropic hormone (ACTH)-secreting adenomas of the anterior pituitary. High ACTH ends up causes adrenal hyperplasia, which leads to secretion of extra cortisol. Corticosteroid use is the leading cause of Cushing syndrome, rather than Cushing's disease.

Example Question #14 : Endocrine Conditions

How does insulin affect serum electrolytes? 

Possible Answers:

Insulin increases the permeability of many cells to chlorine, sodium and potassium ions

Insulin increases the permeability of many cells to potassium, magnesium and phosphate ions

Insulin has no effect on serum electrolyte levels

Insulin decreases the permeability of many cells to potassium, magnesium and phosphate ions

Correct answer:

Insulin increases the permeability of many cells to potassium, magnesium and phosphate ions

Explanation:

Insulin activates sodium-potassium ATPase in skeletal muscle cells causing an influx of potassium. Under certain circumstances, an incorrectly administered injection of insulin may kill patients due to its ability to acutely suppress plasma potassium concentrations.

Example Question #421 : Conditions And Treatments

What mediates intracellular transport of glucose into the beta cells of the pancreas? 

Possible Answers:

GLUT-2, an insulin-independent glucose transporter

GLUT-4, an insulin-independent glucose transporter

GLUT-4, an insulin-dependent glucose transporter

GLUT-2, an insulin-dependent glucose transporter

Correct answer:

GLUT-2, an insulin-independent glucose transporter

Explanation:

GLUT-2 is the primary carrier for glucose transport into pancreatic beta cells. It does not depend on insulin to function. It thus aids the pancreatic beta cells sense glucose levels in the blood, which are then triggered to release insulin. GLUT-4 is active primarily in adipose and muscle tissue. 

Example Question #15 : Endocrine Conditions

What is the triad of presenting symptoms of diabetes mellitus in adults?

Possible Answers:

Polyuria, polydypsia, and polyphagia

Polydypsia, weight loss, and enuresis

Polyuria, weight loss, and polydypsia

Weight gain, enuresis, and polydypsia

Correct answer:

Polyuria, polydypsia, and polyphagia

Explanation:

The first onset of diabetes is generally marked by the following three signs: polyuria - frequent urination, polydypsia - increased thirst & fluid intake, and polyphagia - increased appetite. In children with type 1 diabetes, enuresis (involuntary urination) is often the first sign noticed by parents, along with unexplained weight loss and recurrent infections.

Example Question #16 : Endocrine Conditions

Which of the following lifestyle exposures can lead to a thyroid disorder?

Possible Answers:

Smoking

Diet high in oxalates

Asbestos

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Correct answer:

Smoking

Explanation:

Smokers have higher levels of the chemical thiocyanate, a degradation product of cyanide in tobacco smoke, which can block iodine uptake by the thyroid. A high oxalate diet is associated with kidney stones, asbestos exposure is associated with mesothelioma, and nonsteroidal anti-inflammatory drugs (NSAIDs) use, while associated with several gastric disorders, has not been shown to have a significant effect on thyroid function. 

Example Question #17 : Endocrine Conditions

What is the most common cause of primary hyperparathyroidism?

Possible Answers:

Parathyroid hyperplasia

Parathyroid adenoma

Parathyroid carcinoma

None of these

Correct answer:

Parathyroid adenoma

Explanation:

Primary hyperparathyroidism is most commonly due to a parathyroid adenoma. 80-90% of cases of primary hyperparathyroidism are due to parathyroid adenoma. 10-15% cases are due to parathyroid hyperplasia, and parathyroid carcinoma accounts for 1-5% of all cases.

Example Question #18 : Endocrine Conditions

Secondary hyperparathyroidism is the result of chronically diminished levels of serum calcium. Depressed levels of serum calcium leads to a compensatory increase in the activity of the parathyroid glands. 

What is the most common cause of secondary hyperparathyroidism?

Possible Answers:

Pituitary tumor

Renal failure

Poor nutrition

Bone cancers

Correct answer:

Renal failure

Explanation:

Renal failure is by far the most common cause of secondary hyperparathyroidismIf kidneys are unable to convert vitamin D to its active form, serum vitamin D levels will drop. Lower vitamin D levels reduce the absorption of calcium in the intestines and reduce the kidneys' ability to resorb calcium from the urine. In addition, if the kidneys are unable to adequately excrete phosphate, calcium phosphate forms, which further lowers free calcium levels in the blood. Poor nutrition is not a common cause of secondary hyperparathyroidism, though low vitamin D levels due to malabsorption can be a contributing factor. Pituitary tumors can be seen with hyperparathyroidism when part of multiple endocrine neoplasia type I, but this is not as common as renal failure. Bone cancers are more often associated with elevated calcium levels, resulting in low or undetectable parathyroid hormone levels. 

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. 

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