Endocrine NCLEX questions
To prepare for your NCLEX exam, you will need to review the high yield topics. Get started with our Endocrine NCLEX questions and endocrine review. Can you answer the following questions:
Question A nurse is assessing a patient with a suspected diagnosis of hyperthyroidism. Which of the following symptoms would the nurse most likely observe?
A. Bradycardia
B. Cold intolerance
C. Constipation
D. Weight loss
E. Dry skin
Rationale: Hyperthyroidism is characterized by an overactive thyroid gland, which increases metabolism. Symptoms commonly include weight loss, despite an increased appetite, due to the accelerated metabolism. Other symptoms of hyperthyroidism, not listed as options here, include heat intolerance and increased sweating, rather than cold intolerance or dry skin. Bradycardia and constipation are more commonly associated with hypothyroidism.
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@qbankproacademy 4000+ Free NCLEX QUESTIONS. Go to QBankProAcademy.com FREE Qbank questions for NCLEX RN, PN, HESI Exit, Med Surg, AANP, ANCC, and HesiA2. Practice questions, quizzes, and listen to the Free Podcast. In this video, we review a question on Hyperthyroidism,Graves Disease,Thyroid Eye Disease (exophthalmos) in Nursing Care. At QbankproAcademy.com our mission is to provide free QBanks, videos, and the most up to date test prep information for nurses. If you find our website helpful, please tell other aspiring nurses, nursing students, and professors. Please link to our site from your blogs, videos, and college websites, or share us on your favorite social media sites. Thank you for your support! Free nursing NCLEX 60-DAY CHALLENGE https://qbankpro.thinkific.com/courses/qbankpro-academy nclex Nurses Nursing aanp qbank ancc hesi qbank
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Question A patient with Addison’s disease is being educated on managing their condition. Which advice by the nurse is most appropriate?
A. “Increase your intake of dietary sodium.”
B. “Limit your fluid intake to avoid edema.”
C. “You should reduce your carbohydrate consumption.”
D. “Avoid stress as much as possible.”
E. “Increase your intake of potassium-rich foods.”
Rationale: Addison’s disease results from insufficient production of hormones by the adrenal glands, leading to symptoms such as hypotension and hyponatremia. Increasing dietary sodium can help manage hypotension. Limiting fluid intake and reducing carbohydrate consumption are not standard advice for managing Addison’s disease. While avoiding stress is beneficial for overall health, it’s not a specific dietary management strategy. Patients with Addison’s disease often have hyperkalemia, so increasing potassium intake would not be advisable.
Question A nurse is caring for a patient with Cushing’s syndrome. Which of the following features would the nurse expect to find during the assessment?
A. Hypertension
B. Hypoglycemia
C. Muscle hypertrophy
D. Weight loss
E. Decreased appetite
Rationale: Cushing’s syndrome, caused by prolonged exposure to high levels of cortisol, often presents with hypertension due to the increase in blood volume and cardiac output. Hypoglycemia is not a feature of Cushing’s syndrome; hyperglycemia is more common due to cortisol’s glucocorticoid activity. Muscle wasting (not hypertrophy) and weight gain (particularly central obesity), rather than weight loss, are characteristic of Cushing’s syndrome. Increased appetite can occur, contradicting the option of decreased appetite.
Question A patient with diabetes insipidus is admitted to the hospital. Which nursing intervention is most critical for this patient?
A. Monitoring blood glucose levels frequently
B. Encouraging carbohydrate intake
C. Providing a diet high in potassium
D. Monitoring fluid intake and output
E. Administering insulin as prescribed
Rationale: Diabetes insipidus is characterized by an inability of the kidneys to conserve water, leading to significant polyuria and risk of dehydration. Monitoring fluid intake and output is crucial for managing this condition and preventing dehydration. While monitoring blood glucose levels is important for diabetes mellitus, it’s not the primary concern in diabetes insipidus. Carbohydrate intake and administering insulin are interventions related to diabetes mellitus, not insipidus. Potassium is not specifically related to the management of diabetes insipidus.
Question A nurse is providing education to a patient newly diagnosed with hypothyroidism. Which statement by the patient indicates an understanding of the dietary changes needed?
A. “I should consume more soy products.”
B. “I will increase my intake of iodine-rich foods.”
C. “I need to avoid foods high in calcium.”
D. “I will limit my consumption of water.”
E. “I should avoid eating cruciferous vegetables.”
Rationale: Hypothyroidism can result from iodine deficiency because iodine is essential for thyroid hormone synthesis. Increasing the intake of iodine-rich foods can help support thyroid function in individuals with iodine-deficient hypothyroidism. Soy products and cruciferous vegetables, in large amounts, can interfere with thyroid hormone production but are not typically avoided unless recommended by a healthcare provider. Calcium and water intake do not directly affect thyroid hormone production and are not typically restricted in hypothyroidism management.
Question Which medication would the nurse anticipate administering to a patient with a diagnosis of hyperthyroidism to manage symptoms effectively?
A. Levothyroxine
B. Methimazole
C. Insulin
D. Hydrocortisone
E. Calcium supplements
Rationale: Methimazole is an antithyroid medication that inhibits the synthesis of thyroid hormones and is used in the treatment of hyperthyroidism. Levothyroxine is a synthetic form of thyroid hormone used to treat hypothyroidism, not hyperthyroidism. Insulin is used for managing diabetes mellitus. Hydrocortisone is used for adrenal insufficiency and does not directly treat hyperthyroidism. Calcium supplements are not a treatment for hyperthyroidism but may be used in conditions affecting bone density.
Question A nurse is planning care for a patient with acromegaly. Which of the following outcomes should the nurse prioritize?
A. Reduction in sodium retention
B. Increase in blood glucose levels
C. Decrease in joint pain
D. Increase in urine output
E. Stabilization of heart rate
Rationale: Acromegaly, caused by excessive growth hormone, often leads to joint pain due to abnormal bone growth and soft tissue swelling. Managing joint pain and improving mobility are important nursing care priorities. Sodium retention is not directly related to acromegaly. While acromegaly can cause insulin resistance and higher blood glucose levels, increasing glucose is not a goal. Urine output and heart rate stabilization are not directly related to the primary symptoms of acromegaly.
Question A patient with pheochromocytoma is being monitored in the hospital. What is the most important parameter for the nurse to monitor?
A. Blood pressure
B. Calcium levels C. Body temperature
D. Respiratory rate
E. Blood glucose levels
Rationale: Pheochromocytoma is a tumor of the adrenal gland that secretes excessive amounts of catecholamines, leading to episodes of hypertension. Monitoring blood pressure is critical to prevent hypertensive crises. Calcium levels, body temperature, respiratory rate, and blood glucose levels are not directly affected by pheochromocytoma and, while important, are not the primary concern in this condition.
Question Which intervention is most appropriate for a patient experiencing thyroid storm?
A. Providing a warm environment
B. Administering beta-blockers
C. Encouraging increased physical activity
D. Administering glucose-elevating agents
E. Increasing dietary iodine intake
Rationale: Thyroid storm is a life-threatening condition characterized by an extreme overproduction of thyroid hormones, leading to severe tachycardia and hyperthermia. Beta-blockers are administered to control the heart rate and reduce symptoms associated with high thyroid levels. Providing a warm environment and encouraging physical activity would exacerbate symptoms. Glucose-elevating agents and increasing dietary iodine intake are not appropriate interventions for managing thyroid storm.
Question A nurse is educating a patient with Graves’ disease about managing their condition. Which statement by the patient indicates a need for further education?
A. “I should monitor my heart rate regularly.”
B. “I will report any episodes of diarrhea or abdominal pain.”
C. “It’s important to follow a low-iodine diet.”
D. “I need to take my antithyroid medication as prescribed.”
E. “I should avoid strenuous exercise initially.”
Rationale: Graves’ disease is an autoimmune condition that leads to hyperthyroidism, not related to iodine excess. While dietary modifications may be necessary for other conditions, a low-iodine diet is specifically indicated for preparations for radioactive iodine therapy or in cases of iodine-induced hyperthyroidism, not as a general management strategy for Graves’ disease. Monitoring heart rate, reporting gastrointestinal symptoms, taking antithyroid medication, and avoiding strenuous exercise initially are all appropriate actions for managing Graves’ disease.
The symptoms of hypothyroidism and hyperthyroidism are almost opposite. It is important to understand these symptoms and the treatment.
Hypothyroid vs Hyperthyroid Symptoms
How do we define thyrotoxicosis? Thyrotoxicosis refers to a hyperthyroid condition. For example, if I told you that your water lead levels are “toxic”, what would that tell you about t lead levels? It’s not in the normal range.To be more specific, an abnormal can mean it is too high or it is too low. So, a toxic range means the lead level is too high. In these patients, the thyroid hormone level is too high. My next question is what are some features of patients who have thyroid hormone levels that are too high? Thyroid hormone refers to t3 and t4. First, weight loss is a symptom.
To help you remember, what if I ask you to describe a person or child who is hyperactive? The individual has excess energy. That should help you recall or think about a hypermetabolic state. Elevated heart rate, temperature, gastrointestinal tract peristalsis or diarrhea, tremor, increased energy, and irritability are key features. We see insomnia or difficulty sleeping. Other characteristics are thinning hair and oligomenorrhea. What is a sign of improvement in a patient on a new antithyroid medication? The answer is, improved sleep and improvement in the symptoms mentioned above.
NCLEX endocrine questions
The treatment for hyperthyroidism in many cases is medication. Pharmacology questions on the NCLEX exam focus on the drug action and the adverse effects of the drug. Propylthiouracil and methimazole (Tapazole) are important antithyroid medications that reduce the effects of elevated circulating thyroid hormone. Propylthiouracil (PTU) inhibits thyroid hormone synthesis It can cause serious liver problems or worsen the condition in a patient with underlying liver disease. Instruct patient contact their doctor if they have abdominal pain, bleeding, itching, yellowing of the skin (jaundice), or dark urine.
Methimazole, like PTU, inhibits thyroid hormone synthesis. Methimazole can adversely affect patients with liver disease and may cause immunosuppression. Avoid methimazole during pregnancy and when breastfeeding. Notify the doctor if you have abdominal pain, bleeding, itching, yellowing of the skin (jaundice), dark urine, infections or persistent sores.
Surgery for hyperthyroidism
When is surgery indicated for patients with hyperthyroidism? We treat patients with Graves’ disease with medications, radioactive iodine, or surgery. Surgery is done in patients with large goiters causing compression and there are other factors that may be considered. The exam will often ask about an important complication of thyroid surgery. The answer is recurrent laryngeal nerve damage. This surgical complication can have medicolegal consequences. It is very specific to thyroid surgery and thyroid anatomy, and you need to remember it is a post-op complication that you may be asked about.
Endocrine Nursing Assessment
Hypothyroidism Symptoms
What are the symptoms of hypothyroidism? Individuals with hypothyroidism experience tiredness, weakness, weight gain, slow heart rate (bradycardia), constipation, menorrhagia, coarse hair, cold sensitivity, and depressed mood. The treatment is levothyroxine (Synthroid). Levothyroxine will reduce the symptoms of hypothyroidism. It is given on an empty stomach before breakfast. Levothyroxine replaces the body’s thyroxine. Patients should be told about the side effects of levothyroxine. Taking too much levothyroxine causes tachycardia, headache, tremor, and feeling nervous or irritable.
NCLEX Endocrine Questions
Endocrine is a high-yield topic on the NCLEX. To practice free NCLEX endocrine questions, select the NCLEX Campus page above and select your topic.
Risk factors for developing Type II Diabetes
It is important to understand the difference between type I and type II diabetes. Type I diabetics are diagnosed early. Patients are born with this defect, so it is usually recognized very early in childhood. Type II diabetes develops later, for example,age 40-50s. Poor diet, obesity, and lack of exercise lead to type II diabetes. Women who have infants greater than 9 pounds are at increased risk for the development of diabetes. A body mass index (BMI) greater than 30 and hypertension increase the risk for diabetes. What is the effect of race on diabetes? Native Americans and Asians have a higher risk of developing type II diabetes. Having siblings with type II diabetes and pediatric patients who are over their percentile weight are at risk for type II diabetes.
what is kussmaul breathing?
There is a famous name attached to this type of respiratory pattern,“Kussmaul.” Kussmaul respirations are rapid deep breaths that occur with diabetic ketoacidosis as the patient attempts to compensate for metabolic acidosis.
normal blood sugar 2 hours after eating
The nurse will assess blood sugar levels after a meal in a nondiabetic or after administering regular insulin after a meal at 2 hours. Most individuals’ blood sugar is normal 2 hours postprandial.
diet for a diabetic patient
Dietary changes in diabetes include limiting concentrated sugars. To maintain more stable blood sugar levels you will recommend meals with carbohydrates, in particular simple carbohydrates not complex carbohydrates. Milk and crackers contain complex carbohydrates. Other choices like cola, muffins, and coffee with sugar contain simple carbohydrates and that’s going to be less appropriate for these patients.
What Is Adrenal Insufficiency?
The hormones affected in primary adrenal insufficiency are glucocorticoids, mineralocorticoids, and androgens. These individuals have weakness, chronic pain, hyperpigmentation, low blood pressure, salt cravings, and hypoglycemia. They may have abdominal cramping, hyponatremia, and hyperkalemia. The condition is commonly referred to as Addison disease. The disease affects the adrenal gland and impairs the secretion of the steroids normally produced by the gland. Treatment involves the replacement of glucocorticoids and mineralocorticoids. Options include prednisone, hydrocortisone, cortisone, and fludrocortisone usually prescribed under the care of a specialist. We often talk about adrenal crisis in these patients. Critical patients may need to receive steroids if they have a major physiological stress such as surgery, blood loss, or sepsis. They cannot respond appropriately to stress and may have severe hypotension. What problem do we worry about in patients who are hyperkalemic? The answer is cardiac rhythm disturbances and in severe hyperkalemia – cardiac arrest.
Hypoadrenal Crisis
Adrenal crisis is a condition where there is not enough cortisol to deal with severe physiologic stress. Causes include, for example, surgery, requiring general anesthesia, acute respiratory illness requiring mechanical ventilation, major trauma, and labor and delivery. Treatment of these patients includes intravenous or intramuscular hydrocortisone. Hypotension will be treated with saline infusion while carefully monitoring the patient’s hemodynamic status. If the patient is hypoglycemic, glucose is administered. The underlying condition that caused the crisis should be treated.
Cushing’s Syndrome
In patients with Cushing’s syndrome, you will see very thin legs, a round “moon” face, a fatty hump on the upper back, and stretch marks or striae on the skin. You will not expect bulging eyes as you saw in Graves’ disease and hyperthyroid. In addition, the skin is fragile and bruises easily. Patients with Cushing’s syndrome have poor wound healing. Hirsutism or excessive hair growth due to virilization due to the hormones produced occurs. Cushing’s syndrome affects mental health. Depression is not uncommon in Cushing patients especially in young females because the increase in hormones causes masculine characteristic development. These females are concerned about acne and excessive hair growth on the face or other parts of the body. Acne can be quite severe and the voice may deepen. It is important to monitor the mental health of Cushing’s patients. Consider counseling and psychotherapy for patients with problems coping with the physical changes. The treatment of this condition depends on the cause. Establish the cause of the hypercortisolism. Is the source a pituitary tumor, the adrenal gland, ectopic or exogenous?
What are the effects of hyperaldosteronism?
Aldosterone causes the body to retain sodium. In Cushing syndrome, patients will maintain a low-sodium diet. Daily weights help to identify water excess.
Bilateral adrenalectomy
Bilateral adrenalectomy or the removal of both adrenal glands is considered in patients with bilateral adrenal disease. This cures the patient of hypercortisolism. Subsequently, patients require lifelong steroid replacement. Patients receive steroids and are stabilized prior to surgery. These patients are at risk for post-operative complications (after surgery) including poor wound healing and infection.
Community screening for diabetes
Community-wide screening for undiagnosed diabetes is done in some communities. However, a screening test requires a confirmatory test. Screening tests are not diagnostic of the disease, they require further work-up.
Diabetes presenting symptoms
Remember the three important signs of diabetes: polyuria, polydipsia and polyphagia. Polyuria is excessive urination, polydipsia is excessive thirst, and polyphagia is increased appetite. Patients may report unintentional weight loss, skin infections, yeast infections, urinary tract infections, and blurred vision.
Educating patients with Type II diabetes
The best way to approach a patient newly diagnosed with diabetes is first to find out the patient’s level of knowledge of the diagnosis. This is a good starting point, and you can do this by asking questions. Provide pamphlets, and initiate one-on-one discussions. Q&A is one of the best ways to find out as much as you can about what the patients know about the diagnosis and the management of the disease.
Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is one of the most serious complications of diabetes. It is characterized by hyperglycemia, acidosis, and ketones in the blood. Patients often present with severe dehydration and electrolyte disturbances. Some patients report nausea, vomiting, and gastrointestinal discomfort. Patients who are unconscious may have Kussmaul breathing and fruity breath as a result of ketosis. Successful treatment includes close monitoring, correction of hyperglycemia and metabolic abnormalities, and rehydration.
START ENDOCRINE QUIZ
NCLEX QUESTION: 1) Which of the following is a treatment for pancreatitis? (select all that apply)
B. Low salt, healthy heart diet
C. Around the clock alternating Tylenol and Ibuprofen (Motrin) for pain
D. Parenteral nutrition if malnutrition is severe
NCLEX QUESTION: 2) What labs are elevated in acute pancreatitis? (select all that apply)
A. White blood cells
B. Alkaline phosphatase
C. Urinary amylase
D. Blood glucose
NCLEX QUESTION: 3) What is the most common cause of acute
pancreatitis?
A. Hyperlipidemia
B. Gallstones
C. Alcohol excess
D. Viral
NCLEX QUESTION: 4) Which of the following are symptoms of acute pancreatitis? ( select all that apply)
A. Leukocytosis
B. Nausea
C. Weight gain
D. Elevated amylase
NCLEX QUESTION: 5) What “signs” are found in pancreatitis? ( select all that apply)
A. Babinski’s sign
B. Turner’s sign
C. Kernig’s sign
D. Cullen’s sign
NCLEX QUESTION: 6) Which of the following are dietary recommendations for a patient discharged after treatment for chronic pancreatitis? (select all that apply)
A. Low-fat diet
B. High protein diet
C. Avoid alcohol
D. Take pancreatic enzymes as prescribed
NCLEX QUESTION: 7) What is the sign that refers to pain in the right upper quadrant when a patient takes a deep
breath? ( select all that apply)
A. Brudzenski’s sign
B. Murphy’s sign
C. Kernig’s sign
D. Blumer’s shelf sign
NCLEX QUESTION: 8) Which of the following are signs of acute cholecystits ? (select all that apply)
A. Left upper quadrant pain
B. Nausea/ vomiting
C. Pain worsened by eating high fat foods
D. Leukopenia
NCLEX QUESTION: 8) Which of the following are signs of acute cholecystits ? (select all that apply)
A. Left upper quadrant pain
B. Nausea/ vomiting
C. Pain worsened by eating high-fat foods
D. Leukopenia
NCLEX QUESTION: 9) Which of the following are treatments for acute cholecystits? (select all that apply)
A. High protein diet
B. Antiemetics
C. NGT for severe vomiting
D. Pain medication
NCLEX QUESTION: 10) In a patient undergoing liver biopsy in 2 hours, which of the following laboratory findings are most concerning? (select all that apply)
A. Serum sodium: 145 mEq/L
B. Blood glucose: 155 mg/dL
C. PT: 17 seconds
D. WBC: 8,000
NCLEX QUESTION: 11) What laboratory tests would the nurse expect to find on the patients orders to assess liver disease? (select all that apply)
A. Lipase
B. Amylase
C. Aspartate aminotransferase (AST)
D. Alkaline phosphatase
NCLEX QUESTION: 12) What are the liver enzymes tested to assess liver function?
A. Aspartate aminotransferase (AST)
B. Amylase
C. Alkaline phosphatase
D. Alanine aminotransferase (ALT)
NCLEX QUESTION: 13) What findings are expected in a patient with prolonged liver damage? (select all that apply)
A. Elevated creatinine
B. Prolonged PT
C. Hypocalcemia
D. Elevated serum ammonia
NCLEX QUESTION: 14) How do individuals prevent hepatitis B? (select all that apply)
A. Hand washing
B. Avoiding blood spills and contamination
C. Vaccination
D. Avoid drinking contaminated water
NCLEX QUESTION: 15) What is the most common cause of Hepatitis C? (select all that apply)
A. Needle sharing in IV drug use
B. Drinking contaminated water
C. Transfusion of contaminated blood
D. Eating contaminated meat
Answers to NCLE Questions
1. A,D
2. A,C,D
3. D
4. A,B,D
5. B,D
6. C,D
7. B
8. B,C
9. B,C,D
10. C
11. C,D
12. A,C,D
13. B,C,D
14. A,B,C
15. A,C
What is thyrotoxicosis?
Describe the symptoms of hyperthyroidism?
Explain the difference between hyperthyroidism and hypothyroidism?
Can you describe the physical features of Graves’ disease?
What are medications for hypothyroidism?
How do you define myxedema?
What is the difference between Type 1 and Type 2 Diabetes?
Question A nurse is assessing a patient with a suspected diagnosis of hyperthyroidism. Which of the following symptoms would the nurse most likely observe?
A. Bradycardia
B. Cold intolerance
C. Constipation
D. Weight loss
E. Dry skin
Rationale: Hyperthyroidism is characterized by an overactive thyroid gland, which increases metabolism. Symptoms commonly include weight loss, despite an increased appetite, due to the accelerated metabolism. Other symptoms of hyperthyroidism, not listed as options here, include heat intolerance and increased sweating, rather than cold intolerance or dry skin. Bradycardia and constipation are more commonly associated with hypothyroidism.
NCLEX Question POP QUIZ
@qbankproacademy 4000+ Free NCLEX QUESTIONS. Go to QBankProAcademy.com FREE Qbank questions for NCLEX RN, PN, HESI Exit, Med Surg, AANP, ANCC, and HesiA2. Practice questions, quizzes, and listen to the Free Podcast. In this video, we review a question on Hyperthyroidism,Graves Disease,Thyroid Eye Disease (exophthalmos) in Nursing Care. At QbankproAcademy.com our mission is to provide free QBanks, videos, and the most up to date test prep information for nurses. If you find our website helpful, please tell other aspiring nurses, nursing students, and professors. Please link to our site from your blogs, videos, and college websites, or share us on your favorite social media sites. Thank you for your support! Free nursing NCLEX 60-DAY CHALLENGE https://qbankpro.thinkific.com/courses/qbankpro-academy nclex Nurses Nursing aanp qbank ancc hesi qbank
♬ original sound – QBank Pro Academy – QBank Pro Academy
Question A patient with Addison’s disease is being educated on managing their condition. Which advice by the nurse is most appropriate?
A. “Increase your intake of dietary sodium.”
B. “Limit your fluid intake to avoid edema.”
C. “You should reduce your carbohydrate consumption.”
D. “Avoid stress as much as possible.”
E. “Increase your intake of potassium-rich foods.”
Rationale: Addison’s disease results from insufficient production of hormones by the adrenal glands, leading to symptoms such as hypotension and hyponatremia. Increasing dietary sodium can help manage hypotension. Limiting fluid intake and reducing carbohydrate consumption are not standard advice for managing Addison’s disease. While avoiding stress is beneficial for overall health, it’s not a specific dietary management strategy. Patients with Addison’s disease often have hyperkalemia, so increasing potassium intake would not be advisable.
Question A nurse is caring for a patient with Cushing’s syndrome. Which of the following features would the nurse expect to find during the assessment?
A. Hypertension
B. Hypoglycemia
C. Muscle hypertrophy
D. Weight loss
E. Decreased appetite
Rationale: Cushing’s syndrome, caused by prolonged exposure to high levels of cortisol, often presents with hypertension due to the increase in blood volume and cardiac output. Hypoglycemia is not a feature of Cushing’s syndrome; hyperglycemia is more common due to cortisol’s glucocorticoid activity. Muscle wasting (not hypertrophy) and weight gain (particularly central obesity), rather than weight loss, are characteristic of Cushing’s syndrome. Increased appetite can occur, contradicting the option of decreased appetite.
Question A patient with diabetes insipidus is admitted to the hospital. Which nursing intervention is most critical for this patient?
A. Monitoring blood glucose levels frequently
B. Encouraging carbohydrate intake
C. Providing a diet high in potassium
D. Monitoring fluid intake and output
E. Administering insulin as prescribed
Rationale: Diabetes insipidus is characterized by an inability of the kidneys to conserve water, leading to significant polyuria and risk of dehydration. Monitoring fluid intake and output is crucial for managing this condition and preventing dehydration. While monitoring blood glucose levels is important for diabetes mellitus, it’s not the primary concern in diabetes insipidus. Carbohydrate intake and administering insulin are interventions related to diabetes mellitus, not insipidus. Potassium is not specifically related to the management of diabetes insipidus.
Question A nurse is providing education to a patient newly diagnosed with hypothyroidism. Which statement by the patient indicates an understanding of the dietary changes needed?
A. “I should consume more soy products.”
B. “I will increase my intake of iodine-rich foods.”
C. “I need to avoid foods high in calcium.”
D. “I will limit my consumption of water.”
E. “I should avoid eating cruciferous vegetables.”
Rationale: Hypothyroidism can result from iodine deficiency because iodine is essential for thyroid hormone synthesis. Increasing the intake of iodine-rich foods can help support thyroid function in individuals with iodine-deficient hypothyroidism. Soy products and cruciferous vegetables, in large amounts, can interfere with thyroid hormone production but are not typically avoided unless recommended by a healthcare provider. Calcium and water intake do not directly affect thyroid hormone production and are not typically restricted in hypothyroidism management.
Question Which medication would the nurse anticipate administering to a patient with a diagnosis of hyperthyroidism to manage symptoms effectively?
A. Levothyroxine
B. Methimazole
C. Insulin
D. Hydrocortisone
E. Calcium supplements
Rationale: Methimazole is an antithyroid medication that inhibits the synthesis of thyroid hormones and is used in the treatment of hyperthyroidism. Levothyroxine is a synthetic form of thyroid hormone used to treat hypothyroidism, not hyperthyroidism. Insulin is used for managing diabetes mellitus. Hydrocortisone is used for adrenal insufficiency and does not directly treat hyperthyroidism. Calcium supplements are not a treatment for hyperthyroidism but may be used in conditions affecting bone density.
Question A nurse is planning care for a patient with acromegaly. Which of the following outcomes should the nurse prioritize?
A. Reduction in sodium retention
B. Increase in blood glucose levels
C. Decrease in joint pain
D. Increase in urine output
E. Stabilization of heart rate
Rationale: Acromegaly, caused by excessive growth hormone, often leads to joint pain due to abnormal bone growth and soft tissue swelling. Managing joint pain and improving mobility are important nursing care priorities. Sodium retention is not directly related to acromegaly. While acromegaly can cause insulin resistance and higher blood glucose levels, increasing glucose is not a goal. Urine output and heart rate stabilization are not directly related to the primary symptoms of acromegaly.
Question A patient with pheochromocytoma is being monitored in the hospital. What is the most important parameter for the nurse to monitor?
A. Blood pressure
B. Calcium levels C. Body temperature
D. Respiratory rate
E. Blood glucose levels
Rationale: Pheochromocytoma is a tumor of the adrenal gland that secretes excessive amounts of catecholamines, leading to episodes of hypertension. Monitoring blood pressure is critical to prevent hypertensive crises. Calcium levels, body temperature, respiratory rate, and blood glucose levels are not directly affected by pheochromocytoma and, while important, are not the primary concern in this condition.
Question Which intervention is most appropriate for a patient experiencing thyroid storm?
A. Providing a warm environment
B. Administering beta-blockers
C. Encouraging increased physical activity
D. Administering glucose-elevating agents
E. Increasing dietary iodine intake
Rationale: Thyroid storm is a life-threatening condition characterized by an extreme overproduction of thyroid hormones, leading to severe tachycardia and hyperthermia. Beta-blockers are administered to control the heart rate and reduce symptoms associated with high thyroid levels. Providing a warm environment and encouraging physical activity would exacerbate symptoms. Glucose-elevating agents and increasing dietary iodine intake are not appropriate interventions for managing thyroid storm.
Question A nurse is educating a patient with Graves’ disease about managing their condition. Which statement by the patient indicates a need for further education?
A. “I should monitor my heart rate regularly.”
B. “I will report any episodes of diarrhea or abdominal pain.”
C. “It’s important to follow a low-iodine diet.”
D. “I need to take my antithyroid medication as prescribed.”
E. “I should avoid strenuous exercise initially.”
Rationale: Graves’ disease is an autoimmune condition that leads to hyperthyroidism, not related to iodine excess. While dietary modifications may be necessary for other conditions, a low-iodine diet is specifically indicated for preparations for radioactive iodine therapy or in cases of iodine-induced hyperthyroidism, not as a general management strategy for Graves’ disease. Monitoring heart rate, reporting gastrointestinal symptoms, taking antithyroid medication, and avoiding strenuous exercise initially are all appropriate actions for managing Graves’ disease.
The symptoms of hypothyroidism and hyperthyroidism are almost opposite. It is important to understand these symptoms and the treatment.
Hypothyroid vs Hyperthyroid Symptoms
How do we define thyrotoxicosis? Thyrotoxicosis refers to a hyperthyroid condition. For example, if I told you that your water lead levels are “toxic”, what would that tell you about t lead levels? It’s not in the normal range.To be more specific, an abnormal can mean it is too high or it is too low. So, a toxic range means the lead level is too high. In these patients, the thyroid hormone level is too high. My next question is what are some features of patients who have thyroid hormone levels that are too high? Thyroid hormone refers to t3 and t4. First, weight loss is a symptom.
To help you remember, what if I ask you to describe a person or child who is hyperactive? The individual has excess energy. That should help you recall or think about a hypermetabolic state. Elevated heart rate, temperature, gastrointestinal tract peristalsis or diarrhea, tremor, increased energy, and irritability are key features. We see insomnia or difficulty sleeping. Other characteristics are thinning hair and oligomenorrhea. What is a sign of improvement in a patient on a new antithyroid medication? The answer is, improved sleep and improvement in the symptoms mentioned above.
NCLEX endocrine questions
The treatment for hyperthyroidism in many cases is medication. Pharmacology questions on the NCLEX exam focus on the drug action and the adverse effects of the drug. Propylthiouracil and methimazole (Tapazole) are important antithyroid medications that reduce the effects of elevated circulating thyroid hormone. Propylthiouracil (PTU) inhibits thyroid hormone synthesis It can cause serious liver problems or worsen the condition in a patient with underlying liver disease. Instruct patient contact their doctor if they have abdominal pain, bleeding, itching, yellowing of the skin (jaundice), or dark urine.
Methimazole, like PTU, inhibits thyroid hormone synthesis. Methimazole can adversely affect patients with liver disease and may cause immunosuppression. Avoid methimazole during pregnancy and when breastfeeding. Notify the doctor if you have abdominal pain, bleeding, itching, yellowing of the skin (jaundice), dark urine, infections or persistent sores.
Surgery for hyperthyroidism
When is surgery indicated for patients with hyperthyroidism? We treat patients with Graves’ disease with medications, radioactive iodine, or surgery. Surgery is done in patients with large goiters causing compression and there are other factors that may be considered. The exam will often ask about an important complication of thyroid surgery. The answer is recurrent laryngeal nerve damage. This surgical complication can have medicolegal consequences. It is very specific to thyroid surgery and thyroid anatomy, and you need to remember it is a post-op complication that you may be asked about.
Endocrine Nursing Assessment
Hypothyroidism Symptoms
What are the symptoms of hypothyroidism? Individuals with hypothyroidism experience tiredness, weakness, weight gain, slow heart rate (bradycardia), constipation, menorrhagia, coarse hair, cold sensitivity, and depressed mood. The treatment is levothyroxine (Synthroid). Levothyroxine will reduce the symptoms of hypothyroidism. It is given on an empty stomach before breakfast. Levothyroxine replaces the body’s thyroxine. Patients should be told about the side effects of levothyroxine. Taking too much levothyroxine causes tachycardia, headache, tremor, and feeling nervous or irritable.
NCLEX Endocrine Questions
Endocrine is a high-yield topic on the NCLEX. To practice free NCLEX endocrine questions, select the NCLEX Campus page above and select your topic.
Risk factors for developing Type II Diabetes
It is important to understand the difference between type I and type II diabetes. Type I diabetics are diagnosed early. Patients are born with this defect, so it is usually recognized very early in childhood. Type II diabetes develops later, for example,age 40-50s. Poor diet, obesity, and lack of exercise lead to type II diabetes. Women who have infants greater than 9 pounds are at increased risk for the development of diabetes. A body mass index (BMI) greater than 30 and hypertension increase the risk for diabetes. What is the effect of race on diabetes? Native Americans and Asians have a higher risk of developing type II diabetes. Having siblings with type II diabetes and pediatric patients who are over their percentile weight are at risk for type II diabetes.
what is kussmaul breathing?
There is a famous name attached to this type of respiratory pattern,“Kussmaul.” Kussmaul respirations are rapid deep breaths that occur with diabetic ketoacidosis as the patient attempts to compensate for metabolic acidosis.
normal blood sugar 2 hours after eating
The nurse will assess blood sugar levels after a meal in a nondiabetic or after administering regular insulin after a meal at 2 hours. Most individuals’ blood sugar is normal 2 hours postprandial.
diet for a diabetic patient
Dietary changes in diabetes include limiting concentrated sugars. To maintain more stable blood sugar levels you will recommend meals with carbohydrates, in particular simple carbohydrates not complex carbohydrates. Milk and crackers contain complex carbohydrates. Other choices like cola, muffins, and coffee with sugar contain simple carbohydrates and that’s going to be less appropriate for these patients.
What Is Adrenal Insufficiency?
The hormones affected in primary adrenal insufficiency are glucocorticoids, mineralocorticoids, and androgens. These individuals have weakness, chronic pain, hyperpigmentation, low blood pressure, salt cravings, and hypoglycemia. They may have abdominal cramping, hyponatremia, and hyperkalemia. The condition is commonly referred to as Addison disease. The disease affects the adrenal gland and impairs the secretion of the steroids normally produced by the gland. Treatment involves the replacement of glucocorticoids and mineralocorticoids. Options include prednisone, hydrocortisone, cortisone, and fludrocortisone usually prescribed under the care of a specialist. We often talk about adrenal crisis in these patients. Critical patients may need to receive steroids if they have a major physiological stress such as surgery, blood loss, or sepsis. They cannot respond appropriately to stress and may have severe hypotension. What problem do we worry about in patients who are hyperkalemic? The answer is cardiac rhythm disturbances and in severe hyperkalemia – cardiac arrest.
Hypoadrenal Crisis
Adrenal crisis is a condition where there is not enough cortisol to deal with severe physiologic stress. Causes include, for example, surgery, requiring general anesthesia, acute respiratory illness requiring mechanical ventilation, major trauma, and labor and delivery. Treatment of these patients includes intravenous or intramuscular hydrocortisone. Hypotension will be treated with saline infusion while carefully monitoring the patient’s hemodynamic status. If the patient is hypoglycemic, glucose is administered. The underlying condition that caused the crisis should be treated.
Cushing’s Syndrome
In patients with Cushing’s syndrome, you will see very thin legs, a round “moon” face, a fatty hump on the upper back, and stretch marks or striae on the skin. You will not expect bulging eyes as you saw in Graves’ disease and hyperthyroid. In addition, the skin is fragile and bruises easily. Patients with Cushing’s syndrome have poor wound healing. Hirsutism or excessive hair growth due to virilization due to the hormones produced occurs. Cushing’s syndrome affects mental health. Depression is not uncommon in Cushing patients especially in young females because the increase in hormones causes masculine characteristic development. These females are concerned about acne and excessive hair growth on the face or other parts of the body. Acne can be quite severe and the voice may deepen. It is important to monitor the mental health of Cushing’s patients. Consider counseling and psychotherapy for patients with problems coping with the physical changes. The treatment of this condition depends on the cause. Establish the cause of the hypercortisolism. Is the source a pituitary tumor, the adrenal gland, ectopic or exogenous?
What are the effects of hyperaldosteronism?
Aldosterone causes the body to retain sodium. In Cushing syndrome, patients will maintain a low-sodium diet. Daily weights help to identify water excess.
Bilateral adrenalectomy
Bilateral adrenalectomy or the removal of both adrenal glands is considered in patients with bilateral adrenal disease. This cures the patient of hypercortisolism. Subsequently, patients require lifelong steroid replacement. Patients receive steroids and are stabilized prior to surgery. These patients are at risk for post-operative complications (after surgery) including poor wound healing and infection.
Community screening for diabetes
Community-wide screening for undiagnosed diabetes is done in some communities. However, a screening test requires a confirmatory test. Screening tests are not diagnostic of the disease, they require further work-up.
Diabetes presenting symptoms
Remember the three important signs of diabetes: polyuria, polydipsia and polyphagia. Polyuria is excessive urination, polydipsia is excessive thirst, and polyphagia is increased appetite. Patients may report unintentional weight loss, skin infections, yeast infections, urinary tract infections, and blurred vision.
Educating patients with Type II diabetes
The best way to approach a patient newly diagnosed with diabetes is first to find out the patient’s level of knowledge of the diagnosis. This is a good starting point, and you can do this by asking questions. Provide pamphlets, and initiate one-on-one discussions. Q&A is one of the best ways to find out as much as you can about what the patients know about the diagnosis and the management of the disease.
Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is one of the most serious complications of diabetes. It is characterized by hyperglycemia, acidosis, and ketones in the blood. Patients often present with severe dehydration and electrolyte disturbances. Some patients report nausea, vomiting, and gastrointestinal discomfort. Patients who are unconscious may have Kussmaul breathing and fruity breath as a result of ketosis. Successful treatment includes close monitoring, correction of hyperglycemia and metabolic abnormalities, and rehydration.
START ENDOCRINE QUIZ
NCLEX QUESTION: 1) Which of the following is a treatment for pancreatitis? (select all that apply)
B. Low salt, healthy heart diet
C. Around the clock alternating Tylenol and Ibuprofen (Motrin) for pain
D. Parenteral nutrition if malnutrition is severe
NCLEX QUESTION: 2) What labs are elevated in acute pancreatitis? (select all that apply)
A. White blood cells
B. Alkaline phosphatase
C. Urinary amylase
D. Blood glucose
NCLEX QUESTION: 3) What is the most common cause of acute
pancreatitis?
A. Hyperlipidemia
B. Gallstones
C. Alcohol excess
D. Viral
NCLEX QUESTION: 4) Which of the following are symptoms of acute pancreatitis? ( select all that apply)
A. Leukocytosis
B. Nausea
C. Weight gain
D. Elevated amylase
NCLEX QUESTION: 5) What “signs” are found in pancreatitis? ( select all that apply)
A. Babinski’s sign
B. Turner’s sign
C. Kernig’s sign
D. Cullen’s sign
NCLEX QUESTION: 6) Which of the following are dietary recommendations for a patient discharged after treatment for chronic pancreatitis? (select all that apply)
A. Low-fat diet
B. High protein diet
C. Avoid alcohol
D. Take pancreatic enzymes as prescribed
NCLEX QUESTION: 7) What is the sign that refers to pain in the right upper quadrant when a patient takes a deep
breath? ( select all that apply)
A. Brudzenski’s sign
B. Murphy’s sign
C. Kernig’s sign
D. Blumer’s shelf sign
NCLEX QUESTION: 8) Which of the following are signs of acute cholecystits ? (select all that apply)
A. Left upper quadrant pain
B. Nausea/ vomiting
C. Pain worsened by eating high fat foods
D. Leukopenia
NCLEX QUESTION: 8) Which of the following are signs of acute cholecystits ? (select all that apply)
A. Left upper quadrant pain
B. Nausea/ vomiting
C. Pain worsened by eating high-fat foods
D. Leukopenia
NCLEX QUESTION: 9) Which of the following are treatments for acute cholecystits? (select all that apply)
A. High protein diet
B. Antiemetics
C. NGT for severe vomiting
D. Pain medication
NCLEX QUESTION: 10) In a patient undergoing liver biopsy in 2 hours, which of the following laboratory findings are most concerning? (select all that apply)
A. Serum sodium: 145 mEq/L
B. Blood glucose: 155 mg/dL
C. PT: 17 seconds
D. WBC: 8,000
NCLEX QUESTION: 11) What laboratory tests would the nurse expect to find on the patients orders to assess liver disease? (select all that apply)
A. Lipase
B. Amylase
C. Aspartate aminotransferase (AST)
D. Alkaline phosphatase
NCLEX QUESTION: 12) What are the liver enzymes tested to assess liver function?
A. Aspartate aminotransferase (AST)
B. Amylase
C. Alkaline phosphatase
D. Alanine aminotransferase (ALT)
NCLEX QUESTION: 13) What findings are expected in a patient with prolonged liver damage? (select all that apply)
A. Elevated creatinine
B. Prolonged PT
C. Hypocalcemia
D. Elevated serum ammonia
NCLEX QUESTION: 14) How do individuals prevent hepatitis B? (select all that apply)
A. Hand washing
B. Avoiding blood spills and contamination
C. Vaccination
D. Avoid drinking contaminated water
NCLEX QUESTION: 15) What is the most common cause of Hepatitis C? (select all that apply)
A. Needle sharing in IV drug use
B. Drinking contaminated water
C. Transfusion of contaminated blood
D. Eating contaminated meat
Answers to NCLE Questions
1. A,D
2. A,C,D
3. D
4. A,B,D
5. B,D
6. C,D
7. B
8. B,C
9. B,C,D
10. C
11. C,D
12. A,C,D
13. B,C,D
14. A,B,C
15. A,C
What is thyrotoxicosis?
Describe the symptoms of hyperthyroidism?
Explain the difference between hyperthyroidism and hypothyroidism?
Can you describe the physical features of Graves’ disease?
What are medications for hypothyroidism?
How do you define myxedema?
What is the difference between Type 1 and Type 2 Diabetes?
