ENDOCRINE NCLEX
FINAL STUDY GUIDE 2026 EXAM
QUESTIONS AND ANSWERS
Which of the following assessment findings characterize thyroid storm?
a) increased body temperature, decreased pulse, and increased blood pressure
b) increased body temperature, increased pulse, and increased blood pressure
c) increased body temperature, decreased pulse, and decreased blood pressure
d) increased body temperature, increased pulse, and decreased blood pressure - ANSWER-b)
increased body temperature, increased pulse, and increased blood pressure
Thyroid storm is characterized by SNS activation. Thyroid hormones potentiate effects of
cathecolamines (epinephrine/norepinephrine). Therefore, all vital signs will be increased.
The nurse is planning care for a client with hyperthyroidism. Which of the following nursing
interventions are appropriate? Select all that apply
a) instill isotonic eye drops as necessary
b) provide several, small, well-balanced meals
c) provide rest periods
d) keep environment warm
e) encourage frequent visitors and conversation
f) weigh the client daily - ANSWER-a, b, c, and f
(a) The client with hyperthyroidism may experience exopthalmos. This requires instillation of
eye drops to prevent dryness and ulceration of the cornea.
,(b and f) The client experiences weight loss because of hypermetabolism. Several, small, well-
balanced meals are given to improve nutritional status of the client and daily weights should be
monitored. Weight is the most objective indicator of nutritional status.
(c) The client is usually exhausted due to restlessness and agitation. Frequent rest periods help
the client regain energy.
After thyroidectomy, which of the following is the priority assessment to observe laryngeal
nerve damage?
a) hoarseness of voice
b) difficulty in swallowing
c) tetany
d) fever - ANSWER-a) hoarseness of voice
Laryngeal nerve damage is manifested by severe hoarseness of voice of "whispery voice".
When caring for a male client with diabetes insipidus, nurse Juliet expects to administer:
a. vasopressin (Pitressin Synthetic)
b. furosemide (Lasix).
c. regular insulin.
d. 10% dextrose. - ANSWER-a. vasopressin (Pitressin Synthetic)
Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin)
production, the nurse should expect to administer synthetic vasopressin for hormone
replacement therapy. Furosemide, a diuretic, is contraindicated because a client with diabetes
insipidus experiences polyuria. Insulin and dextrose are used to treat diabetes mellitus and its
complications, not diabetes insipidus.
Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's
syndrome, the nurse would expect to find:
a. Hypotension.
,b. Thick, coarse skin.
c. Deposits of adipose tissue in the trunk and dorsocervical area.
d. Weight gain in arms and legs. - ANSWER-c. Deposits of adipose tissue in the trunk and
dorsocervical area
Because of changes in fat distribution, adipose tissue accumulates in the trunk, face
(moonface), and dorsocervical areas (buffalo hump). Hypertension is caused by fluid retention.
Skin becomes thin and bruises easily because of a loss of collagen. Muscle wasting causes
muscle atrophy and thin extremities.
For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client
for Chvostek's sign and Trousseau's sign because they indicate which of the following?
a. Hypocalcemia
b. Hypercalcemia
c. Hypokalemia
d. Hyperkalemia - ANSWER-a. Hypocalcemia
The client who has undergone a thyroidectomy is at risk for developing hypocalcemia from
inadvertent removal or damage to the parathyroid gland. The client with hypocalcemia will
exhibit a positive Chvostek's sign (facial muscle contraction when the facial nerve in front of the
ear is tapped) and a positive Trousseau's sign (carpal spasm when a blood pressure cuff is
inflated for a few minutes). These signs aren't present with hypercalcemia, hypokalemia, or
hyperkalemia.
An incoherent female client with a history of hypothyroidism is brought to the emergency
department by the rescue squad. Physical and laboratory findings reveal hypothermia,
hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the
face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby
prepares to take emergency action to prevent the potential complication of:
a. Thyroid storm.
b. Cretinism.
, c. Myxedema coma.
d. Hashimoto's thyroiditis. - ANSWER-c. Myexedema coma.
Severe hypothyroidism may result in myxedema coma, in which a drastic drop in the metabolic
rate causes decreased vital signs, hypoventilation (possibly leading to respiratory acidosis), and
nonpitting edema. Thyroid storm is an acute complication of hyperthyroidism. Cretinism is a
form of hypothyroidism that occurs in infants. Hashimoto's thyroiditis is a common chronic
inflammatory disease of the thyroid gland in which autoimmune factors play a prominent role.
In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse
Lyzette would expect a decline in:
a. Serum glucose level.
b. Hair loss.
c. Bone mineralization.
d. Menstrual flow. - ANSWER-a. Serum glucose level.
Hyperglycemia, which develops from glucocorticoid excess, is a manifestation of Cushing's
syndrome. With successful treatment of the disorder, serum glucose levels decline. Hirsutism is
common in Cushing's syndrome; therefore, with successful treatment, abnormal hair growth
also declines. Osteoporosis occurs in Cushing's syndrome; therefore, with successful treatment,
bone mineralization increases. Amenorrhea develops in Cushing's syndrome. With successful
treatment, the client experiences a return of menstrual flow, not a decline in it.
Nurse Oliver should expect a client with hypothyroidism to report which health concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
c. Nervousness and tremors
d. Thyroid gland swelling - ANSWER-b. Puffiness of the face and hands
FINAL STUDY GUIDE 2026 EXAM
QUESTIONS AND ANSWERS
Which of the following assessment findings characterize thyroid storm?
a) increased body temperature, decreased pulse, and increased blood pressure
b) increased body temperature, increased pulse, and increased blood pressure
c) increased body temperature, decreased pulse, and decreased blood pressure
d) increased body temperature, increased pulse, and decreased blood pressure - ANSWER-b)
increased body temperature, increased pulse, and increased blood pressure
Thyroid storm is characterized by SNS activation. Thyroid hormones potentiate effects of
cathecolamines (epinephrine/norepinephrine). Therefore, all vital signs will be increased.
The nurse is planning care for a client with hyperthyroidism. Which of the following nursing
interventions are appropriate? Select all that apply
a) instill isotonic eye drops as necessary
b) provide several, small, well-balanced meals
c) provide rest periods
d) keep environment warm
e) encourage frequent visitors and conversation
f) weigh the client daily - ANSWER-a, b, c, and f
(a) The client with hyperthyroidism may experience exopthalmos. This requires instillation of
eye drops to prevent dryness and ulceration of the cornea.
,(b and f) The client experiences weight loss because of hypermetabolism. Several, small, well-
balanced meals are given to improve nutritional status of the client and daily weights should be
monitored. Weight is the most objective indicator of nutritional status.
(c) The client is usually exhausted due to restlessness and agitation. Frequent rest periods help
the client regain energy.
After thyroidectomy, which of the following is the priority assessment to observe laryngeal
nerve damage?
a) hoarseness of voice
b) difficulty in swallowing
c) tetany
d) fever - ANSWER-a) hoarseness of voice
Laryngeal nerve damage is manifested by severe hoarseness of voice of "whispery voice".
When caring for a male client with diabetes insipidus, nurse Juliet expects to administer:
a. vasopressin (Pitressin Synthetic)
b. furosemide (Lasix).
c. regular insulin.
d. 10% dextrose. - ANSWER-a. vasopressin (Pitressin Synthetic)
Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin)
production, the nurse should expect to administer synthetic vasopressin for hormone
replacement therapy. Furosemide, a diuretic, is contraindicated because a client with diabetes
insipidus experiences polyuria. Insulin and dextrose are used to treat diabetes mellitus and its
complications, not diabetes insipidus.
Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's
syndrome, the nurse would expect to find:
a. Hypotension.
,b. Thick, coarse skin.
c. Deposits of adipose tissue in the trunk and dorsocervical area.
d. Weight gain in arms and legs. - ANSWER-c. Deposits of adipose tissue in the trunk and
dorsocervical area
Because of changes in fat distribution, adipose tissue accumulates in the trunk, face
(moonface), and dorsocervical areas (buffalo hump). Hypertension is caused by fluid retention.
Skin becomes thin and bruises easily because of a loss of collagen. Muscle wasting causes
muscle atrophy and thin extremities.
For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client
for Chvostek's sign and Trousseau's sign because they indicate which of the following?
a. Hypocalcemia
b. Hypercalcemia
c. Hypokalemia
d. Hyperkalemia - ANSWER-a. Hypocalcemia
The client who has undergone a thyroidectomy is at risk for developing hypocalcemia from
inadvertent removal or damage to the parathyroid gland. The client with hypocalcemia will
exhibit a positive Chvostek's sign (facial muscle contraction when the facial nerve in front of the
ear is tapped) and a positive Trousseau's sign (carpal spasm when a blood pressure cuff is
inflated for a few minutes). These signs aren't present with hypercalcemia, hypokalemia, or
hyperkalemia.
An incoherent female client with a history of hypothyroidism is brought to the emergency
department by the rescue squad. Physical and laboratory findings reveal hypothermia,
hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the
face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby
prepares to take emergency action to prevent the potential complication of:
a. Thyroid storm.
b. Cretinism.
, c. Myxedema coma.
d. Hashimoto's thyroiditis. - ANSWER-c. Myexedema coma.
Severe hypothyroidism may result in myxedema coma, in which a drastic drop in the metabolic
rate causes decreased vital signs, hypoventilation (possibly leading to respiratory acidosis), and
nonpitting edema. Thyroid storm is an acute complication of hyperthyroidism. Cretinism is a
form of hypothyroidism that occurs in infants. Hashimoto's thyroiditis is a common chronic
inflammatory disease of the thyroid gland in which autoimmune factors play a prominent role.
In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse
Lyzette would expect a decline in:
a. Serum glucose level.
b. Hair loss.
c. Bone mineralization.
d. Menstrual flow. - ANSWER-a. Serum glucose level.
Hyperglycemia, which develops from glucocorticoid excess, is a manifestation of Cushing's
syndrome. With successful treatment of the disorder, serum glucose levels decline. Hirsutism is
common in Cushing's syndrome; therefore, with successful treatment, abnormal hair growth
also declines. Osteoporosis occurs in Cushing's syndrome; therefore, with successful treatment,
bone mineralization increases. Amenorrhea develops in Cushing's syndrome. With successful
treatment, the client experiences a return of menstrual flow, not a decline in it.
Nurse Oliver should expect a client with hypothyroidism to report which health concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
c. Nervousness and tremors
d. Thyroid gland swelling - ANSWER-b. Puffiness of the face and hands
