2026 UPDATED QUESTIONS DOWNLOAD
ATI Med-Surg Endocrine Exam 2025/2026 | 300
Questions with Italicized Rationales | High-Yield
Prep & Study Guide
This comprehensive study guide features 300 high-yield multiple-choice
questions specifically designed for the ATI Medical-Surgical Endocrine Exam. Each question
includes a detailed rationale in italics, helping you master complex concepts like DKA,
SIADH, and adrenal disorders through active learning. It is perfectly formatted for quick review
and guaranteed to strengthen your clinical judgment for your next nursing school assessment.
1. A patient 1 day post-subtotal thyroidectomy reports tingling in the hands and
around the lips. What is the priority nursing action?
A. Check for Chvostek's sign
B. Administered D5W
C. Place the patient in a prone position
D. Assess for a Babinski sign
Rationale: Tingling indicates potential hypocalcemia due to accidental parathyroid
damage during surgery; Chvostek's sign (facial twitch) confirms this.
2. Which intervention is appropriate for a client experiencing the Somogyi effect?
A. Omit the evening snack
B. Monitor nighttime blood glucose levels
C. Administer bedtime insulin glargine
D. Increase the morning dose of NPH insulin
Rationale: The Somogyi effect is rebound morning hyperglycemia caused by nighttime
hypoglycemia; checking 0300 blood sugar is the diagnostic step.
3. A nurse is assessing a client with Graves' disease. Which finding suggests a
thyroid storm?
A. Constipation and bradycardia
B. Hypertension and tachycardia
C. Dry, scaly skin and lethargy
D. Hypotension and bradypnea
Rationale: Thyroid storm is a hypermetabolic crisis marked by extreme tachycardia,
high fever, and severe hypertension.
,2026 UPDATED QUESTIONS DOWNLOAD
4. A client post-bilateral adrenalectomy will require which lifelong medication?
A. Glucocorticoids
B. Loop diuretics
C. Oral hypoglycemics
D. Calcium gluconate
Rationale: Removal of both adrenal glands results in a permanent lack of cortisol and
aldosterone, requiring lifelong replacement therapy.
5. Which snack choice is best for a client with Addison's disease?
A. Raw broccoli and carrots
B. Turkey and cheese sandwich
C. Sliced bananas
D. Baked potato with skin
Rationale: Addison's requires a high-sodium, low-potassium diet because the lack of
aldosterone causes sodium wasting and potassium retention.
6. A nurse is caring for a client with SIADH. Which finding should the nurse
expect?
A. Serum sodium 150 mEq/L
B. Polyuria
C. Urine specific gravity 1.035
D. Weight loss
Rationale: SIADH causes excessive water reabsorption, leading to highly concentrated
urine (specific gravity >1.030) and dilutional hyponatremia.
7. Which finding is the hallmark of Diabetes Insipidus (DI)?
A. Polyuria
B. Oliguria
C. Glycosuria
D. Proteinuria
Rationale: DI is caused by a deficiency of ADH, leading to the excretion of massive
amounts of very dilute urine.
8. Which statement by a diabetic client indicates understanding of foot care?
A. "I will apply lotion between my toes daily."
B. "I will perform a daily foot inspection."
C. "I will soak my feet in hot water to improve circulation."
D. "I will trim my toenails in a curved shape."
Rationale: Daily inspection is vital for early detection of injuries due to neuropathy; lotion
between toes promotes fungal growth and should be avoided.
,2026 UPDATED QUESTIONS DOWNLOAD
9. A nurse is assessing a client with Cushing’s syndrome. Which finding is
expected?
A. Trunkal weight loss
B. Paper-thin skin
C. Hypotension
D. Bronze skin pigmentation
Rationale: High cortisol levels lead to protein catabolism, resulting in fragile, thin skin
and easy bruising.
10. A client is prescribed intranasal desmopressin for DI. Which instruction is
correct?
A. "You do not need a medical alert tag."
B. "Limit your fluid intake to 3L per day."
C. "Report any nasal congestion or drainage."
D. "Use the spray only when you have a headache."
Rationale: Nasal congestion or discharge can significantly decrease the absorption and
effectiveness of the medication.
11. What is the priority intervention for a client in Hyperosmolar Hyperglycemic
State (HHS)?
A. Administer 100 units of NPH insulin
B. Start rapid IV fluid replacement with Normal Saline
C. Administer IV Bicarbonate
D. Prepare for endotracheal intubation
Rationale: Severe dehydration is the primary threat in HHS; fluid resuscitation is the first
priority before addressing hyperglycemia.
12. Which finding is associated with hyperparathyroidism?
A. Muscle twitching
B. Positive Trousseau's sign
C. Bone pain and pathological fractures
D. Hyperactive deep tendon reflexes
Rationale: Excess PTH pulls calcium from the bones into the blood, leading to
weakened bones and hypercalcemia.
13. A nurse is teaching a client about glipizide. When should the medication be
taken?
A. 30 minutes before a meal
B. At bedtime
, 2026 UPDATED QUESTIONS DOWNLOAD
C. Only when blood sugar is over 200
D. Two hours after a meal
Rationale: Sulfonylureas like glipizide stimulate insulin release and are most effective
when taken shortly before eating.
14. Which finding indicates that levothyroxine therapy for hypothyroidism is
effective?
A. Weight gain
B. Heart rate of 48/min
C. Increased energy levels
D. Persistent constipation
Rationale: Successful treatment reverses the slow metabolism of hypothyroidism,
leading to improved energy and weight stabilization.
15. What is the most critical assessment for a client with pheochromocytoma?
A. Urine output
B. Blood pressure
C. Daily weight
D. Peripheral pulses
Rationale: Pheochromocytoma (adrenal tumor) secretes catecholamines that cause
dangerous, sudden hypertensive crises.
16. A nurse is explaining the HbA1c test. Which statement is accurate?
A. "It measures your average blood sugar over 24 hours."
B. "It requires a 12-hour fast before the blood draw."
C. "It reflects your glucose control over the last 2 to 3 months."
D. "You must stop taking insulin for 2 days before the test."
Rationale: HbA1c measures the glucose attached to red blood cells over their 120-day
lifespan, providing a long-term picture of control.
17. Which clinical manifestation is common in Hyperthyroidism?
A. Bradycardia
B. Heat intolerance and weight loss
C. Cold intolerance
D. Constipation
Rationale: Excessive thyroid hormone accelerates metabolism, leading to heat
intolerance, tremors, and weight loss despite increased appetite.
18. A client with Addison's disease is under physical stress (surgery). They are at
high risk for:
A. Thyroid storm
ATI Med-Surg Endocrine Exam 2025/2026 | 300
Questions with Italicized Rationales | High-Yield
Prep & Study Guide
This comprehensive study guide features 300 high-yield multiple-choice
questions specifically designed for the ATI Medical-Surgical Endocrine Exam. Each question
includes a detailed rationale in italics, helping you master complex concepts like DKA,
SIADH, and adrenal disorders through active learning. It is perfectly formatted for quick review
and guaranteed to strengthen your clinical judgment for your next nursing school assessment.
1. A patient 1 day post-subtotal thyroidectomy reports tingling in the hands and
around the lips. What is the priority nursing action?
A. Check for Chvostek's sign
B. Administered D5W
C. Place the patient in a prone position
D. Assess for a Babinski sign
Rationale: Tingling indicates potential hypocalcemia due to accidental parathyroid
damage during surgery; Chvostek's sign (facial twitch) confirms this.
2. Which intervention is appropriate for a client experiencing the Somogyi effect?
A. Omit the evening snack
B. Monitor nighttime blood glucose levels
C. Administer bedtime insulin glargine
D. Increase the morning dose of NPH insulin
Rationale: The Somogyi effect is rebound morning hyperglycemia caused by nighttime
hypoglycemia; checking 0300 blood sugar is the diagnostic step.
3. A nurse is assessing a client with Graves' disease. Which finding suggests a
thyroid storm?
A. Constipation and bradycardia
B. Hypertension and tachycardia
C. Dry, scaly skin and lethargy
D. Hypotension and bradypnea
Rationale: Thyroid storm is a hypermetabolic crisis marked by extreme tachycardia,
high fever, and severe hypertension.
,2026 UPDATED QUESTIONS DOWNLOAD
4. A client post-bilateral adrenalectomy will require which lifelong medication?
A. Glucocorticoids
B. Loop diuretics
C. Oral hypoglycemics
D. Calcium gluconate
Rationale: Removal of both adrenal glands results in a permanent lack of cortisol and
aldosterone, requiring lifelong replacement therapy.
5. Which snack choice is best for a client with Addison's disease?
A. Raw broccoli and carrots
B. Turkey and cheese sandwich
C. Sliced bananas
D. Baked potato with skin
Rationale: Addison's requires a high-sodium, low-potassium diet because the lack of
aldosterone causes sodium wasting and potassium retention.
6. A nurse is caring for a client with SIADH. Which finding should the nurse
expect?
A. Serum sodium 150 mEq/L
B. Polyuria
C. Urine specific gravity 1.035
D. Weight loss
Rationale: SIADH causes excessive water reabsorption, leading to highly concentrated
urine (specific gravity >1.030) and dilutional hyponatremia.
7. Which finding is the hallmark of Diabetes Insipidus (DI)?
A. Polyuria
B. Oliguria
C. Glycosuria
D. Proteinuria
Rationale: DI is caused by a deficiency of ADH, leading to the excretion of massive
amounts of very dilute urine.
8. Which statement by a diabetic client indicates understanding of foot care?
A. "I will apply lotion between my toes daily."
B. "I will perform a daily foot inspection."
C. "I will soak my feet in hot water to improve circulation."
D. "I will trim my toenails in a curved shape."
Rationale: Daily inspection is vital for early detection of injuries due to neuropathy; lotion
between toes promotes fungal growth and should be avoided.
,2026 UPDATED QUESTIONS DOWNLOAD
9. A nurse is assessing a client with Cushing’s syndrome. Which finding is
expected?
A. Trunkal weight loss
B. Paper-thin skin
C. Hypotension
D. Bronze skin pigmentation
Rationale: High cortisol levels lead to protein catabolism, resulting in fragile, thin skin
and easy bruising.
10. A client is prescribed intranasal desmopressin for DI. Which instruction is
correct?
A. "You do not need a medical alert tag."
B. "Limit your fluid intake to 3L per day."
C. "Report any nasal congestion or drainage."
D. "Use the spray only when you have a headache."
Rationale: Nasal congestion or discharge can significantly decrease the absorption and
effectiveness of the medication.
11. What is the priority intervention for a client in Hyperosmolar Hyperglycemic
State (HHS)?
A. Administer 100 units of NPH insulin
B. Start rapid IV fluid replacement with Normal Saline
C. Administer IV Bicarbonate
D. Prepare for endotracheal intubation
Rationale: Severe dehydration is the primary threat in HHS; fluid resuscitation is the first
priority before addressing hyperglycemia.
12. Which finding is associated with hyperparathyroidism?
A. Muscle twitching
B. Positive Trousseau's sign
C. Bone pain and pathological fractures
D. Hyperactive deep tendon reflexes
Rationale: Excess PTH pulls calcium from the bones into the blood, leading to
weakened bones and hypercalcemia.
13. A nurse is teaching a client about glipizide. When should the medication be
taken?
A. 30 minutes before a meal
B. At bedtime
, 2026 UPDATED QUESTIONS DOWNLOAD
C. Only when blood sugar is over 200
D. Two hours after a meal
Rationale: Sulfonylureas like glipizide stimulate insulin release and are most effective
when taken shortly before eating.
14. Which finding indicates that levothyroxine therapy for hypothyroidism is
effective?
A. Weight gain
B. Heart rate of 48/min
C. Increased energy levels
D. Persistent constipation
Rationale: Successful treatment reverses the slow metabolism of hypothyroidism,
leading to improved energy and weight stabilization.
15. What is the most critical assessment for a client with pheochromocytoma?
A. Urine output
B. Blood pressure
C. Daily weight
D. Peripheral pulses
Rationale: Pheochromocytoma (adrenal tumor) secretes catecholamines that cause
dangerous, sudden hypertensive crises.
16. A nurse is explaining the HbA1c test. Which statement is accurate?
A. "It measures your average blood sugar over 24 hours."
B. "It requires a 12-hour fast before the blood draw."
C. "It reflects your glucose control over the last 2 to 3 months."
D. "You must stop taking insulin for 2 days before the test."
Rationale: HbA1c measures the glucose attached to red blood cells over their 120-day
lifespan, providing a long-term picture of control.
17. Which clinical manifestation is common in Hyperthyroidism?
A. Bradycardia
B. Heat intolerance and weight loss
C. Cold intolerance
D. Constipation
Rationale: Excessive thyroid hormone accelerates metabolism, leading to heat
intolerance, tremors, and weight loss despite increased appetite.
18. A client with Addison's disease is under physical stress (surgery). They are at
high risk for:
A. Thyroid storm
