ATI MED-SURG ENDOCRINE EXAM
2025/2026|Updated With verified Answers.
1. A nurse is assessing a client with hyperthyroidism. Which of the following findings
should the nurse expect?
• A. Cold intolerance
• B. Bradycardia
• C. Weight gain
• D. Exophthalmos
Answer: D. Exophthalmos
Rationale: Exophthalmos (protrusion of the eyeballs) is a classic finding in Graves' disease
(hyperthyroidism). Cold intolerance, bradycardia, and weight gain are associated with
hypothyroidism.
2. A nurse is caring for a client following a thyroidectomy. Which of the following findings
should alert the nurse to possible hypocalcemia?
• A. Positive Chvostek's sign
• B. Decreased deep tendon reflexes
• C. Bradycardia
• D. Hypothermia
Answer: A. Positive Chvostek's sign
Rationale: Hypocalcemia often occurs after thyroidectomy due to accidental removal of
parathyroid glands. Chvostek's sign (facial twitching when tapping the facial nerve) indicates
hypocalcemia.
3. A client with diabetes mellitus type 1 is found unresponsive. Which of the following
actions should the nurse take first?
• A. Administer glucagon IM
• B. Check blood glucose
• C. Start IV fluids
• D. Give orange juice orally
,Answer: B. Check blood glucose
Rationale: The priority is to assess blood glucose to differentiate between hypoglycemia and
hyperglycemia before treatment. Glucagon is given if hypoglycemia is confirmed and the
client is unconscious; oral fluids are unsafe if unresponsive.
4. A nurse is teaching a client about self-administration of insulin. Which of the following
statements indicates understanding?
• A. "I will shake the NPH vial vigorously before drawing it up."
• B. "I will inject rapid-acting insulin 30 minutes before meals."
• C. "I will draw up clear insulin (regular) before cloudy insulin (NPH)."
• D. "I will store my open insulin vial in the freezer."
Answer: C. "I will draw up clear insulin (regular) before cloudy insulin (NPH)."
Rationale: To prevent contamination, draw clear (regular) before cloudy (NPH). Shaking
insulin causes bubbles; rapid-acting insulin is given just before or immediately after meals;
insulin should not be frozen.
5. A client with Cushing's syndrome is likely to exhibit which of the following
manifestations?
• A. Hypotension
• B. Bronze skin pigmentation
• C. Buffalo hump and moon face
• D. Weight loss
Answer: C. Buffalo hump and moon face
Rationale: Excess cortisol causes central obesity, moon face, buffalo hump, purple striae, and
hypertension. Bronze pigmentation is seen in Addison's disease.
6. A nurse is monitoring a client with diabetic ketoacidosis (DKA). Which of the following
laboratory findings is expected?
• A. Serum bicarbonate 22 mEq/L
• B. Blood glucose 300 mg/dL
• C. pH 7.35
• D. Positive serum ketones
Answer: D. Positive serum ketones
Rationale: DKA is characterized by hyperglycemia, ketosis, metabolic acidosis (low pH and
bicarbonate). Glucose is often >250 mg/dL (300 is possible, but ketones are definitive).
, 7. A nurse is providing discharge teaching to a client with Addison's disease. Which of the
following should the nurse emphasize?
• A. "Increase potassium-rich foods."
• B. "Stop taking hydrocortisone if you feel better."
• C. "Wear a medical alert bracelet."
• D. "Limit fluid intake to 1 L/day."
Answer: C. "Wear a medical alert bracelet."
Rationale: Clients with adrenal insufficiency need lifelong steroids and should wear ID for
emergency stress dosing. Hydrocortisone is never stopped abruptly; potassium should be
restricted (hyperkalemia common); fluids are encouraged.
8. A client is started on levothyroxine for hypothyroidism. The nurse should instruct the
client to take this medication:
• A. With food to prevent nausea
• B. At bedtime for better absorption
• C. On an empty stomach in the morning
• D. With antacids to reduce GI upset
Answer: C. On an empty stomach in the morning
Rationale: Levothyroxine is absorbed best on an empty stomach, at least 30–60 minutes
before breakfast. Antacids and food decrease absorption.
9. Which of the following findings is most concerning in a client with
hyperparathyroidism?
• A. Polyuria and polydipsia
• B. Positive Trousseau's sign
• C. Serum calcium 11.5 mg/dL
• D. Bone pain and fractures
Answer: B. Positive Trousseau's sign
Rationale: Trousseau's sign (carpal spasm with BP cuff inflation) indicates hypocalcemia, not
hyperparathyroidism. In hyperparathyroidism, calcium is high; the most concerning acute
risk is hypercalcemic crisis (arrhythmias, coma). Among options, polyuria (due to
hypercalcemia) is common but not as emergent. However, positive Trousseau's would be
incorrect for hyperparathyroidism—if present, suspect hypoparathyroidism. Actually, careful:
In hyperparathyroidism, calcium is elevated; Trousseau's is a sign of low calcium. So this
question tests recognition: a positive Trousseau's in a client with presumed
2025/2026|Updated With verified Answers.
1. A nurse is assessing a client with hyperthyroidism. Which of the following findings
should the nurse expect?
• A. Cold intolerance
• B. Bradycardia
• C. Weight gain
• D. Exophthalmos
Answer: D. Exophthalmos
Rationale: Exophthalmos (protrusion of the eyeballs) is a classic finding in Graves' disease
(hyperthyroidism). Cold intolerance, bradycardia, and weight gain are associated with
hypothyroidism.
2. A nurse is caring for a client following a thyroidectomy. Which of the following findings
should alert the nurse to possible hypocalcemia?
• A. Positive Chvostek's sign
• B. Decreased deep tendon reflexes
• C. Bradycardia
• D. Hypothermia
Answer: A. Positive Chvostek's sign
Rationale: Hypocalcemia often occurs after thyroidectomy due to accidental removal of
parathyroid glands. Chvostek's sign (facial twitching when tapping the facial nerve) indicates
hypocalcemia.
3. A client with diabetes mellitus type 1 is found unresponsive. Which of the following
actions should the nurse take first?
• A. Administer glucagon IM
• B. Check blood glucose
• C. Start IV fluids
• D. Give orange juice orally
,Answer: B. Check blood glucose
Rationale: The priority is to assess blood glucose to differentiate between hypoglycemia and
hyperglycemia before treatment. Glucagon is given if hypoglycemia is confirmed and the
client is unconscious; oral fluids are unsafe if unresponsive.
4. A nurse is teaching a client about self-administration of insulin. Which of the following
statements indicates understanding?
• A. "I will shake the NPH vial vigorously before drawing it up."
• B. "I will inject rapid-acting insulin 30 minutes before meals."
• C. "I will draw up clear insulin (regular) before cloudy insulin (NPH)."
• D. "I will store my open insulin vial in the freezer."
Answer: C. "I will draw up clear insulin (regular) before cloudy insulin (NPH)."
Rationale: To prevent contamination, draw clear (regular) before cloudy (NPH). Shaking
insulin causes bubbles; rapid-acting insulin is given just before or immediately after meals;
insulin should not be frozen.
5. A client with Cushing's syndrome is likely to exhibit which of the following
manifestations?
• A. Hypotension
• B. Bronze skin pigmentation
• C. Buffalo hump and moon face
• D. Weight loss
Answer: C. Buffalo hump and moon face
Rationale: Excess cortisol causes central obesity, moon face, buffalo hump, purple striae, and
hypertension. Bronze pigmentation is seen in Addison's disease.
6. A nurse is monitoring a client with diabetic ketoacidosis (DKA). Which of the following
laboratory findings is expected?
• A. Serum bicarbonate 22 mEq/L
• B. Blood glucose 300 mg/dL
• C. pH 7.35
• D. Positive serum ketones
Answer: D. Positive serum ketones
Rationale: DKA is characterized by hyperglycemia, ketosis, metabolic acidosis (low pH and
bicarbonate). Glucose is often >250 mg/dL (300 is possible, but ketones are definitive).
, 7. A nurse is providing discharge teaching to a client with Addison's disease. Which of the
following should the nurse emphasize?
• A. "Increase potassium-rich foods."
• B. "Stop taking hydrocortisone if you feel better."
• C. "Wear a medical alert bracelet."
• D. "Limit fluid intake to 1 L/day."
Answer: C. "Wear a medical alert bracelet."
Rationale: Clients with adrenal insufficiency need lifelong steroids and should wear ID for
emergency stress dosing. Hydrocortisone is never stopped abruptly; potassium should be
restricted (hyperkalemia common); fluids are encouraged.
8. A client is started on levothyroxine for hypothyroidism. The nurse should instruct the
client to take this medication:
• A. With food to prevent nausea
• B. At bedtime for better absorption
• C. On an empty stomach in the morning
• D. With antacids to reduce GI upset
Answer: C. On an empty stomach in the morning
Rationale: Levothyroxine is absorbed best on an empty stomach, at least 30–60 minutes
before breakfast. Antacids and food decrease absorption.
9. Which of the following findings is most concerning in a client with
hyperparathyroidism?
• A. Polyuria and polydipsia
• B. Positive Trousseau's sign
• C. Serum calcium 11.5 mg/dL
• D. Bone pain and fractures
Answer: B. Positive Trousseau's sign
Rationale: Trousseau's sign (carpal spasm with BP cuff inflation) indicates hypocalcemia, not
hyperparathyroidism. In hyperparathyroidism, calcium is high; the most concerning acute
risk is hypercalcemic crisis (arrhythmias, coma). Among options, polyuria (due to
hypercalcemia) is common but not as emergent. However, positive Trousseau's would be
incorrect for hyperparathyroidism—if present, suspect hypoparathyroidism. Actually, careful:
In hyperparathyroidism, calcium is elevated; Trousseau's is a sign of low calcium. So this
question tests recognition: a positive Trousseau's in a client with presumed
