NURS 120 Introduction to Medical-Surgical Nursing: Diabetes &
Endocrine Disorders 2026 |WCU
1. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood
glucose of 650 mg/dL, arterial pH of 7.25, and positive ketones in the urine.
Which is the immediate priority intervention?
A. Administering a bolus of 50% Dextrose
B. Assisting the patient with a high-protein meal
C. Subcutaneous administration of long-acting insulin
D. Initiating intravenous fluid resuscitation with Normal Saline
Answer: D
Rationale: In Diabetic Ketoacidosis (DKA), the priority is fluid resuscitation to restore
circulatory volume and renal perfusion before starting insulin therapy.
2. Which clinical manifestation is a hallmark sign of the Somogyi effect?
A. Hyperglycemia at 3:00 AM followed by morning hypoglycemia
B. Consistent hyperglycemia throughout the night and morning
C. Hypoglycemia at 3:00 AM followed by rebound morning hyperglycemia
D. Normal blood glucose levels until 6:00 AM
Answer: C
Rationale: The Somogyi effect involves hypoglycemia during the night (around 3 AM),
which triggers counter-regulatory hormones to cause rebound hyperglycemia in the
morning.
,3. A patient is diagnosed with Diabetes Insipidus (DI). Which laboratory finding
would the nurse expect to observe?
A. Serum potassium of 5.8 mEq/L
B. Serum sodium of 125 mEq/L
C. Urine osmolarity of 1200 mOsm/kg
D. Urine specific gravity of 1.002
Answer: D
Rationale: DI is characterized by a deficiency of ADH, leading to the excretion of large
amounts of dilute urine with a very low specific gravity (typically <1.005).
4. In a patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH),
which electrolyte imbalance is most critical to monitor?
A. Hypercalcemia
B. Hypokalemia
C. Hypermagnesemia
D. Dilutional hyponatremia
Answer: D
Rationale: SIADH causes excessive water retention, leading to dilutional hyponatremia,
which can cause cerebral edema and seizures if severe.
5. Following a total thyroidectomy, a patient develops tetany and a positive
Chvostek’s sign. Which medication should the nurse have readily available?
A. Potassium Chloride
B. Sodium Bicarbonate
C. Calcium Gluconate
D. Levothyroxine
Answer: C
Rationale: Chvostek’s sign indicates hypocalcemia, often due to accidental parathyroid
gland removal during thyroidectomy. IV calcium gluconate is the emergency treatment.
, 6. A patient with Cushing’s Syndrome is at high risk for which of the following
metabolic disturbances?
A. Hypoglycemia and metabolic acidosis
B. Hyperglycemia and hypokalemia
C. Hyperkalemia and hyponatremia
D. Hypercalcemia and hypernatremia
Answer: B
Rationale: Cushing’s syndrome involves excess cortisol, which increases gluconeogenesis
(hyperglycemia) and causes mineralocorticoid effects like potassium wasting
(hypokalemia).
7. What is the primary pathophysiology behind Type 2 Diabetes Mellitus?
A. Insulin resistance and relative insulin deficiency
B. Absolute insulin deficiency due to beta-cell destruction
C. Excessive production of glucagon by alpha cells
D. Destruction of the adrenal cortex
Answer: A
Rationale: Type 2 DM is characterized by cells becoming resistant to insulin and the
pancreas being unable to produce enough insulin to overcome this resistance.
8. Which assessment finding is most indicative of a Thyroid Storm?
A. Bradycardia and bradypnea
B. Hypotension and lethargy
C. Severe hyperthermia and tachycardia
D. Weight gain and cold intolerance
Answer: C
Rationale: Thyroid storm is a life-threatening hypermetabolic state characterized by high
fever, extreme tachycardia, and agitation.
Endocrine Disorders 2026 |WCU
1. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood
glucose of 650 mg/dL, arterial pH of 7.25, and positive ketones in the urine.
Which is the immediate priority intervention?
A. Administering a bolus of 50% Dextrose
B. Assisting the patient with a high-protein meal
C. Subcutaneous administration of long-acting insulin
D. Initiating intravenous fluid resuscitation with Normal Saline
Answer: D
Rationale: In Diabetic Ketoacidosis (DKA), the priority is fluid resuscitation to restore
circulatory volume and renal perfusion before starting insulin therapy.
2. Which clinical manifestation is a hallmark sign of the Somogyi effect?
A. Hyperglycemia at 3:00 AM followed by morning hypoglycemia
B. Consistent hyperglycemia throughout the night and morning
C. Hypoglycemia at 3:00 AM followed by rebound morning hyperglycemia
D. Normal blood glucose levels until 6:00 AM
Answer: C
Rationale: The Somogyi effect involves hypoglycemia during the night (around 3 AM),
which triggers counter-regulatory hormones to cause rebound hyperglycemia in the
morning.
,3. A patient is diagnosed with Diabetes Insipidus (DI). Which laboratory finding
would the nurse expect to observe?
A. Serum potassium of 5.8 mEq/L
B. Serum sodium of 125 mEq/L
C. Urine osmolarity of 1200 mOsm/kg
D. Urine specific gravity of 1.002
Answer: D
Rationale: DI is characterized by a deficiency of ADH, leading to the excretion of large
amounts of dilute urine with a very low specific gravity (typically <1.005).
4. In a patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH),
which electrolyte imbalance is most critical to monitor?
A. Hypercalcemia
B. Hypokalemia
C. Hypermagnesemia
D. Dilutional hyponatremia
Answer: D
Rationale: SIADH causes excessive water retention, leading to dilutional hyponatremia,
which can cause cerebral edema and seizures if severe.
5. Following a total thyroidectomy, a patient develops tetany and a positive
Chvostek’s sign. Which medication should the nurse have readily available?
A. Potassium Chloride
B. Sodium Bicarbonate
C. Calcium Gluconate
D. Levothyroxine
Answer: C
Rationale: Chvostek’s sign indicates hypocalcemia, often due to accidental parathyroid
gland removal during thyroidectomy. IV calcium gluconate is the emergency treatment.
, 6. A patient with Cushing’s Syndrome is at high risk for which of the following
metabolic disturbances?
A. Hypoglycemia and metabolic acidosis
B. Hyperglycemia and hypokalemia
C. Hyperkalemia and hyponatremia
D. Hypercalcemia and hypernatremia
Answer: B
Rationale: Cushing’s syndrome involves excess cortisol, which increases gluconeogenesis
(hyperglycemia) and causes mineralocorticoid effects like potassium wasting
(hypokalemia).
7. What is the primary pathophysiology behind Type 2 Diabetes Mellitus?
A. Insulin resistance and relative insulin deficiency
B. Absolute insulin deficiency due to beta-cell destruction
C. Excessive production of glucagon by alpha cells
D. Destruction of the adrenal cortex
Answer: A
Rationale: Type 2 DM is characterized by cells becoming resistant to insulin and the
pancreas being unable to produce enough insulin to overcome this resistance.
8. Which assessment finding is most indicative of a Thyroid Storm?
A. Bradycardia and bradypnea
B. Hypotension and lethargy
C. Severe hyperthermia and tachycardia
D. Weight gain and cold intolerance
Answer: C
Rationale: Thyroid storm is a life-threatening hypermetabolic state characterized by high
fever, extreme tachycardia, and agitation.
