ADULT HEALTH 1 ENDOCRINE MASTERY PRACTICE
QUESTIONS & NURSING REVIEW FOR THE NCLEX EXAM
COMPLETE QUESTIONS WITH 100% CORRECT ANSWERS
1. A patient with syndrome of inappropriate antidiuretic hormone (SIADH) has a
serum sodium level of 120 mEq/L. Which nursing intervention is the priority?
A. Restrict oral fluids to 800 mL per day.
B. Administer a 3% sodium chloride infusion as prescribed.
C. Encourage intake of high-sodium foods.
D. Prepare for hemodialysis.
Correct Answer: B. A sodium level of 120 mEq/L indicates severe hyponatremia,
which can lead to neurological symptoms like seizures and coma. The priority is
the rapid but cautious correction of sodium with hypertonic (3%) saline to prevent
cerebral edema. Fluid restriction is used for mild to moderate SIADH, but is not
the priority for severe, life-threatening hyponatremia.
Explanation: Severe symptomatic hyponatremia is a medical emergency requiring
immediate intervention with hypertonic saline.
2. A patient is prescribed levothyroxine (Synthroid) for newly diagnosed
hypothyroidism. What instruction should the nurse include in the teaching plan?
A. "Take this medication on an empty stomach in the morning."
B. "You can stop the medication when your symptoms improve."
C. "Take this medication with a glass of milk to prevent stomach upset."
D. "This medication will cure your thyroid condition."
Correct Answer: A. Levothyroxine is best absorbed on an empty stomach, at least
30-60 minutes before breakfast. It is a replacement therapy, not a cure, and is
taken for life. It should not be taken with dairy or calcium supplements as they
,interfere with absorption.
Explanation: Proper administration timing is critical for effective absorption and
consistent hormone levels.
3. A patient with diabetes insipidus (DI) is receiving desmopressin acetate
(DDAVP) intranasally. Which finding indicates that the medication is effective?
A. Urine output increases to 200 mL/hr.
B. Blood pressure drops from 140/90 to 100/60.
C. Serum sodium decreases from 150 to 140 mEq/L.
D. The patient complains of a severe headache.
Correct Answer: C. DI is characterized by excessive urination and hypernatremia
due to a lack of ADH. Desmopressin is a synthetic ADH. Effectiveness is
demonstrated by a decrease in urine output, an increase in urine osmolality, and a
return of serum sodium to a normal range.
Explanation: A decrease in serum sodium toward normal indicates that the
kidneys are reabsorbing water in response to the medication.
4. The nurse is assessing a patient with Cushing's syndrome. Which physical
finding is most consistent with this disorder?
A. Exophthalmos and a thin, fragile appearance.
B. Hypertension, moon face, and buffalo hump.
C. Hypotension and hyperpigmentation.
D. Tachycardia and heat intolerance.
Correct Answer: B. Cushing's syndrome is caused by excess cortisol, leading to a
classic presentation of central obesity, a moon-shaped face, a buffalo hump (fat
deposition at the back of the neck), hypertension, and purple striae.
Explanation: These are the characteristic physical manifestations of chronic
glucocorticoid excess.
,5. A patient with type 1 diabetes mellitus is experiencing nausea, vomiting, and
abdominal pain. Their blood glucose is 450 mg/dL, and urine ketones are large.
The nurse recognizes this as a sign of:
A. Hyperosmolar hyperglycemic state (HHS).
B. Dawn phenomenon.
C. Diabetic ketoacidosis (DKA).
D. Somogyi effect.
Correct Answer: C. The classic triad of DKA includes hyperglycemia, ketosis
(indicated by large urine ketones), and metabolic acidosis. The symptoms of
nausea, vomiting, and abdominal pain are common in DKA due to the
accumulation of ketones in the blood.
Explanation: DKA is a life-threatening complication of type 1 diabetes
characterized by hyperglycemia, ketone production, and metabolic acidosis.
6. A patient is being discharged on prednisone for an exacerbation of Addison's
disease. Which statement by the patient indicates a need for further teaching?
A. "I will carry a medical ID bracelet at all times."
B. "I should never stop taking this medication abruptly."
C. "If I feel stressed or sick, I will need to increase my dose."
D. "If I gain more than 1 pound in a week, it's a sign my dose is too high."
Correct Answer: D. A weight gain of more than 1-2 pounds a week or a rapid
increase in weight is a sign of fluid retention, a side effect of corticosteroid
therapy, but it does not indicate the dose is too high in the context of stopping the
medication. The critical teaching points are to never stop abruptly (risk of adrenal
crisis), take the medication exactly as prescribed, and increase the dose during
times of stress (stress-dose steroids).
Explanation: The patient should be taught about signs of adrenal crisis
(hypotension, weakness, vomiting) and the need for stress-dose steroids. Weight
gain is a side effect, not a sign of the dose being "too high" in this context.
, 7. A patient admitted with DKA has an arterial blood gas (ABG) result of pH 7.20,
PaCO2 30 mm Hg, and HCO3- 14 mEq/L. The nurse interprets this as:
A. Partially compensated respiratory acidosis.
B. Uncompensated metabolic acidosis.
C. Partially compensated metabolic acidosis.
D. Fully compensated metabolic alkalosis.
Correct Answer: C. The pH is low (acidosis). The HCO3- is low, indicating a
metabolic acidosis (the primary problem). The PaCO2 is low, indicating respiratory
compensation (hyperventilation to blow off CO2). Because the pH is still not in the
normal range (7.35-7.45), it is partially compensated.
Explanation: In metabolic acidosis, the body tries to compensate by
hyperventilating to lower PaCO2. Compensation is partial if the pH remains
abnormal.
8. The nurse is teaching a patient with hyperthyroidism about the prescribed
medication propylthiouracil (PTU). The nurse should instruct the patient to
immediately report which symptom?
A. Constipation.
B. Weight gain.
C. Sore throat and fever.
D. Drowsiness.
Correct Answer: C. Propylthiouracil (PTU) is a thioamide that can cause
agranulocytosis, a severe drop in white blood cells. The patient should be taught
to report signs of infection, such as a sore throat, fever, or chills, immediately.
Explanation: Agranulocytosis is a life-threatening side effect that requires
immediate discontinuation of the drug.
9. A patient's laboratory results show a serum potassium of 2.8 mEq/L and a
serum glucose of 350 mg/dL. Which type of diabetes insipidus is most likely the
cause?
A. Neurogenic (central) DI.
QUESTIONS & NURSING REVIEW FOR THE NCLEX EXAM
COMPLETE QUESTIONS WITH 100% CORRECT ANSWERS
1. A patient with syndrome of inappropriate antidiuretic hormone (SIADH) has a
serum sodium level of 120 mEq/L. Which nursing intervention is the priority?
A. Restrict oral fluids to 800 mL per day.
B. Administer a 3% sodium chloride infusion as prescribed.
C. Encourage intake of high-sodium foods.
D. Prepare for hemodialysis.
Correct Answer: B. A sodium level of 120 mEq/L indicates severe hyponatremia,
which can lead to neurological symptoms like seizures and coma. The priority is
the rapid but cautious correction of sodium with hypertonic (3%) saline to prevent
cerebral edema. Fluid restriction is used for mild to moderate SIADH, but is not
the priority for severe, life-threatening hyponatremia.
Explanation: Severe symptomatic hyponatremia is a medical emergency requiring
immediate intervention with hypertonic saline.
2. A patient is prescribed levothyroxine (Synthroid) for newly diagnosed
hypothyroidism. What instruction should the nurse include in the teaching plan?
A. "Take this medication on an empty stomach in the morning."
B. "You can stop the medication when your symptoms improve."
C. "Take this medication with a glass of milk to prevent stomach upset."
D. "This medication will cure your thyroid condition."
Correct Answer: A. Levothyroxine is best absorbed on an empty stomach, at least
30-60 minutes before breakfast. It is a replacement therapy, not a cure, and is
taken for life. It should not be taken with dairy or calcium supplements as they
,interfere with absorption.
Explanation: Proper administration timing is critical for effective absorption and
consistent hormone levels.
3. A patient with diabetes insipidus (DI) is receiving desmopressin acetate
(DDAVP) intranasally. Which finding indicates that the medication is effective?
A. Urine output increases to 200 mL/hr.
B. Blood pressure drops from 140/90 to 100/60.
C. Serum sodium decreases from 150 to 140 mEq/L.
D. The patient complains of a severe headache.
Correct Answer: C. DI is characterized by excessive urination and hypernatremia
due to a lack of ADH. Desmopressin is a synthetic ADH. Effectiveness is
demonstrated by a decrease in urine output, an increase in urine osmolality, and a
return of serum sodium to a normal range.
Explanation: A decrease in serum sodium toward normal indicates that the
kidneys are reabsorbing water in response to the medication.
4. The nurse is assessing a patient with Cushing's syndrome. Which physical
finding is most consistent with this disorder?
A. Exophthalmos and a thin, fragile appearance.
B. Hypertension, moon face, and buffalo hump.
C. Hypotension and hyperpigmentation.
D. Tachycardia and heat intolerance.
Correct Answer: B. Cushing's syndrome is caused by excess cortisol, leading to a
classic presentation of central obesity, a moon-shaped face, a buffalo hump (fat
deposition at the back of the neck), hypertension, and purple striae.
Explanation: These are the characteristic physical manifestations of chronic
glucocorticoid excess.
,5. A patient with type 1 diabetes mellitus is experiencing nausea, vomiting, and
abdominal pain. Their blood glucose is 450 mg/dL, and urine ketones are large.
The nurse recognizes this as a sign of:
A. Hyperosmolar hyperglycemic state (HHS).
B. Dawn phenomenon.
C. Diabetic ketoacidosis (DKA).
D. Somogyi effect.
Correct Answer: C. The classic triad of DKA includes hyperglycemia, ketosis
(indicated by large urine ketones), and metabolic acidosis. The symptoms of
nausea, vomiting, and abdominal pain are common in DKA due to the
accumulation of ketones in the blood.
Explanation: DKA is a life-threatening complication of type 1 diabetes
characterized by hyperglycemia, ketone production, and metabolic acidosis.
6. A patient is being discharged on prednisone for an exacerbation of Addison's
disease. Which statement by the patient indicates a need for further teaching?
A. "I will carry a medical ID bracelet at all times."
B. "I should never stop taking this medication abruptly."
C. "If I feel stressed or sick, I will need to increase my dose."
D. "If I gain more than 1 pound in a week, it's a sign my dose is too high."
Correct Answer: D. A weight gain of more than 1-2 pounds a week or a rapid
increase in weight is a sign of fluid retention, a side effect of corticosteroid
therapy, but it does not indicate the dose is too high in the context of stopping the
medication. The critical teaching points are to never stop abruptly (risk of adrenal
crisis), take the medication exactly as prescribed, and increase the dose during
times of stress (stress-dose steroids).
Explanation: The patient should be taught about signs of adrenal crisis
(hypotension, weakness, vomiting) and the need for stress-dose steroids. Weight
gain is a side effect, not a sign of the dose being "too high" in this context.
, 7. A patient admitted with DKA has an arterial blood gas (ABG) result of pH 7.20,
PaCO2 30 mm Hg, and HCO3- 14 mEq/L. The nurse interprets this as:
A. Partially compensated respiratory acidosis.
B. Uncompensated metabolic acidosis.
C. Partially compensated metabolic acidosis.
D. Fully compensated metabolic alkalosis.
Correct Answer: C. The pH is low (acidosis). The HCO3- is low, indicating a
metabolic acidosis (the primary problem). The PaCO2 is low, indicating respiratory
compensation (hyperventilation to blow off CO2). Because the pH is still not in the
normal range (7.35-7.45), it is partially compensated.
Explanation: In metabolic acidosis, the body tries to compensate by
hyperventilating to lower PaCO2. Compensation is partial if the pH remains
abnormal.
8. The nurse is teaching a patient with hyperthyroidism about the prescribed
medication propylthiouracil (PTU). The nurse should instruct the patient to
immediately report which symptom?
A. Constipation.
B. Weight gain.
C. Sore throat and fever.
D. Drowsiness.
Correct Answer: C. Propylthiouracil (PTU) is a thioamide that can cause
agranulocytosis, a severe drop in white blood cells. The patient should be taught
to report signs of infection, such as a sore throat, fever, or chills, immediately.
Explanation: Agranulocytosis is a life-threatening side effect that requires
immediate discontinuation of the drug.
9. A patient's laboratory results show a serum potassium of 2.8 mEq/L and a
serum glucose of 350 mg/dL. Which type of diabetes insipidus is most likely the
cause?
A. Neurogenic (central) DI.
