Welcome to NCLEX Questions on Diabetes Mellitus. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :
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36. A nurse provides instructions to the client with type 1 diabetes mellitus who takes NPH insulin daily about how to prevent diabetic ketoacidosis (DKA) on days when the client is feeling ill. Which statement by the client indicates a need for further instructions?
a) I need to stop my insulin if I am vomiting
b) I need to call my physician if I feel ill for more than 24 hours
c) I need to eat carbohydrates every 1 to 2 hours
d) I need to drink small quantities of fluid every 15 to 30 minutes
37. A nurse is providing instructions to the client with diabetes mellitus about hypoglycemia. Which statement by the client indicates a need for further instructions?
a) hypoglycemia can occur at any time of the day or night
b) if hypoglycemia occurs, I need to take my Regular insulin
c) if I feel sweaty or shaky I might be experiencing hypoglycemia
d) I can drink 8 ounces of 2% milk if hypoglycemia occurs
38. A nurse is caring for a client with diabetic ketoacidosis (DKA). The nurse monitors the client for which gastrointestinal symptom(s) frequently caused by acidosis?
a) nausea and vomiting
b) melena
c) absolute true borborygmi
d) constipation
39. A nurse monitors a client with uncontrolled diabetes mellitus for which sign that indicates hyperglycemia?
a) tremors
b) diaphoresis
c) polyuria
d) anuria
40. A nurse is performing a physical assessment on a lethargic client brought to the emergency department by emergency medical services. The nurse notes a fruity odor to the client’s breath and suspects:
a) hyperglycemic hyperosmolar nonketotic syndrome (HHNS)
b) diabetic ketoacidosis
c) ethanol oxide intoxication
d) hypoglycemia
NCLEX Questions on Diabetes Mellitus
Answers and Rationale
36) A
The client needs to be instructed to take insulin even if vomiting and unable to eat. It is important to self-monitor blood glucose levels more frequently (every 2 to 4 hours) during illness. If the pre-meal blood glucose is greater than 250 mg/dL, the client should test for urine ketones and contact the physician. Options B, C, and D are accurate interventions.
37) B
- If a hypoglycemia reaction occurs, the client will need to consume 10 to 15 g of carbohydrate: 6 to 8 ounces of 2% milk contain this amount of carbohydrate. Tremors and diaphoresis are signs of mild hypoglycemia. Insulin is not taken as a treatment for hypoglycemia because the insulin will lower the blood glucose level. Hypoglycemic reactions can occur any time of the day or night.
38) A
- Nausea, vomiting, and diarrhea occur secondary to acidosis. There may be increased bowel sounds secondary to increased peristalsis, but true borborygmi primarily suggests a mechanical obstruction of the small intestine. Melena results from bleeding in the upper gastrointestinal tract and usually is a sign of a peptic ulcer or small bowel disease.
39) C
- Classic symptoms of hyperglycemia include polydipsia, polyuria, and polyphagia. Tremors and diaphoresis are signs of hypoglycemia.
40) B
- Clients with DKA accumulate large amounts of ketone bodies in extracellular fluids. A fruity breath odor develops as a result of the volatile nature of acetone. A fruity breath odor is not a characteristic of HHNS, ethanol oxide intoxication, or hypoglycemia.
After you reviewed your answers through its rationale, you can now proceed to the next set of questions:
NCLEX Review Questions Endocrine (41-45)
or you can go back and start from the beginning:
NCLEX Review Questions Endocrine (1-5)
Welcome to NCLEX Review Questions Endocrine. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :
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31. The nurse is caring for a client receiving fludrocortisone acetate (Florinef) for the treatment of Addison’s disease. The nurse monitors the client for improvement, knowing that the anticipated therapeutic effect of this medication is to:
a) promote electrolyte balance
b) stimulate thyroid production
c) stimulate the immune response
d) stimulate thyrotropin production
32. A client is admitted to the hospital with Cushing’s syndrome. The nurse reviews the results of the client’s laboratory studies for which manifestation of this disorder?
a) hypokalemia
b) hyperglycemia
c) decreased plasma cortisol levels
d) low white blood cell (WBC) count
33. A nurse is assessing a client with a diagnosis of goiter. Which of the following would the nurse expect to note during the assessment of the client?
a) client complaints of slow wound healing
b) client complaints of chronic fatigue
c) an enlarged thyroid gland
d) indications of heart damage
34. A nurse is evaluating a client’s understanding about the signs of hyperglycemia. Which statement by the client reflects an understanding?
a) I may become diaphoretic and faint
b) I need to take an extra diabetic pill if my blood glucose is greater than 300
c) I may notice signs of fatigue, dry skin, and increased urination
d) I should restrict my fluid intake if my blood glucose is greater than 250 mg
35. A client is diagnosed with hypothyroidism and is to begin thyroid supplements, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further instructions?
a) I need to take my daily dose every night at bedtime
b) I need to call my physician if I develop any chest pain
c) I need to speak to my physician when I plan to have a child
d) my appetite may increase because of the medication
NCLEX Review Questions Endocrine
Answers and Rationale
31) A
- Florinef is a long-acting oral medication with mineralocorticoid and moderate glucocorticoid activity that is used for long-term management of Addison’s disease. Mineralocorticoids act on the renal distal tubules to enhance the reabsorption of sodium and chloride ions and the excretion of potassium and hydrogen ions. The client can rapidly develop hypotension and fluid and electrolyte imbalance if the medication is discontinued abruptly. The medication does not affect the immune response or thyroid or thyrotropin production.
32) B
- The client with adrenocorticosteroid excess experiences hyperkalemia, hyperglycemia, elevated WBC count, and elevated plasma cortisol and adrenocorticotropic hormone (ACTH) levels. These abnormalities are caused by the effects of excess glucocorticoids and mineralocorticoids on the body.
33) C
- An enlarged thyroid gland occurs in the client with goiter because excessive amounts of thyroxine in the thyroid gland cause it to enlarge. Slow wound healing occurs with zinc deficiency. Chronic fatigue occurs with iron deficiency. Heart damage occurs with selenium deficiency. Additionally, heart damage would not likely be noted during the nursing assessment. Further diagnostic tests, in addition to the assessment, would be necessary to determine the heart damage.
34) C
- Fatigue, dry skin, polyuria, and polydipsia are classic symptoms of hyperglycemia. Fatigue occurs because of lack of energy from the inability of the body to use glucose. Dry skin occurs secondary to dehydration related to polyuria. Polydipsia occurs secondary to fluid loss. Diaphoresis is associated with hypoglycemia. A client should not take extra hypoglycemic agents to reduce an elevated blood glucose level. A client with hyperglycemia becomes dehydrated secondary to the osmotic effect of the elevated glucose. Therefore, the client must increase fluid intake.
35) A
- The client is instructed to take the medication in the morning to prevent insomnia. If the client experiences any chest pain it may indicate overdose, and the physician needs to be notified. The dose needs to be adjusted if the client is pregnant or plans to get pregnant. Gastrointestinal complaints from thyroid supplements include increased appetite, nausea, and diarrhea.
After you reviewed your answers through its rationale, you can now proceed to the next set of questions:
NCLEX Review Questions Endocrine (36-40)
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NCLEX Review Questions Endocrine (1-5)
Welcome to NCLEX Review Questions Endocrine. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :
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26. The nurse is assessing a client with Addison’s disease for signs if hyperkalemia. The nurse expects to note which of the following if hyperkalemia is present?
a) polyuria
b) cardiac dysrhythmias
c) dry mucous membranes
d) prolong bleeding time
27. The nurse is admitting a client to the hospital who recently had a bilateral adrenalectomy. Which intervention is essential for the nurse to include in the client’s plan of care?
a) prevent social isolation
b) consider occupational therapy
c) discuss changes in body image
d) avoid stress-producing situations and procedures
28. The nurse who is caring for a client with Grave’s disease notes a nursing diagnosis of “imbalanced nutrition: less than body requirements related to the effects of the hypercatabolic state” in the care plan. Which of the following indicates a successful outcome for this diagnosis?
a) the client verbalizes the need to avoid snacking between meals
b) the client discusses the relationship between mealtime and the blood glucose level
c) the client maintains the normal weight or gradually gains weight if it is below normal
d) the client demonstrates knowledge regarding the need to consume a diet that is high in fat and low in protein
29. The nurse assesses the client with a diagnosis of thyroid storm. Which classic signs and symptoms associated with thyroid storm indicate the priority need for immediate nursing intervention?
a) polyuria, nausea, and severe headache
b) hypotension, translucent skin, and obesity
c) fever, tachycardia, and systolic hypertension
d) profuse diaphoresis, flushing, and constipation
30. A client is admitted to the hospital for a thyroidectomy. While preparing the client for surgery, the nurse assesses the client for psychosocial problems that may cause preoperative anxiety, knowing that a realistic source of anxiety is fear of:
a) sexual dysfunction and infertility
b) imposed dietary restrictions after discharge
c) developing gynecomastia and hirsutism postoperatively
d) changes in body image secondary to the location of the incision
NCLEX Review Questions Endocrine
Answers and Rationale
26) B
- The inadequate production of aldosterone in clients with Addison’s disease causes the inadequate excretion of potassium and results in hyperkalemia. The clinical manifestations of hyperkalemia are the result of altered nerve transmission. The most harmful consequence of hyperkalemia is its effect on cardiac function. Options A, C, and D are not manifestations that are associated with Addison’s disease or hyperkalemia.
27) D
- Adrenalectomy can lead to adrenal insufficiency. Adrenal hormones are essential to maintaining homeostasis in response to stressors. Options A, B, and C are not essential interventions specific to this client’s problem.
28) C
- Graves’ disease causes a state of chronic nutritional and caloric deficiency caused by the metabolic effects of excessive T3 and T4. Clinical manifestations are weight loss and increased appetite. Therefore, it is a nutritional goal that the client will not lose additional weight and that he or she will gradually return to the ideal body weight, if necessary. To accomplish this, the client must be encouraged to eat frequent high-calorie, high-protein, and high-carbohydrate meals and snacks.
29) C
- The excessive amounts of thyroid hormone cause a rapid increase in the metabolic rate, thereby causing the classic signs and symptoms of thyroid storm such as fever, tachycardia, and hypertension. When these signs present themselves, the nurse must take quick action to prevent deterioration of the client’s health because death can ensue. Priority interventions include maintaining a patent airway and stabilizing the hemodynamic status. Options A, B, and D do not indicate the need for immediate nursing intervention.
30) D
- Because the incision is in the neck area, the client may be fearful of having a large scar postoperatively. Sexual dysfunction and infertility could possibly occur if the entire thyroid gland was removed and if the client was not placed on thyroid replacement medications. The client will not have specific dietary restrictions after discharge. Having all or part of the thyroid gland removed will not cause the client to experience gynecomastia or hirsutism.
After you reviewed your answers through its rationale, you can now proceed to the next set of questions:
NCLEX Review Questions Endocrine (31-35)
or you can go back and start from the beginning:
NCLEX Review Questions Endocrine (1-5)
Welcome to NCLEX Questions on Diabetes Mellitus. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :
Complete NCLEX Study Materials
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21. The nurse requests that a client with diabetes mellitus ask his or her significant other(s) to attend an educational conference about the self-administration of insulin. The client questions why significant others need to be included. The nurse’s best response would be:
a) family members can take you to the doctor
b) family members are at risk of developing diabetes
c) nurses need someone to call and check on a client’s progress
d) clients and families often work together to develop strategies for the management of diabetes
22. A male client is admitted to the hospital with diabetic ketoacidosis (DKA). The client’s daughter says to the nurse, “My mother died last month, and now this. I’ve been trying to follow all of the instructions form the doctor, but what have I done wrong?” The nurse makes which response to the client’s daughter?
a) tell me what you think you did wrong
b) maybe we can keep your father in the hospital for a while longer to give you a rest
c) you should talk to the social worker about getting you someone at home who is more capable with managing a diabetic’s care
d) an emotional stress such as your mother’s death can trigger DKA in a diabetic client, even though the prescribed regimen is being followed
23. A client with hyperaldosteronism has developed renal failure and says to the nurse, “This means that i will die very soon.” The nurse makes which appropriate response to the client?
a) you will do just fine
b) what are you thinking about?
c) you sound discouraged today
d) I read that death is a beautiful experience
24. A client with diabetes mellitus has expressed frustration with learning the diabetic regimen and insulin administration. Which of the following is an initial action by the home care nurse?
a) attempt to identify the cause of the frustration
b) call the physician to discuss the termination of home-care services
c) offer to administer the insulin on a daily basis until the client is ready to learn
d) continue with diabetic teaching, knowing that the client will overcome any frustrations
25. A client who has been newly diagnosed with diabetes mellitus has a nursing diagnosis of Ineffective health maintenance related to anxiety regarding the self-administration of insulin. Initially, the nurse should plan to:
a) teach a family member to give the client the insulin
b) use an orange for the client to inject into until the client is less anxious
c) insert the needle, and have the client push in the plunger and remove the needle
d) give the injection until the client feels confident enough to do so by himself or herself
NCLEX Questions on Diabetes Mellitus
Answers and Rationale
21) D
- Families and significant others may be included in diabetes education to assist with adjustments of the diabetic regimen. Although options A and B may be accurate, they are not the most appropriate responses. Option C devalues the client, disregards the issue of independence, and promotes powerlessness.
22) D
- initiate the physiological mechanism of DKA. Options A and C substantiate the daughters’ feelings of guilt and incompetence. Option B is not a cost-effective intervention.
23) C
- Option C uses the therapeutic communication technique of reflection, and it both clarifies and encourages the further expression of the client’s feelings. Options A and D deny the client’s concerns and provide false reassurance. Option B requests an explanation and does not encourage the expression of feelings.
24) A
- The home-care nurse must determine what is causing the client’s frustration. Continuing to teach may only further block the learning process. Administering the insulin provides only a short-term solution. Terminating the client from home-care services achieves nothing and is considered abandonment unless other follow-up care is arranged.
25) C
- Some clients find it difficult to insert a needle into their own skin. For these clients, the nurse might assist by selecting the site and inserting the needle. Then, as a first step in self-injection, the client can push in the plunger and remove the needle. Options A and D place the client in a dependent role. Option B is not realistic, considering the subject of the question.
After you reviewed your answers through its rationale, you can now proceed to the next set of questions:
NCLEX Questions on Diabetes Mellitus (26-30)
or you can go back and start from the beginning:
NCLEX Questions on Diabetes Mellitus (1-5)
Welcome to NCLEX Questions on Diabetes Mellitus. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :
Complete NCLEX Study Materials
Enjoy answering and I hope that Nurse Certifications can somehow help you in your future examination.
Good Luck
16. A client with diabetes mellitus has received instructions about foot care. Which statement by the client would indicate that the client needs further instructions?
a) I’ll trim my nails straight across after my bath
b) my feet should be inspected daily using a mirror
c) the cuticles of my nails must be cut to prevent overgrowth
d) cotton stockings should be worn to absorb excess moisture
17. The nurse has taught a client about the signs and symptoms and treatment of hyperglycemia. Which statement by the client reflects an accurate understanding?
a) I may become diaphoretic and faint
b) I may notice that I have dry skin and increased urination and thirst
c) I should restrict my fluid intake if my blood glucose level is more than 250 mg/dl
d) I need to take an extra diabetic pill if my blood glucose level is more than 300 mg/dL
18. A client with the diagnosis of hyperparathyroidism says to the nurse, “I can’t stay on this diet. It is too difficult for me.” When intervening in this situation, how should the nurse respond?
a) Why do you think you find this diet plan difficult to adhere to?
b) it really isn’t difficult to stick to this diet. Just avoid milk products
c) you are having difficult time staying on this plan. Let’s discuss this
d) it is very important that you stay on this diet to avoid forming renal calculi
19. The nurse is caring for a client with newly diagnosed type 1 diabetes mellitus. To develop an effective teaching plan, it would be most important for the nurse to assess the client for:
a) knowledge of the diabetic diet
b) expression of denial of having diabetes
c) fear of performing insulin administration
d) feelings of depression about lifestyle changes
20. A client with newly diagnosed type 1 diabetes mellitus has been seen for 3 consecutive days in the emergency department with hyperglycemia. During the assessment, the client says to the nurse, “I’m sorry to keep bothering you every day, but I just can’t give myself those awful shots.” The nurse makes which therapeutic response?
a) I couldn’t give myself a shot either
b) you must learn to give yourself the shots
c) let me see if the doctor can change your medication
d) I’m sorry that you are having trouble with your injections. Has someone given you instructions about how to perform them?
NCLEX Questions on Diabetes Mellitus
Answers and Rationale
16) C
- Trimming or cutting the cuticles of the nails can lead to injury to the foot by scratching the skin. Even small injuries can be dangerous to the client with diabetes mellitus who has decreased peripheral vascular circulation. A manicure stick can be used to gently push the cuticle back under the nail. Nails can be cut straight across; and after a bath is the best time, because the nails are softest then. White cotton stockings are best, and the client needs to inspect the feet daily. The client can use a mirror for those areas that are difficult to inspect.
17) B
- Dry skin, polyuria (excess urination), and polydipsia (excess thirst) are classic symptoms of hyperglycemia. Dry skin occurs as a result of dehydration related to the polyuria. Polydipsia occurs as a result of fluid loss. Diaphoresis is associated with hypoglycemia. Clients should not take extra oral hypoglycemic agents to reduce an elevated blood glucose level. A client with hyperglycemia becomes dehydrated as a result of the osmotic effect of elevated glucose; therefore, the client must increase fluid intake.
18) C
- By paraphrasing the client’s statement, the nurse can encourage the client to verbalize emotions. The nurse also sends feedback to the client that the message was understood. An open-ended statement or question such as this prompts a lengthy response from the client. Option A requests information that the client may not be able to express. Option B devalues the client’s feelings. Option D gives advice, which blocks communication.
19) B
- When diabetes mellitus is first diagnosed, the client may go through the phases of grief: denial, fear, anger, bargaining, depression, and acceptance. Denial is the phase that is the most detrimental to the teaching and learning process. If the client is denying the fact that he or she has diabetes, then he or she probably will not listen to discussions about the disease or how to manage it. Denial must be identified before the nurse can develop a teaching plan.
20) D
- It is important to determine and deal with a client’s underlying fear of self-injection. The nurse should determine whether a knowledge deficit exists. Positive reinforcement should occur rather than focusing on negative behaviors (option A). Demanding that the client perform a behavior or skill is inappropriate (option B). The nurse should not offer a change in regimen that cannot be accomplished (option C).
After you reviewed your answers through its rationale, you can now proceed to the next set of questions:
NCLEX Questions on Diabetes Mellitus (21-25)
or you can go back and start from the beginning:
NCLEX Questions on Diabetes Mellitus (1-5)
Categories:
Endocrine, NCLEX Tags:
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Welcome to Endocrine NCLEX Practice Questions. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :
Complete NCLEX Study Materials
Enjoy answering and I hope that Nurse Certifications can somehow help you in your future examination.
Good Luck
11. The nurse is reviewing home-care instructions with an older client who has type 1 diabetes mellitus and a history of diabetic ketoacidosis (DKA). The client’s spouse is present when the instructions are given. Which statement by the spouse indicates that further teaching is necessary?
a) if he is vomiting, I shouldn’t give him any insulin
b) I should bring him to physician’s office if he develops a fever
c) if the grandchildren are sick, they probably shouldn’t come to visit
d) I should call the doctor if he has nausea or abdominal pain lasting for more than 1 or 2 days
12. The nurse provides home-care instructions to a client with Cushing’s syndrome. The nurse determines that the client understands the hospital discharge instructions if the client makes which statement?
a) I need to eat foods low in potassium
b) I need to check the color of my stools
c) I need to check the temperature of my legs twice a day
d) I need to take aspirin rather than Tylenol for a headache
13. The nurse in an outpatient diabetes clinic is monitoring a client with type 1 diabetes mellitus. Today’s blood work reveals a glycosylated hemoglobin level of 10%. The nurse creates a teaching plan on the basis of the understanding that this result indicates which of the following?
a) a normal value that indicates that the client is managing blood glucose control well
b) a value that does not offer information regarding that client’s management of the disease
c) a low value that the client is not managing blood glucose control very well
d) a high value that indicates the client is not managing blood glucose control very well
14. The nurse is instructing a client with type 1 diabetes mellitus about the management of hypoglycemic reactions. The nurse instructs the client that hypoglycemia most likely occurs during what time interval after insulin administration?
15. The nurse is caring for a client with type 1 diabetes mellitus. Because the client is at risk for hypoglycemia, the nurse teaches the client to:
a) monitor the urine for acetone
b) report any feelings of drowsiness
c) keep glucose tablets and subcutaneous glucagon available
d) omit the evening dose of NPH insulin if the client has been exercising
Endocrine NCLEX Practice Questions
Answers and Rationale
11) A
- Infection and the stopping of insulin are precipitating factors for DKA. Nausea and abdominal pain that last more than 1 or 2 days need to be reported to the physician, because these signs may be indicative of DKA.
12) B
- Cushing’s syndrome results in an increased secretion of cortisol. Cortisol stimulates the secretion of gastric acid, and this can result in the development of peptic ulcers and gastrointestinal bleeding. The client should be encouraged to eat potassium-rich foods to correct the hypokalemia that occurs with this disorder. Cushing’s syndrome does not affect temperature changes in the lower extremities. Aspirin can increase the risk for gastric bleeding and skin bruising.
13) D
- Glycosylated hemoglobin is a measure of glucose control during the 6 to 8 weeks before the test. It is a reliable measure for determining the degree of glucose control in diabetic clients over a period of time, and it is not influenced by dietary management a day or two before the test is done. The glycosylated hemoglobin level should be 7.0% or less, with elevated levels indicating poor glucose control.
14) A
- Insulin reactions are most likely to occur during the peak time after insulin administration, when the medication is at its maximum action. Peak action depends on the type of insulin, the amount administered, the injection site, and other factors.
15) C
- Glucose tablets are taken if a hypoglycemic reaction occurs. Glucagon is administered subcutaneously or intramuscularly if the client loses consciousness and is unable to take glucose by mouth. Glucagon releases glycogen stores and raises the blood glucose levels of hypoglycemic clients. Family members can be taught to administer this medication and possibly to prevent an emergency department visit. Acetone in the urine may indicate hyperglycemia. Although signs of hypoglycemia need to be taught to the client, drowsiness and coma are not the initial and key signs of this complication. The nurse would not instruct a client to omit insulin.
After you reviewed your answers through its rationale, you can now proceed to the next set of questions:
Endocrine NCLEX Practice Questions (16-20)
or you can go back and start from the beginning:
Endocrine NCLEX Practice Questions (1-5)
Welcome to Endocrine NCLEX Practice Questions. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :
Complete NCLEX Study Materials
Enjoy answering and I hope that Nurse Certifications can somehow help you in your future examination.
Good Luck
6. A client is diagnosed with hypothyroidism and is scheduled to begin taking thyroid supplements. The nurse instructs the client about the medication. Which statement by the client would indicate the need for further instructions?
a) I need to take my daily dose every night at bedtime
b) I need to notify my physician if I develop any chest pain
c) I may experience some gastrointestinal problems, such as diarrhea
d) I need to speak to my physician when I begin to plan for parenthood
7. The clinic nurse instructs a client with diabetes mellitus about how to prevent diabetic ketoacidosis on days when the client is feeling ill. Which statement by the client indicates the need for further instructions?
a) I need to stop my insulin if I am vomiting
b) I need to eat 10 to 15 g of carbohydrates every 1 to 2 hours
c) I need to call my physician if I am ill for more than 24 hours
d) I need to drink small quantities of fluid every 15 to 30 minutes
8. The nurse is instructing a client with diabetes mellitus regarding hypoglycemia. Which statement by the client indicates the need for further instructions?
a) hypoglycemia can occur at any time of the day or night
b) I can drink 6 to 8 ounces of milk if hypoglycemia occurs
c) if I feel sweaty or shaky, I might be experiencing hypoglycemia
d) if hypoglycemia occurs, I need to take my regular insulin as prescribed
9. The nurse develops a plan of care for an older client with diabetes mellitus. The nurse plans to first:
a) structure menus for adherence to diet
b) teach with videotapes showing insulin administration to ensure competence
c) encourage dependence on others to prepare the client for the chronicity of the disease
d) assess the client’s ability to read label markings on syringes and glucose monitoring equipment
10. A nurse is teaching a client who had been newly diagnosed with diabetes mellitus about blood glucose monitoring. The nurse teaches the client to report glucose levels that consistently exceed:
a) 150 mg/dL
b) 200 mg/dL
c) 250 mg/dL
d) 350 mg/dL
Endocrine NCLEX Practice Questions
Answers and Rationale
6) A
- The client is instructed to take the medication in the morning to prevent insomnia. If the client experiences any chest pain, it may indicate an overdose, and the physician needs to be notified. Gastrointestinal complaints from thyroid supplements include increased appetite, nausea, and diarrhea. The dose needs to be adjusted if the client is pregnant or plans to get pregnant.
7) A
- The client needs to be instructed to take insulin, even if he or she is vomiting and unable to eat. It is important to self-monitor blood glucose more frequently during illness (every 2 to 4 hours). If the premeal blood glucose is more than 250 mg/dL, the client should test for urine ketones and contact the physician. Options B, C, and D are accurate interventions.
D
- Insulin is not taken as a treatment for hypoglycemia, because the insulin will lower the blood glucose level. Hypoglycemic reactions can occur at any time of the day or night. If a hypoglycemic reaction occurs, the client will need to consume 10 to 15 g of carbohydrate; 6 to 8 ounces of milk contains this amount of carbohydrate. Tremors and diaphoresis are signs of mild hypoglycemia.
9) D
- The nurse first assesses the client’s ability for self-care. Structuring menus for the client promotes dependence. Allowing the client to have hands-on experience rather than teaching with videos is more effective. Independence should be encouraged.
10) C
- The client should be taught to report blood glucose levels that exceed 250 mg/dL, unless otherwise instructed by the physician. Options A and B are low levels that do not require physician notification. Option D is a high value.
After you reviewed your answers through its rationale, you can now proceed to the next set of questions:
Endocrine NCLEX Practice Questions (11-15)
or you can go back and start from the beginning:
Endocrine NCLEX Practice Questions (1-5)
Welcome to Endocrine NCLEX Practice Questions. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :
Complete NCLEX Study Materials
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1. The nurse is performing an admission assessment on a client admitted to the hospital with a diagnosis of pheochromocytoma. The nurse prepares to implement what action to assess for the principal manifestation associated with this disorder?
a) checks the client’s pupils
b) checks the peripheral pulses
c) takes the client’s blood pressure
d) assesses for the presence of peripheral edema
2. Regular insulin by continuous intravenous (IV) infusion is prescribed for a client with a blood glucose level of 700 mg/dL. The nurse plans to:
a) mix the solution in 5% dextrose
b) change the solution every 6 hours
c) infuse the medication via an electronic infusion pump
d) titrate the infusion according to the client’s urine glucose levels
3. The nurse is developing a plan of a care for a client with diabetic ketoacidosis (DKA). The nurse includes which intervention in the plan?
a) assess for fluid overload
b) limit family visitation time
c) ambulate the client every 2 hours
d) maintain side rails in the upright position
4. A client undergoes a subtotal thyroidectomy. The nurse ensures that which priority item is at the client’s bedside upon arrival from the operating room?
a) an apnea monitor
b) a suction unit and oxygen
c) a blood transfusion warmer
d) an ampule of phytonadione (vitamin K)
5. The nurse is preparing the bedside for a postoperative parathyroidectomy client who is expected to return to the nursing unit from the recovery room in 1 hour. The nurse ensures that which piece of medical equipment is at the client’s bedside?
a) cardiac monitor
b) tracheotomy set
c) intermittent gastric suction
d) underwater seal chest drainage system
Endocrine NCLEX Practice Questions
Answers and Rationale
1) C
- Pheochromocytoma is a catecholamine-secreting tumor that is usually located in the adrenal medulla. Hypertension is the principal manifestation associated with pheochromocytoma, and it can be persistent, fluctuating, intermittent, or paroxysmal. The blood pressure status would be assessed by taking the client’s blood pressure. The assessments in options A, B, and D are not associated with this disorder.
2) C
- Insulin is administered via an infusion pump to prevent inadvertent overdose and subsequent hypoglycemia. There is no reason to change the solution every 6 hours. Dextrose is added to the IV infusion once the serum glucose level reaches 250 mg/dL to prevent the occurrence of hypoglycemia. Administering dextrose to a client with a serum glucose level of 700 mg/dL would counteract the beneficial effects of insulin in reducing the glucose level. Glycosuria is not a reliable indicator of the actual serum glucose levels because many factors affect the renal threshold for glucose loss in the urine.
3) D
- The client with DKA may experience a decrease in the level of consciousness (LOC) secondary to acidosis. Safety becomes a priority for any client with a decreased LOC, thus requiring the use of side rails to prevent fall injuries. The client will experience fluid loss (dehydration) rather than overload and may be too ill to ambulate. Family visitation is helpful for both the client and family to assist with psychosocial adaptation.
4) B
- Following thyroidectomy, respiratory distress can occur from tetany, tissue swelling, or hemorrhage. It is important to have oxygen and suction equipment readily available and in working order if such an emergency were to arise. Apnea is not a problem associated with thyroidectomy, unless the client experienced a respiratory arrest. Blood transfusions can be administered without a warmer, if necessary. Vitamin K would not be administered for a client who is hemorrhaging, unless deficiencies in clotting factors warrant its administration.
5) B
- Respiratory distress caused by hemorrhage and swelling and compression of the trachea is a primary concern for the nurse managing the care of a postoperative parathyroidectomy client. An emergency tracheotomy set is always routinely placed at the bedside of the client with this type of surgery, in anticipation of this potential complication. Options A, C, and D are not specifically needed with the surgical procedure.
After you reviewed your answers through its rationale, you can now proceed to the next set of questions:
Endocrine NCLEX Practice Questions (6-10)
Categories:
Endocrine, NCLEX Tags:
endocrine nclex practice questions, endocrine practice questions, endocrine practice test, endocrine system nclex questions, endocrine system practice questions, endocrine test questions, nclex diabetes practice questions, nclex endocrine, nclex questions on endocrine, nclex questions on endocrine system
Welcome to Cardiac Nursing Questions. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :
Complete NCLEX Study Materials
Enjoy answering and I hope that Nurse Certifications can somehow help you in your future examination.
Good Luck
46. The nurse has applied the patch electrodes of an automatic external defibrillator (AED) to the chest of a client who is pulseless. The defibrillator has interpreted the rhythm to the ventricular fibrillation. The nurse then:
a) administers rescue breathing during the defibrillation
b) performs cardiopulmonary resuscitation (CPR) for 1 minute before defibrillating
c) charges the machine and immediately pushes the “discharge” buttons on the console
d) orders any personnel away from the client, charges the machine, and defibrillates through the console
47. The nurse is planning care for a client diagnosed with deep vein thrombosis (DVT) of the left leg who is experiencing severe edema and pain in the affected extremity. Which intervention should the nurse avoid in the care of this client?
a) elevate the left leg
b) apply moist heat to the left leg
c) administer acetaminophen (Tylenol)
d) ambulate in the hall three times per shift
48. The nurse is planning preoperative care for a client scheduled for insertion of an inferior vena cava filter. The nurse questions the physician about withholding which regularly scheduled medication on the day before surgery?
a) docusate sodium (Colace)
b) furisemide (Lasix)
c) potassium chloride (K-Dur)
d) warfarin sodium (Coumadin)
49. A hospitalized client with hypertension has been started on catopril (Capoten). The nurse ensures that the client does which of the following specific to this medication?
a) drinks plenty of water
b) eats foods that are high in potassium
c) takes in sufficient amounts of high-fiber foods
d) moves from a sitting to a standing position slowly
50. A 24-year old female with a family history of heart disease presents to the physician’s office asking to begin oral contraceptive therapy for birth control. The nurse would next inquire whether the client:
a) exercises regularly
b) is currently a smoker
c) eats a low-cholesterol diet
d) has taken oral contraceptives before
Cardiac Nursing Questions
Answers and Rationale
46) D
- If the AED advises to defibrillate, the nurse or rescuer orders all persons away from the client, charges the machine, and pushes both of the “discharge” buttons on the console at the same time. The charge is delivered through the patch electrodes, and this method is known as “hands-off” defibrillation, which is safest for the rescuer. The sequence of charges (up to three consecutive attempts at 200, 300, and 360 joules) is similar to that of conventional defibrillation. Option A is contraindicated for the safety of any rescuer. Performing CPR delays the defibrillation attempt.
47) D
- Management of the client with DVT who is experiencing severe edema and pain includes bed rest; limb elevation; relief of discomfort with warm moist heat and analgesics as needed; anticoagulant therapy; and monitoring for signs of pulmonary embolism. In current practice, activity restriction may not be ordered if the client is receiving low-molecular-weight heparin; however, some physicians may still prefer bed rest for the client.
48) D
- In the preoperative period, the nurse consults with the physician about withholding warfarin sodium to avoid the occurrence of hemorrhage. Docusate sodium is a stool softener, furosemide is a diuretic, and potassium chloride is a supplement.
49) D
- Orthostatic hypotension is a concern for clients taking antihypertensive medications. Clients are advised to avoid standing in one position for lengthy amounts of time, to change positions slowly, and to avoid extreme warmth (showers, bath, and weather). Clients are also taught to recognize the symptoms of orthostatic hypotension, including dizziness, light-headedness, weakness, and syncope. Options A, B, and C are not specific to this medication.
50) B
- Oral contraceptive use is a risk factor for heart disease, particularly when it is combined with cigarette smoking. Regular exercise and keeping total cholesterol levels less than 200 mg/dL are general measures to decrease cardiovascular risk.
After you reviewed your answers through its rationale, you can proceed to the next set of questions:
Cardiac Nursing Questions (51-55)
or you can go back and start from the beginning:
Cardiac Nursing Questions (1-5)
Categories:
Cardiovascular, NCLEX Tags:
cardiac exam questions, cardiac nursing certification, cardiac nursing questions, cardiac nursing quiz, cardiac quiz questions, cardiac test questions, cardiovascular nursing questions, nursing board questions, nursing question, nursing quiz questions
Welcome to Cardiac Nursing Questions. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :
Complete NCLEX Study Materials
Enjoy answering and I hope that Nurse Certifications can somehow help you in your future examination.
Good Luck
41. The nurse is teaching a client with cardiomyopathy about home care safety measures. The nurse provides instructions on which most important measure to ensure client safety?
a) reporting pain
b) taking vasodilators
c) avoiding over-the-counter medications
d) moving slowly from a sitting to a standing position
42. The nurse instructs a client with a diagnosis of atrial fibrillation to use an electric razor for shaving. The nurse tells the client that the importance of its use is that:
a) cuts need to be avoided
b) any cut may cause infection
c) electric razors can be disinfected
d) all straight razors contain bacteria
43. A cardiac catheterization, using the femoral artery approach, is performed to assess the degree of coronary artery thrombosis in a client. Which nursing action following the procedure is unsafe for the client?
a) encouraging the client to increase fluid intake
b) placing the client’s bed in the fowler’s position
c) resuming prescribed precatheterization medications
d) instructing the client to move the toes when checking circulation, motion, and sensation
44. The nurse is receiving a client being transferred from the postanesthesia care unit following an above-the-knee amputation. The nurse should take which action to safely position the client at this time?
a) elevate the foot of the bed
b) position the residual limb flat on the bed
c) put the bed in reverse trendelenburg’s position
d) keep the residual limb flat with the client lying on the operative side
45. The postmyocardial infarction client is scheduled for a technetium-99m ventriculography (multigated acquisition [MUGA] scan). The nurse ensures that which item is in place before the procedure?
a) a foley catheter
b) signed informed consent
c) a central venous pressure (CVP) line
d) notation of allergies to iodine or shellfish
Cardiac Nursing Questions
Answers and Rationale
41) D
- Orthostatic changes can occur in the client with cardiomyopathy as a result of venous return obstruction. Sudden changes in blood pressure may lead to falls. Vasodilators are not normally prescribed for the client with cardiomyopathy. Options A and C, although important, are not directly related to the issue of safety.
42) A
- Clients with atrial fibrillation are placed on anticoagulants to prevent thrombus formation and possible stroke. The importance of use of an electric razor is to prevent cuts and possible bleeding. Options B, C, and D are all unrelated to the subject of bleeding; rather, they relate to infection.
43) B
- Immediately following a cardiac catheterization with the femoral artery approach, the client should not flex or hyperextend the affected leg to avoid blood vessel occlusion or hemorrhage. Placing the client in the Fowler’s position (flexion) increases the risk of occlusion or hemorrhage. Fluids are encouraged to assist in removing the contrast medium from the body. The precatheterization medications are needed to treat acute and chronic conditions. Asking the client to move the toes is done to assess motion, which could be impaired if a hematoma or thrombus was developing.
44) A
- Edema of the residual limb is controlled by elevating it on pillows or the foot of the bed for the first 24 hours only after surgery. Following the first 24 hours, the residual limb is usually placed flat on the bed to reduce hip contracture. Edema is also controlled by residual limb wrapping techniques. Reverse Trendelenburg’s position does not provide direct limb elevation.
45) B
- MUGA is a radionuclide study used to detect myocardial infarction, decreased myocardial blood flow, and left ventricular function. A radioisotope is injected intravenously. Therefore, a signed informed consent is necessary. A Foley catheter and CVP line are not required. The procedure does not use radiopaque dye; therefore, allergy to iodine and shellfish is not a concern.
After you reviewed your answers through its rationale, you can proceed to the next set of questions:
Cardiac Nursing Questions (46-50)
or you can go back and start from the beginning:
Cardiac Nursing Questions (1-5)
Categories:
Cardiovascular, NCLEX Tags:
cardiac exam questions, cardiac nclex review questions, cardiac nurse, cardiac nurse certification, cardiac nursing, cardiac nursing courses, cardiac nursing questions, cardiac nursing quiz, cardiac questions, cardiac quiz questions, cardiac test questions, cardiac vascular nurse certification, cardiovascular nursing questions
