1. After pituitary surgery the nurse should assess the client for which of the following?
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a. Urine specific gravity less than 1.010
b. Urine output between 1 and 2L/day
c. Blood glucose level higher than 300mg/100ml
d. Urine negative for glucose and ketones
Correct answer
a. Urine specific gravity less than 1.010
2. Vasopressin is administered to the client with diabetes insipidus (DI) because it
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a. Decrease blood pressure
b. Increase tubular reabsorption of water
c. Increases release of insulin from the pancreas
d. Decreases glucose production within the liver
No correct answers
3. Which of the following constitutes a priority outcome for the client with DI?
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a. Maintains normal fluid and electrolyte balance
b. Selects American diabetes association diet correctly
c. States dietary restrictions
d. Exhibits serum glucose level within normal range
4. Immediately after a hypophysectomy, the nurse should be concerned if the client has:
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a. Sore throat and dysphagia
b. Been complaining of feeling hungry
c. Complaint of lack of appetite
d. Been frequently asking for water to drink
Correct answer
d. Been frequently asking for water to drink
5. Which of the following tests is used to diagnose Diabetes Insipidus?
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a. Capillary blood glucose test
b. Fluid Deprivation Test
c. Dexamethasone Suppression Test
d. Thallium Scan
6. Which nursing intervention would be included in fluid management for a client diagnosed
with
syndrome of inappropriate antidiuretic hormone ( SIADH )?
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a. Rapid IV fluid infusion
b. Fluid restriction
c. Increased oral fluid intake
d. Administration of dextrose fluids IV
7. The change nurse is determining in which room to place a client who is being admitted with
hyperthyroidism. Which room assignment would be the best for this client?
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a. A semi-private room near the elevators,
b. A private room near the end of the hall.
c. A private room near the nurses’ station.
d. A multibed room with one shared bathroom.
8. A 30-year-old woman is receiving levothyroxine sodium (Synthroid) 0.1 mg PO daily. Which
of the following findings would indicate to the nurse that the client is getting favorable results
from the medication?
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a. Decreased blood pressure.
b. Increased urine output.
c. Decreased pulse rate.
d. Increased respiratory rate
9. A 64-year-old client has a previous thyroidectomy and admitted for myxedema
(hypothyroidism). Assessment of this client will most likely reveal which of the following
findings?
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a. Puffy appearance
b. Increased pulse rate
c. Elevated basal metabolic rate
d. Hypertension
10. Assessing the client with hyperthyroidism, the nurse will most likely observe which of the
following clinical signs?
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a. Sunken eyeball
b. Loss of weight
c. Loss of appetite
d. Bradycardia
11. The nurse a caring for a client with myxedema. Which of the following would indicate to the
nurse that the client’s condition is deteriorating?
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a. An increase in pulse rate and respirations
b. Cold skin and episodes of chills
c. Difficulty in arousing the client for medications
d. Clients complaints of palpations
Correct answer
c. Difficulty in arousing the client for medications
12. Thyroidectomy is recommended for a client with hyperthyroidism. Stable iodine preparation
(Lugol’s Solution) is ordered. The beneficial effect of this medication on a client
with hyperthyroidism is brought about his action which is it:
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a. Blocks the cell utilization of the thyroid hormone
b. Blocks hormone synthesis by preventing iodine and thyroxine form combining
c. Destroys the stored thyroid hormone
d. Stores thyroid hormones in the thyroid gland
Correct answer
d. Stores thyroid hormones in the thyroid gland
13. While taking care of an immediate post–operative thyroidectomy client, the nurse noted the
following observations. Which one should be immediate reported to the physician?
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a. Crowing respirations
b. dysphagia
c. Poor intake of fluids
d. Sore throat
Correct answer
a. Crowing respirations
14. In assessing the client with hyperthyroidism, the most significant serum electrolyte test result
that will contribute to its diagnosis is:
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a. Elevated phosphorous
b. Low potassium
c. Low sodium
d. Elevated calcium
Correct answer
d. Elevated calcium
15. In the case of the client with hyperparathyroidism, an associated problem which the nurse
should consider in her care plan is:
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a. Azotemia
b. Nephrolithiasis
c. Paralysis
d. Glomerulonephritis
16. The nurse should include which of the following in the pre-procedure instruction given to the
parents of a child scheduled for a thyroid function test?
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a. NPO after midnight
b. A high-carbohydrate meal should be eaten the day before the test
c. A concentrated glucose will be given just prior to the test
d. It is important that the child remain still during the procedure
Correct answer
d. It is important that the child remain still during the procedure
17. An adult who is newly diagnosed with Grave’s disease asks the nurse “Why do I need to take
Propanolol (Inderal)?” Based on the nurse’s understanding of the medication and Graves disease,
the best response would be?
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a. The medication will limit thyroid hormone secretion
b. The medication will inhibit synthesis of thyroid hormones
c. The medication will relieve the symptoms of Grave’s disease
d. The medication will increase the synthesis of thyroid hormones
Correct answer
c. The medication will relieve the symptoms of Grave’s disease
18. The nurse is caring for a client who is status post-thyroidectomy. The client is exhibiting
hyperreflexia, muscle twitching, and spasms. The first action the nurse should perform is to?
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a. Assess for additional signs of tetany
b. Prepare to send a blood sample to the
laboratoryfor a calcium level
c. Place the client in Semi-Fowlers Position
d. Administer post-op pain medication
Correct answer
b. Prepare to send a blood sample to the
19. A client is admitted to an emergency room, and a diagnosis of myxedema coma is made.
Which action would the nurse prepare to carry out initially?
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a. Warm the client
b. Administer fluid replacement
c. Maintain an airway
d. Administer thyroid hormone
Correct answer
c. Maintain an airway
20. After a parathyroidectomy, hungry bone syndrome is manifested by which sign or symptom?
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a. Carpopedal spasms
b. Weakness
c. Back pain
d. Polyuria
Correct answer
a. Carpopedal spasms
21. Which nursing intervention should be included in the discharge teaching for a client with
hypoparathyroidism?
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a. Avoiding diuretics to minimize calcium loss
b. Using over – the – counter vitamin D preparations
c. Supplementing calcium intake
d. Avoiding strenuous exercise
22. Which of the following is the priority for a client in Addisonian crisis?
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a. Controlling hypertension
b. Preventing irreversible shock
c. Preventing infection
d. Relieving anxiety
23. The nurse would expect the client with Addison’s disease to exhibit which of the following
signs and symptoms?
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a. Weight gain
b. Hunger
c. Lethargy
d. Muscle spasms
Correct answer
d. Muscle spasms
24. A 42-year-old female client reports that she has gained weight and that her face and body are
“rounder,” while her legs and arms have become thinner. A tentative diagnosis of Cushing’s
disease is made. When examining this client, the nurse would expect to find
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a. Postural hypotension
b. Muscle hypertrophy in the extremities
c. Bruised areas on the skin
d. Decreased body hair
Correct answer
c. Bruised areas on the skin
25. Signs and symptoms of Cushing’s disease include
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a. Weight loss
b. Thin, fragile skin
c. Hypotension
d. Abdominal pain
Correct answer
b. Thin, fragile skin
26. The client with Cushing’s disease needs to modify dietary intake to control symptoms. In
addition to increasing protein, which strategy would be most appropriate?
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a. Increase calories
b. Restrict sodium
c. Restrict potassium
d. Reduce fat to 10%
27. Bone resorption is a possible complication of Cushing’s disease. Which of the
following intervention should the nurse recommend to help the client prevent this complication?
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a. Increase the amount of potassium in the diet
b. Maintain a regular program of weight – bearing exercise
c. Limit dietary vitamin D intake
d. Perform isometric exercises
Correct answer
b. Maintain a regular program of weight – bearing exercise
28. Which statements should the nurse make when teaching the client about taking oral
glucocorticoids?
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a. “Take your medication with a full glass of water”
b. “Take your medication on an empty stomach”
c. “Take your medication at bedtime to increase absorption”
d. “Take your medication with meals or with an antacid”
Correct answer
a. “Take your medication with a full glass of water”
29. Which of the following is the best indicator for determining whether a client with Addison’s
disease is receiving the correct amount of glucocorticoid replacement?
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a. Skin turgor
b. Temperature
c. Thirst
d. Daily weight
Correct answer
d. Daily weight
30. A client is prescribed with prednisone (Deltasone) daily. Which statement best described
why the nurse instructs the client to take the drug in the morning?
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a. Taking the drug at the same time each day establishes a regular routine, reducing the risk of forgetting
the dose.
b. Prednisone has a longer half-life with morning administration, making it more effective
c. Morning administration of prednisone mimics the body’s natural corticosteroid secretion pattern
d. Prednisone is best absorbed when take in an empty stomach first thing in the morning
31. An adult is readmitted to the medical surgical care unit in Addisonian crisis. He is exhibiting
sings of tachycardia, dehydration, hyponatremia, hyperkalemia, and hypoglycemia. The nurse
should expect that the initial orders for this client will include:
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a. Administration of oxygen via 100% nonrebreathing mask
b. Starting an IV solution of saline and dextrose
c. Administering potassium chloride
d. Preparing for an emergency tracheostomy
Option 5
32. A client who is suspected of having a pheochromocytoma complains of sweating,
palpitations, and headache. Which assessment is essential for the nurse to make first?
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a. Pupil reaction
b. Hand grips
c. Blood pressure
d. Blood glucose
Option 5
33. The primary feature of pheochromocytoma’s effect on blood pressure is
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a. systolic hypertension
b. diastolic hypertension
c. hypertension that is resistant treatment with drugs
d. widening pulse pressure
Correct answer
c. hypertension that is resistant treatment with drugs
34. Which of the following therapeutic classes of drugs is used to treat tachycardia and angina in
a client with pheochromocytoma?
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a. ACE inhibitors
b. Calcium channel blocker
c. Beta – blockers
d. Diuretic
35. Which of the following should the nurse include in the teaching plan of a female client with
bilateral adrenalectomy?
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a. Emphasizing that the client will need steroid replacement for the rest of her life
b. Instructing the client about the importance of tapering steroid medication carefully to prevent crisis
c. Informing the client that steroids will be required only until her body can manufacture sufficient
quantities
d. Emphasizing that the client will need to take steroids whenever her life involves physical or emotional
stress
36. The nurse would report which of the following laboratory results as consistent with a
diagnosis of primary aldosteronism?
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a. Serum potassium of 3 mEq/L
b. Serum phosphorus of 3 mg/dL
c. Serum sodium of 130 mEq/L
d. Serum Calcium of 12 mg/dL
Correct answer
a. Serum potassium of 3 mEq/L
37. Mrs. Sullivan has type 2 diabetes mellitus and is trying to determine how she can change her
lifestyle so as to decrease her serum glucose levels. Which of the following measures would you
suggest as an appropriate intervention?
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a. Get 10 to 12 hours of sleep per day.
b. Exercise.
c. Undergo gastric bypass surgery.
d. Smoke less than 1 pack of cigarette per day.
38. You are teaching a patient with insulin-dependent diabetes about the importance of
absorption of insulin to controlling his diabetes. To best avoid absorption problems, you will
teach him to:
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a. Shake the insulin vial prior to drawing up insulin.
b. Rotate insulin injection sites.
c. Inject the insulin while it is still cold from refrigeration.
d. Use an 18-gauge needle for injection.
Correct answer
b. Rotate insulin injection sites.
39. Your patient is in the waiting room for her usual clinic visit to the diabetic educator. A few
minutes ago, she was rude and inappropriate to the secretary. Now she tells you that she has a
headache, is weak, and has slight tremors. You recognize these as signs of which condition?
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a. Hypoglycemia.
b. Hyperglycemia.
c. Hyperlipidemia.
d. Hypertension.
40. Which outcome represents the best indication of good overall diabetes control?
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a. The client reports urine glucose levels indicating no glucosuria
b. The client displays a glycosylated hemoglobin level within control range
c. The client reports urine ketone levels reflecting no ketonuria
d. The client records home glucose test results daily
Correct answer
b. The client displays a glycosylated hemoglobin level within control range
41. Which of the following conditions are associated with impaired glucose tolerance (IGT)?
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a. Hypotension and hyperlipidemia.
b. Hypoglycemia and prostatitis.
c. Obesity and hypotension.
d. Obesity and syndrome X.
Correct answer
d. Obesity and syndrome X.
42. You are a nurse who is discussing treatment involving insulin with Julie Johnson, a woman
who is newly diagnosed with type 1 diabetes mellitus. Julie asks, “Why can’t I just take the pill
like my friend who has diabetes?” After you give your explanation, which of the following
responses by the patient would indicate that she understood your explanation?
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a. “After I am on insulin for some time, then I can wean myself off insulin and take pills”.
b. “With exercise twice a day and a 1,200-calorie diet, I should be able to avoid having to take insulin”.
c. “Because my body does not produce insulin, I will need to take insulin by injection for the rest of my
life”.
d. “When my body starts to make insulin again, then I can stop the insulin injections and try the pills”.
43. In planning care for a client with diabetic peripheral neuropathy, what would the nurse teach
the client to do?
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a. Massage a thick layer of cream or lotion on the feet and between the toes twice a day.
b. Soak the feet in hot water for 30 minutes twice a day and pat them dry with an absorbent towel.
c. Wear open-toed, rubber-or plastic-soled shoes.
d. Inspect the feet twice a day and wear soft absorbent socks.
Correct answer
d. Inspect the feet twice a day and wear soft absorbent socks.
44. A home care nurse visits a client recently diagnosed with diabetes mellitus. The client is
taking NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin.
The nurse tells the client to?
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a. Freeze the insulin
b. Refrigerate the insulin
c. Keep the insulin at room temperature
d. Store the insuli in a dark, dry place
45. Prednisone(Deltasone) is prescribed for a client with Diabetes Mellitus who is taking NPH
insulin daily. Which of the following prescriptions does the nurse anticipate during therapy with
the Prednisone?
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a. A decreased amount of daily NPH insulin
b. An increased amount of daily NPH insulin
c. An additional dose of Prednisone daily
d. The addition of an oral hypoglycemic medication daily
46. The nurse is observing a staff member preparing to give a client in diabetic ketoacidosis 40
units of NPH insulin IV bolus. Which of the following interventions by the nurse is appropriate?
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a. Assist the staff member preparing the injection by rotating the vial of NPH insulin prior to drawing up
the insulin.
b. Instruct the staff member to follow the NPH IV bolus with 5 to 10 units per hour in normal saline
c. Ask the staff member to give the client the NPH insulin IV bolus for the experience
d. Tell the staff member that the only regular insulin may be administered intravenously
Correct answer
d. Tell the staff member that the only regular insulin may be administered intravenously
47. Which of the following statements is the most accurate explanation by the nurse to a client
who is to have an oral glucose tolerance test and needs to understand the procedure?
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a. You will go to the laboratory and your blood will be drawn
b. After you drink a concentrated glucose solution, you cannot eat or drink anything until your blood is
drawn
c. You will eat a large meal and your blood will be drawn 2 hours later
d. Your blood will be drawn, you will drink a concentrated glucose solution, and your blood will be
drawn again
48. The nurse should explain to a client that tolbutamide (Orinase) is effective for diabetics who
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a. Can no longer produce any insulin.
b. Produce minimal amounts of insulin.
c. Are unable to administer their injections.
d. Have a sustained decreased blood glucose
Correct answer
b. Produce minimal amounts of insulin.
49. A client taking glyburide (DiaBeta), 1.25 mg PO daily, to treat type 2 diabetes mellitus.
Which statement indicates the need for further client teaching about treatment of this disease?
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a. “I always carry hard candy to eat incase my blood glucose level drops.”
b. “I avoid exposure to sun as much as possible.”
c. “I always wear my medical identification bracelet.”
d. “I often skip lunch because I do not feel hungry.”
50. The mother of a 10-year-old boy with IDDM (insulin-dependent diabetes mellitus) calls to
discuss the child's self-monitoring blood glucose (SMBG) home readings. He is being tightly
regulated with a combination of NPH and regular insulin before breakfast and supper. The past
two mornings his blood sugar readings were 220 mg/ dl and 210 mg/dL. The nurse should advise
the mother to
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a. Continue with his medication regime.
b. Check his blood sugar during the night.
c. Give his NPH insulin later in the evening.
d. Serve his bedtime snack earlier in the evening
Correct answer
b. Check his blood sugar during the night.
