test 2 rview endocrine

Which dietary recommendation is most appropriate for a patient with non-diabetic hypoglycemia? 

• Eat fewer meals with high simple sugars 

• Consume smaller, frequent meals high in protein and low in carbohydrates 

• Eliminate all fats and increase carbohydrate intake 

• Eat large meals three times a day with refined sugars 

Answer explanation

Rationale: Treatment for non-diabetic hypoglycemia includes small, frequent meals high in protein and low in carbs while avoiding refined sugar and white flour. 

A patient with non-diabetic hypoglycemia may experience which of the following symptoms? 

• Rapid heartbeat, tremulousness, weakness, anxiety 

• Blurred vision, weight gain, poor wound healing 

• Nausea, vomiting, abdominal pain 

• Increased thirst, polyuria, polyphagia

Answer explanation

Answer: A 
Rationale: Non-diabetic hypoglycemia causes adrenergic symptoms such as tachycardia, tremors, weakness, anxiety, nervousness, and hunger. The other choices align more with hyperglycemia. 

Which patient is at highest risk of developing Type 2 diabetes? 
 

• A 45-year-old with a BMI of 35 and family history of diabetes 

• A 16-year-old with sudden unexplained weight loss 

• A 28-year-old woman who is pregnant 

• A 20-year-old with pancreatic beta cell destruction 

Answer explanation

Answer: A 
Rationale: Type 2 diabetes is strongly linked with obesity and family history. A young person with weight loss and beta cell destruction would be more consistent with Type 1. Pregnancy suggests gestational diabetes. 

Which intervention is most important when managing a patient in diabetic ketoacidosis (DKA)? 

• Lowering blood glucose rapidly with IV insulin

• Monitoring BUN and kidney function 

• Lowering blood glucose levels gradually 

• Restricting fluid intake 

Answer explanation

Answer: C 
Rationale: In DKA, blood glucose must be lowered gradually (hourly monitoring) to prevent cerebral edema and electrolyte imbalances. BUN monitoring is also important, but gradual reduction is priority.

Which patient statement requires further teaching about insulin injections? 

• “I’ll inject into my abdomen or thigh.” 

• “I should rotate injection sites to avoid lipodystrophy.” 

• “I will inject the insulin into my muscle to make it absorb faster.” 

• “This medication is given subcutaneously.” 

Answer explanation

Answer: C 
Rationale: Insulin should be given subcutaneously, not intramuscularly. Rotating sites helps prevent lipodystrophy and ensures absorption. 

Which complication is more common in Type 2 diabetes than in Type 1? 

• Diabetic ketoacidosis (DKA) 

• Hyperglycemic hyperosmolar state (HHS) 

• Rapid weight loss 

• Nausea and vomiting 

Answer explanation

Answer: B 
Rationale: Patients with Type 2 rarely develop DKA but can develop HHS, which involves severe dehydration and hyperglycemia without significant ketoacidosis. 

A newly diagnosed Type 1 diabetic is most likely to present with which classic triad of symptoms? 

• Bradycardia, hypertension, edema 

• Polydipsia, polyuria, polyphagia 

• Dyspnea, fatigue, chest pain 

• Nausea, pruritus, blurred vision

Answer explanation

Answer: B 
Rationale: The three classic signs of Type 1 diabetes are polydipsia (thirst), polyuria (urination), and polyphagia (hunger) due to lack of insulin and poor glucose utilization.

Which of the following best describes Type 1 diabetes mellitus? 

• Caused by insulin resistance and commonly associated with obesity 

• Secondary to malfunction of the beta cells leading to little or no endogenous insulin production

• Occurs only during pregnancy and resolves afterward 

• Characterized by excessive production of insulin by alpha cells

Answer explanation

Answer: B 
Rationale: Type 1 diabetes occurs when the beta cells of the pancreas malfunction and produce little or no insulin. Type 2 is related to insulin resistance, and gestational occurs only during pregnancy. Alpha cells secrete glucagon, not insulin. 

Which patient statement indicates understanding of lifelong Addison disease management? 

• “I only need to take prednisone when I feel weak.”

• “I will need hormone replacement every day for the rest of my life.”

• “Once my adrenal glands heal, I can stop the medicine.” 

• “I can skip fludrocortisone if I eat extra salt.”

Answer explanation

✅ Answer: B 
Rationale: Addison disease requires lifelong glucocorticoid and mineralocorticoid replacement. 

Which disorder involves insufficient cortisol and aldosterone but can be compensated by gonadal hormones? 
 

• Cushing syndrome

• Addison disease 

• Pheochromocytoma

• Gigantism 

Answer explanation

✅ Answer: B 
Rationale: Addison disease affects cortisol and aldosterone; androgen loss is compensated by ovaries/testes.