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Endocrine System Post Test

Total questions: 50

Worksheet time: 25mins

Name
Class
Date
1.

A 45-year-old woman presents with heat intolerance, weight loss despite increased appetite, tremors, and palpitations. Her TSH is suppressed and free T4 is elevated. Which is the most likely diagnosis?

a)

Subacute thyroiditis

b)

Graves disease

c)

Toxic multinodular goiter

d)

Euthyroid sick syndrome

2.

Which medication is most appropriate to rapidly control sympathetic symptoms such as tachycardia and tremors in severe thyrotoxicosis?

a)

Methimazole

b)

Propranolol

c)

Levothyroxine

d)

Radioactive iodine

3.

A patient with Cushing syndrome has elevated midnight cortisol and a non-suppressible dexamethasone suppression test. ACTH is low. Imaging shows an adrenal mass. Which is true among the following options?

a)

ACTH-dependent Cushing disease from pituitary adenoma

b)

Ectopic ACTH secretion

c)

Primary adrenal Cushing syndrome due to an adrenal adenoma

d)

Factitious Cushing from exogenous steroids

4.

A patient with secondary adrenal insufficiency due to chronic glucocorticoid therapy is most likely to have which laboratory finding?

a)

Hyperkalemia

b)

Hypoglycemia

c)

Increased ACTH

d)

Hyperpigmentation

5.

The assessment of a client that would be most indicative of diabetes insipidus is:

a)

Increased blood glucose

b)

Low urinary specific gravity

c)

Elevation of blood pressure

d)

Decreased serum osmolarity

6.

To understand diabetes insipidus, the nurse must be aware that an antidiuretic substance important for maintaining fluid balance is released by the:

a)

Adrenal cortex

b)

Adrenal medulla

c)

Anterior pituitary

d)

Posterior pituitary

7.

The nurse knows that most of the hormones present in the body at any given time were secreted from the endocrine glands:

a)

24 hours ago

b)

4 to 6 hours

c)

8 to 12 hours ago

d)

More than 72 hours ago

8.

Which of the following would be a priority goal of care for the client with SIADH?

a)

Maintain blood glucose level within normal range

b)

Maintain electrolyte balance

c)

Promote a regular sleep pattern

d)

Prevent fluid volume deficit

9.

Mr. Chang has been receiving glucocorticoid replacement. On what principle should Mr. Chang base his medication administration at home?

a)

Various circumstances increase the need for glucocorticoids, so dosage adjustments will be needed.

b)

The need for glucocorticoids stabilizes and a predetermined dose is taken every third day.

c)

Glucocorticoids are cumulative, so a dose is taken every third day.

d)

Because of the pattern of glucocorticoid secretion, a dose is taken every 6 hours.

10.

All patients taking glucocorticoids should be instructed to take them:

a)

With a full glass of water.

b)

On an empty stomach.

c)

Between meals.

d)

With meals or an antacid.

11.

Which of the following factors would be most important in selecting the length of needle the nurse should use for Mrs. Spencer's subcutaneous injection?

a)

The diameter of the needle.

b)

The circumference of the patient's arm.

c)

The viscosity of the solution to be injected.

d)

The amount of medication to be administered.

12.

Situation: A 32-year-old male professor was complaining of easy fatigability, insomnia, intolerance to heat, palpitation and weight loss. He was diagnosed to be suffering from a certain endocrine disorder that affected his body metabolism and heat production. The primary diagnosis of his condition would most likely be:

a)

Hypothyroidism

b)

Hyperthyroidism

c)

Addison’s Disease

d)

Cushing’s Syndrome

13.

Situation: A 32-year-old male professor was complaining of easy fatigability, insomnia, intolerance to heat, palpitation and weight loss. He was diagnosed to be suffering from a certain endocrine disorder that affected his body metabolism and heat production. Which of these manifestations may be seen among his chief complaints?

a)

Anorexia

b)

Fine hand tremors

c)

Bradycardia

d)

Hypotension

14.

Situation: A 32-year-old male professor was complaining of easy fatigability, insomnia, intolerance to heat, palpitation and weight loss. He was diagnosed to be suffering from a certain endocrine disorder that affected his body metabolism and heat production. Diet recommended for this type of client is:

a)

High calorie, high protein

b)

High fat, high protein

c)

Low fat, low salt

d)

Low salt, high fat

15.

Situation: A 32-year-old male professor was complaining of easy fatigability, insomnia, intolerance to heat, palpitation and weight loss. He was diagnosed to be suffering from a certain endocrine disorder that affected his body metabolism and heat production. This complication of hyperthyroidism is also known as:

a)

Myxedema

b)

Thyrotoxicosis

c)

Goiter

d)

Cretinism

16.

Situation: A 32-year-old male professor was complaining of easy fatigability, insomnia, intolerance to heat, palpitation and weight loss. He was diagnosed to be suffering from a certain endocrine disorder that affected his body metabolism and heat production. Various medications are being administered to clients with hyperthyroidism to treat the said condition. These include all the following, except:

a)

Propylthiouracil (PTU)

b)

Atropine

c)

Digoxin (Lanoxin)

d)

Methimazole (Tapazole)

17.

Diabetes insipidus is a possible complication following pituitary surgery. For which symptom should the nurse observe to aid detection of diabetes insipidus?

a)

Urine specific gravity greater than 1.030

b)

Urine output between 5 and 10 L/day

c)

Blood glucose level above 300 mg/100 ml

d)

Urine negative for glucose and ketones

18.

Which of the following statements if made by the patient would require additional health teaching? “I take potassium iodide…”

a)

With meals

b)

With plain water

c)

With fruit juice

d)

Without meals

19.

A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client?

a)

Hoarseness

b)

Hypocalcemia

c)

Audible stridor

d)

Edema at the surgical site

20.

A 62-year-old female lawyer-legislator is experiencing chronic fatigue syndrome and was suspected to have a certain form of endocrine dysfunction. She was diagnosed to have hypothyroidism. Aside from body weakness, which of these manifestations may be seen among her chief complaints?

a)

Diarrhea

b)

Tachycardia

c)

Fine hand tremors

d)

Weight gain

21.

Which of the following is a life-threatening complication in patients with hyperthyroidism?

a)

Myxedema coma

b)

Thyroid storm

c)

Addisonian crisis

d)

Hypoglycemic coma

22.

Which electrolyte imbalance is expected in hyperparathyroidism?

a)

Hypocalcemia, Hyperphosphatemia

b)

Hypercalcemia, Hypophosphatemia

c)

Hyponatremia, Hyperkalemia

d)

Hypernatremia, Hypokalemia

23.

Nursing management for Cushing’s syndrome includes which diet?

a)

High-sodium, low-potassium

b)

Low-sodium, high-potassium

c)

High-carbohydrate, low-protein

d)

High-fat, high-sodium

24.

A 45-year-old male presents with enlarged hands, deep voice, and prognathism. His glucose tolerance test shows GH levels remain elevated after glucose load. Which treatment is most appropriate?

a)

Somatostatin analogs (Octreotide)

b)

Growth hormone injections

c)

Lugol’s solution

d)

Radioactive iodine

25.

A child presents with short stature, delayed puberty, and cubitus valgus. The physician prescribes somatropin injections. Which nursing instruction is MOST important?

a)

Give the injection once weekly.

b)

Expect height gain within a week.

c)

Administer daily injections for several years.

d)

Stop the treatment when puberty starts.

26.

A client with DI is prescribed vasopressin. The nurse should monitor for which complication?

a)

Hypoglycemia

b)

Hypotension

c)

Water intoxication

d)

Hyperkalemia

27.

A female client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, nurse Jacob reviews the pre-operative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize?

a)

You must lie flat for 24 hours after surgery.

b)

You must avoid coughing, sneezing, and blowing your nose.

c)

You must restrict your fluid intake.

d)

You must report ringing in your ears immediately.

28.

When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamines, nurse April is most likely to detect:

a)

A blood pressure of 130/70 mmHg

b)

A blood glucose level of 130 mg/dl

c)

Bradycardia

d)

A blood pressure of 176/88 mm Hg

29.

Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?

a)

Fluid intake is less than 2,500 ml/day

b)

Urine output measures more than 200 ml/hour

c)

Blood pressure is 90/50 mm Hg

d)

The heart rate is 126 beats/minute

30.

For the first 72 hours after thyroidectomy surgery, nurse Prue would assess the female client for Chvostek’s sign and Trousseau’s sign because they indicate which of the following?

a)

Hypocalcemia

b)

Hypercalcemia

c)

Hypokalemia

d)

Hyperkalemia

31.

Nurse Phoebe is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

a)

Tetany

b)

Hemorrhage

c)

Thyroid storm

d)

Laryngeal nerve damage

32.

After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Paige Matthews prescribes levothyroxine (Levothroid), 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent?

a)

Primary hypothyroidism

b)

Graves’ disease

c)

Thyrotoxicosis

d)

Euthyroidism

33.

A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Patty recognize as an adverse drug effect?

a)

Dysuria

b)

Leg cramps

c)

Tachycardia

d)

Blurred vision

34.

Following a unilateral adrenalectomy, nurse Noreen would assess for hyperkalemia shown by which of the following?

a)

Muscle weakness

b)

Tremors

c)

Diaphoresis

d)

Constipation

35.

Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?

a)

Diabetic ketoacidosis

b)

Thyroid crisis

c)

Hypoglycemia

d)

Tetany

36.

A female client has a serum calcium level of 7.2 mg/dl. During the physical examination, nurse Noah expects to assess:

a)

Trousseau’s sign

b)

Homans’ sign

c)

Hegar’s sign

d)

Goodell’s sign

37.

During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which statement?

a)

The head of your bed must remain flat for 24 hours after surgery.

b)

You should avoid deep breathing and coughing after surgery.

c)

You won’t be able to swallow for the first day or two.

d)

You must avoid hyperextending your neck after surgery.

38.

Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 U of regular insulin. Nurse Vince should expect the dose’s:

a)

Onset to be at 2 p.m. and its peak to be at 3 p.m.

b)

Onset to be at 2:15 p.m. and its peak to be at 3 p.m.

c)

Onset to be at 2:30 p.m. and its peak to be at 4 p.m.

d)

Onset to be at 4 p.m. and its peak to be at 6 p.m.

39.

Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide?

a)

Be sure to take glipizide 30 minutes before meals.

b)

Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly.

c)

You won’t need to check your blood glucose level after you start taking glipizide.

d)

Take glipizide after a meal to prevent heartburn.

40.

For a diabetic male client with a foot ulcer, the physician orders bed rest, a wet-to-dry dressing change every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used for this client?

a)

They contain exudate and provide a moist wound environment.

b)

They protect the wound from mechanical trauma and promote healing.

c)

They debride the wound and promote healing by secondary intention.

d)

They prevent the entrance of microorganisms and minimize wound discomfort.

41.

Among the following medications, which one is contraindicated in patients with hypothyroidism?

a)

Valium

b)

Inderal

c)

Aspirin

d)

Synthroid

42.

A patient with Addison’s disease presents to the ER with hypotension, vomiting, and hyperkalemia. What is the immediate priority?

a)

Oral hydrocortisone

b)

IV normal saline and IV hydrocortisone

c)

Beta-blockers

d)

Thyroid hormone replacement

43.

Which finding best suggests diabetic ketoacidosis rather than hyperosmolar hyperglycemic state?

a)

Severe hyperglycemia > 600 mg/dL

b)

Serum ketones and metabolic acidosis

c)

Neurologic deficit only

d)

Profound dehydration without acidosis

44.

Which hormone is secreted by the delta cells of the pancreas?

a)

Insulin

b)

Glucagon

c)

Somatostatin

d)

Amylin

45.

A nurse caring for a patient with hypoglycemia administers glucagon. What is the mechanism?

a)

Stimulates insulin release

b)

Promotes glycogenolysis and gluconeogenesis

c)

Blocks gluconeogenesis

d)

Enhances glucose uptake

46.

Which vitamin is required for normal parathyroid hormone function in calcium absorption?

a)

Vitamin A

b)

Vitamin B12

c)

Vitamin D

d)

Vitamin K

47.

A nurse should teach a patient taking corticosteroids to report which symptom immediately?

a)

Mild weight gain

b)

Signs of infection

c)

Increased appetite

d)

Mood swings

48.

The “Somogyi effect” is best prevented by:

a)

Skipping bedtime snacks

b)

Giving a bedtime snack

c)

Reducing morning insulin dose

d)

Administering extra insulin at bedtime

49.

Nurse Noemi administers glucagon to her diabetic client, then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?

a)

Oral anticoagulants

b)

Anabolic steroids

c)

Beta-adrenergic blockers

d)

Thiazide diuretics

50.

Which instruction about insulin administration should nurse Kate give to a client?

a)

Always follow the same order when drawing the different insulins into the syringe.

b)

Shake the vials before withdrawing the insulin.

c)

Store unopened vials of insulin in the freezer at temperatures well below freezing.

d)

Discard the intermediate-acting insulin if it appears cloudy.