NCLEX Endocrine Questions (26-30)

26. The following are characteristics of type I DM. Select all that apply

a) the client is thin
b) it requires lifelong insulin
c) the client may take sulfonylureas
d) the client is at risk to develop diabetic ketoacidosis
e) onset of the disease is after 30 years of age
f) there is insulin secretion, but the body's demands are increased  

27. The following are signs and symptoms that indicate hyperglycemia in a client with diabetes mellitus. Select all that apply

a) elevated blood sugar level
b) cold, clammy skin
c) increased urination
d) tremors
e) deep, rapid respiration
f) excessive thirst
g) metabolic acidosis

28. The client has been diagnosed to have IDDM. Which order should you question?

a) propranolol
b) insulin injection
c) acetaminophen
d) diltiazem

29. The nurse is assessing a pregnant client with type I diabetes mellitus about her understanding regarding changing insulin needs during pregnancy. The nurse determines that teaching is needed if the client makes which statement?

a) I will need to increase my insulin dosage during the first 3 months of pregnancy
b) my insulin dose will likely need to be increased during the second and third trimester
c) episodes of hypoglycemia are more likely to occur during the first 3 months of pregnancy
d) my insulin needs should return to normal within 7 to 10 days after birth if I am bottle-feeding

30. An adolescent client with type I diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note?

a) sweating and tremors
b) hunger and hypertension
c) cold, clammy skin and irritability
d) fruity breath and decreasing level of consciousness





NCLEX Endocrine Questions:
ANSWERS AND RATIONALE

26) A, B, D
- these are the characteristic of type I DM.

27) A, C, E, F, G
- these are signs and symptoms of hyperglycemia.

28) A
- propranolol, a beta-adrenergic blocker causes hypoglycemia. It is contraindicated among diabetic clients.

29) A
- insulin needs decrease in the first trimester because of increase insulin production by the pancreas and increased peripheral sensitivity to insulin. The statements in option B, C, and D are accurate and signify that the client understands control of her diabetes during pregnancy.

30) D
Hyperglycemia occurs with diabetic ketoacidosis. Signs of hyperglycemia include fruity breath and a decreasing level of consciousness. Hunger can be a sign of hypoglycemia or hyperglycemia, but hypertension is not a sign of diabetic ketoacidosis. Instead, hypotension occurs because of a decrease in blood volume related to the dehydrated state that occurs during diabetic ketoacidosis. Cold, clammy skin, irritability, sweating, and tremors are all signs of hypoglycemia.




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