NCLEX Endocrine Questions (36-40)

NCLEX Endocrine Questions

36. Which of the following assessment findings characterize thyroid storm?

a) increased body temperature, decreased pulse, and increased blood pressure
b) increased body temperature, increased pulse, and increased blood pressure
c) increased body temperature, decreased pulse, and decreased blood pressure
d) increased body temperature, increased pulse, and decreased blood pressure

37. The nurse is planning care for a client with hyperthyroidism. Which of the following nursing interventions are appropriate? Select all that apply

a) instill isotonic eye drops as necessary
b) provide several, small, well-balanced meals
c) provide rest periods
d) keep environment warm
e) encourage frequent visitors and conversation
f) weigh the client daily



38. After thyroidectomy, which of the following is the priority assessment to observe laryngeal nerve damage?

a) hoarseness of voice
b) difficulty in swallowing
c) tetany
d) fever

39. A home care nurse is teaching an adolescent with type I diabetes mellitus about insulin administration and rotation sites. Which statement, if made by the adolescent, would indicate effective teaching?

a) I need to use a different site for each insulin injection
b) I should use only my stomach and my thighs for injections
c) I need to use the same site for 1 month before rotating to another
d) I need to use one major site for 2 to 3 weeks before changing major sites

40. A child with type I diabetes mellitus is brought to an emergency room by the mother, who states that the child has been complaining of abdominal pain and has a fruity odor of the breath. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which intravenous infusion?

a) potassium
b) NPH insulin
c) 5% dextrose
d) normal saline






NCLEX Endocrine Questions:
ANSWERS AND RATIONALE

36) B

- thyroid storm is characterized by SNS activation. Thyroid hormones potentiate effects of cathecolamines (epinephrine/norepinephrine). Therefore, all vital signs will be increased.

37) A, B, C, and F

- the client with hyperthyroidism may experience exopthalmos. This requires instillation of eye drops to prevent dryness and ulceration of the cornea. The client experiences weight loss because of hypermetabolism. Several, small, well-balanced meals are given to improve nutritional status of the client and daily weights should be monitored. Weight is the most objective indicator of nutritional status. The client is usually exhausted due to restlessness and agitation. Frequent rest periods help the client regain energy.

38) A

- laryngeal nerve damage is manifested by severe hoarseness of voice or "whispery voice".
 

39) D

- To help decrease variations in absorption from day to day, the adolescent should use one major site for injections for 2 to 3 weeks before changing major sites. The injections are rotated to different locations within that major site. Options A, B, and C are incorrect.

40) D

- Rehydration is the initial step in resolving diabetic ketoacidosis. Normal saline is the initial IV rehydration fluid. NPH insulin is never administered by the IV route. Dextrose solutions are added to the treatment when the blood glucose level reaches an acceptable level. Intravenously administered potassium may be required, depending on the potassium level, but would not be part of the initial treatment.



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