Endocrine NCLEX Questions (76-80)

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76. A client with a diagnosis of Cushing's syndrome is undergoing a dexamethasone suppression test. The nurse plans to implement which steps during this test?

a ) collect a 24-hour urine specimen to measure serum cortisol levels
b) administer 1 mg of dexamethasone orally at night and obtain serum cortisol levels the next morning
c) draw blood samples before and after exercise to evaluate the effect of exercise on serum cortisol levels
d) administer an injection of adrenocorticotropic hormone (ACTH) 30 minutes before drawing blood to measure serum cortisol levels


77. The nurse is caring for a client with type 1 diabetes mellitus. Which of the following laboratory results would indicate a potential complication associated with this disorder?

a) ketonuria
b) potassium: 4.2 mEq
c) blood glucose: 112 mg/dL
d) blood urea nitrogen (BUN): 18 mg/dL

78. Endocrine NCLEX Questions about the nurse who is employed in a diabetes mellitus clinic is caring for a client on insulin pump therapy. Which statement by the client indicates that a knowledge deficit exists regarding insulin pump therapy?

a) if my blood glucose is elevated, I can bolus myself with additional insulin as ordered
b) I'll need to check my blood glucose before meals in case I need a premeal insulin anymore
c) I still need to follow a diet and exercise plan even though I don't inject myself daily anymore
d) now that I have this pump, I don't have to worry about insulin reactions or ketoacidosis ever happening again

79. A client with Grave's disease has exopthalmos and is experiencing photophobia. Which of the following nursing interventions would best assist the client with this problem?

a) obtain dark glasses for the client
b) lubricate the eyes with tap water every 2 to 4 hours
c) administer methimazole (Tapazole) every 8 hours around the clock
d) instruct the client to avoid straining or heavy lifting because this can increase eye pressure

80. The nurse is completing a health history on a client with diabetes mellitus who has been taking insulin for many years. At present the client states that he is experiencing periods of hypoglycemia followed by periods of hyperglycemia. The most likely cause for this occurrence is which of following?

a) eating snacks between meals
b) initiating the use of the insulin pump
c) injecting insulin at a site of lipodystrophy
d) adjusting insulin according to blood glucose levels





Endocrine NCLEX Questions
Answers and Rationale

76) B

- The dexamethasone suppression test is performed to evaluate the function of the adrenal cortex. The procedure for this test is to administer 1 mg of dexamethasone at 11:00 PM to suppress ACTH formation and then to obtain 8:00 AM serum cortisol levels on the following day.

77) A

- Ketonuria is an abnormal finding in the client with diabetes mellitus indicating ketosis. Ketosis is a metabolic effect from the lack of insulin on fat metabolism and occurs in type 1 diabetes mellitus. It is associated with the severe complication of diabetic ketoacidosis (hyperglycemia, ketosis, and acidosis). Options B, C, and D are all normal laboratory findings.

78) D

- Endocrine NCLEX Questions Rationale: Hypoglycemic reactions can occur if there is an error in calculating the insulin dose or if the pump malfunctions. Ketoacidosis can occur if too little insulin is used or if there is an increase in metabolic need. The pump does not have a built-in blood glucose monitoring feedback system, so the client is subject to the usual complications associated with insulin administration without the use of a pump. Options A, B, and C are accurate regarding the use of the insulin pump.

79) A

- Medical therapy for Graves' disease does not help alleviate the clinical manifestation of exophthalmos. Because photophobia (light intolerance) accompanies this disorder, dark glasses are helpful in alleviating the problem. Tap water, which is hypotonic, could actually cause more swelling around the eye because it could pull fluid into the interstitial space. In addition, the client is at risk for developing an eye infection because the solution is not sterile. Methimazole inhibits the synthesis of thyroid hormone and is used to treat hyperthyroidism but will not alleviate exophthalmos or photophobia. There is no need to avoid straining with exophthalmos.

80) C

- Lipodystrophy, specifically lipohypertrophy, involves swelling of the fat at the site of repeated injections. This can interfere with the absorption of insulin, resulting in erratic blood glucose levels. Because the client has been on insulin for many years, this is the most likely cause of poor control. Options A, B, and D are appropriate techniques to use in order to regulate blood glucose levels.


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Endocrine NCLEX Questions (1-7)