NCLEX Endocrine Practice Questions

15 free NCLEX-RN endocrine questions with answers and rationales — perfect for nclex diabetes questions practice. Want them as an interactive timed quiz?

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1. A 50-year-old male with a history of type 1 diabetes mellitus presents to the emergency department with confusion, fruity breath odor, and deep, rapid respirations. Which of the following is the BEST initial nursing action?
- A. Initiate IV access and begin fluid resuscitation. ✓
- B. Administer regular insulin subcutaneously.
- C. Check the patient's blood glucose level.
- D. Prepare the patient for bicarbonate administration.
Answer: A. Initiate IV access and begin fluid resuscitation. — In diabetic ketoacidosis (DKA), the priority is to correct dehydration with IV fluids, as this can help stabilize the patient and prevent further complications.
2. A nurse is reviewing the laboratory results of a client with suspected hyperthyroidism. Which laboratory finding is consistent with hyperthyroidism?
- A. Elevated TSH, elevated T3, elevated T4.
- B. Decreased TSH, elevated T3, elevated T4. ✓
- C. Elevated TSH, decreased T3, decreased T4.
- D. Decreased TSH, decreased T3, decreased T4.
Answer: B. Decreased TSH, elevated T3, elevated T4. — In hyperthyroidism, the thyroid gland is overactive, causing elevated levels of T3 and T4, which in turn suppresses TSH levels due to negative feedback.
3. A client with Cushing's syndrome is being discharged. Which of the following instructions should the nurse include in the discharge teaching?
- A. Increase sodium intake to compensate for fluid loss.
- B. Avoid exposure to infections. ✓
- C. Discontinue corticosteroids once symptoms improve.
- D. Increase carbohydrate intake to prevent hypoglycemia.
Answer: B. Avoid exposure to infections. — Clients with Cushing's syndrome have an increased risk of infections due to immunosuppression; thus, they should avoid exposure to infections.
4. A 30-year-old woman with diabetes insipidus is admitted for dehydration. Which of the following is the most appropriate nursing intervention?
- A. Restrict oral fluids to prevent overload.
- B. Administer desmopressin as prescribed. ✓
- C. Encourage foods high in potassium.
- D. Administer diuretics to manage fluid balance.
Answer: B. Administer desmopressin as prescribed. — Desmopressin is the treatment of choice for diabetes insipidus as it reduces urine output and helps manage dehydration.
5. A client presents with fatigue, weight gain, and constipation. The nurse suspects hypothyroidism. Which of the following test results would confirm this diagnosis?
- A. Elevated TSH, decreased T3 and T4. ✓
- B. Decreased TSH, decreased T3 and T4.
- C. Elevated TSH, elevated T3 and T4.
- D. Decreased TSH, elevated T3 and T4.
Answer: A. Elevated TSH, decreased T3 and T4. — Hypothyroidism is characterized by elevated TSH (as the body attempts to stimulate the thyroid) and low levels of T3 and T4.
6. A client with type 2 diabetes mellitus is on metformin. Which of the following conditions is a contraindication to the use of this medication?
- A. Hypertension.
- B. Chronic kidney disease. ✓
- C. Hyperlipidemia.
- D. Asthma.
Answer: B. Chronic kidney disease. — Metformin is contraindicated in clients with chronic kidney disease due to the increased risk of lactic acidosis.
7. A client with Addison's disease is admitted with severe hypotension. Which of the following is the most appropriate immediate nursing intervention?
- A. Administer IV fluids and hydrocortisone. ✓
- B. Administer oral glucocorticoids.
- C. Provide a salt-restricted diet.
- D. Administer insulin to reduce blood glucose levels.
Answer: A. Administer IV fluids and hydrocortisone. — In an Addisonian crisis, the priority is to restore blood pressure with IV fluids and hydrocortisone, which the body is deficient in.
8. A client with newly diagnosed type 1 diabetes mellitus asks why insulin is necessary. What is the BEST response by the nurse?
- A. Your body doesn't produce any insulin, so you need it to control your blood sugars. ✓
- B. Insulin helps to digest the food you eat.
- C. It helps to cure diabetes over time.
- D. Insulin will prevent you from developing type 2 diabetes.
Answer: A. Your body doesn't produce any insulin, so you need it to control your blood sugars. — Type 1 diabetes is characterized by the body's inability to produce insulin, so exogenous insulin is necessary to regulate blood glucose levels.
9. A client with hyperparathyroidism presents with muscle weakness and bone pain. Which laboratory finding would the nurse expect to find?
- A. Decreased calcium, increased phosphate.
- B. Increased calcium, decreased phosphate. ✓
- C. Decreased calcium, decreased phosphate.
- D. Increased calcium, increased phosphate.
Answer: B. Increased calcium, decreased phosphate. — Hyperparathyroidism is characterized by increased calcium and decreased phosphate levels due to excessive parathyroid hormone activity.
10. A client with suspected syndrome of inappropriate antidiuretic hormone (SIADH) is being evaluated. Which of the following symptoms is consistent with this condition?
- A. Polyuria and dehydration.
- B. Hyponatremia and concentrated urine. ✓
- C. Hypernatremia and dilute urine.
- D. Increased thirst and dry mucous membranes.
Answer: B. Hyponatremia and concentrated urine. — SIADH causes water retention, leading to hyponatremia and concentrated urine due to excessive ADH release.
11. A 40-year-old client with Graves' disease is experiencing a thyroid storm. Which of the following is the PRIORITY nursing action?
- A. Administer beta-blockers to control the heart rate. ✓
- B. Provide a high-calorie diet to meet metabolic demands.
- C. Encourage ambulation to reduce anxiety.
- D. Administer aspirin to reduce fever.
Answer: A. Administer beta-blockers to control the heart rate. — In a thyroid storm, the priority is to prevent cardiovascular complications by controlling the heart rate with beta-blockers.
12. A client with hyperglycemic hyperosmolar state (HHS) is admitted to the hospital. What is the primary difference between HHS and diabetic ketoacidosis (DKA) that the nurse should recognize?
- A. HHS is characterized by ketone production.
- B. HHS occurs mainly in type 1 diabetes.
- C. HHS typically presents with higher blood glucose levels. ✓
- D. HHS is associated with metabolic acidosis.
Answer: C. HHS typically presents with higher blood glucose levels. — HHS is characterized by extremely high blood glucose levels without significant ketone production, unlike DKA.
13. A client with hypothyroidism is prescribed levothyroxine. Which instruction should the nurse provide?
- A. Take this medication with meals to enhance absorption.
- B. Report any weight gain immediately.
- C. Take this medication in the morning on an empty stomach. ✓
- D. Avoid exposure to sunlight while taking this medication.
Answer: C. Take this medication in the morning on an empty stomach. — Levothyroxine should be taken on an empty stomach in the morning to enhance absorption and maintain consistent thyroid hormone levels.
14. A client with adrenal insufficiency is at risk for which electrolyte imbalance?
- A. Hypernatremia.
- B. Hyperkalemia. ✓
- C. Hypocalcemia.
- D. Hypoglycemia.
Answer: B. Hyperkalemia. — Adrenal insufficiency can lead to hyperkalemia due to decreased aldosterone production, which impairs renal excretion of potassium.
15. A client with a pituitary tumor is experiencing symptoms of acromegaly. Which of the following findings should the nurse expect during assessment?
- A. Short stature and delayed puberty.
- B. Enlarged hands and feet. ✓
- C. Exophthalmos and pretibial myxedema.
- D. Weight loss and hyperactivity.
Answer: B. Enlarged hands and feet. — Acromegaly is characterized by enlarged hands and feet due to excess growth hormone secretion, typically from a pituitary adenoma.

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NCLEX Endocrine Practice Questions

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