Disorders of the Endocrine System

Maria, was admitted at SPH complaining of fatigue, weakness, & an

infected toe. She was suspected of having DM. The following orders were
written by the physician: fasting blood sugar (FBS) & CBC in AM; glucose
tolerance test (GTT); Tuesday AM.

1. The nurse gave Aling Nena the ff. instructions regarding the FBS. You will
have a sample of the blood drawn in the morning and…
a. You may drink fluids but do not eat many food from 8 PM until the blood is
drawn
b. Do not eat or drink anything from 8PM until the blood is drawn in the
morning
c. Do not eat or drink for 2 hours after you eat breakfast
d. You will have a liquid breakfast before the blood is drawn

2. Her FBS result was 300mg/dl blood, which indicates she had…
a. Nothing to eat for 12 hrs c. Too much insulin in her blood
b. Too little glucose in her blood d. Difficulty using the glucose in
her blood property

3. The nurse’s instruction to her concerning the GTT should be that she will be
NPG from 12MN until the test is over in the morning and she will have…
a. 1 blood sample drawn & a urine specimen collected, after which she will
receive a loading dose of glucose solution to drink; then 4 blood samples &
urine specimens will be collected 30 minutes interval for 2 hours.
b. A blood sample drawn & 24-hr urine sample collected
c. A blood sample drawn 2 hrs after each meal & at bedtime w/a urine
sample collected at the same time
d. A loading dose of glucose solution to drink & blood & urine samples taken
2 hrs later
4. The GTT measures…
a. Effectiveness of insulin dose patient is receiving
b. How well patients tolerates a loading dose of glucose
c. Effectiveness of glucose metabolism after a loading dose of glucose is
administered
d. Relative ketone level after administration of loading dose of glucose
5. The major symptoms of uncontrolled DM are…
a. Weight gain, moon face, & mood swings
b. Extreme nervousness, perspiration, & heat tolerance
c. Excessive thirst, polyuria, weight loss, glycosuria
d. Elevated BUN, hematuria, proteinuria, & blood creatinine values
6. She was diagnosed as having DM & was created w/isophane insulin (NPH), 30
units every morning. As a knowledgeable nurse, what do you think is the
reason for giving NPH insulin?
a. To stimulate the pancreas to produce more insulin
b. To reduce the amount of insulin produced
c. To decrease secretion of antidiuretic hormone which results in an increase
of urinary output
d. To replace the insulin that the non-functioning pancreas is unable to
produce
7. NPH insulin is a…
a. Rapid-acting insulin c. Long-acting insulin e. Both a & b
b. Short-acting insulin d. Intermediate-acting insulin
8. Insulin is product by the…
a. Alpha cells in the pancreas c. Beta cells of the pancreas
b. Acinar cells of the pancreas d. G-cells in the Antrum of the
stomach
9. The nurse knew that the most likely times for her to experience symptoms of
hypoglycemia after a 7:30AM dose of NPH insulin would be…
a. 8:00AM b. 7:30PM c. 9:30AM d. 1:30PM

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 10. It was important for the nurse to be sure that she received her bedtime snack
because it was ordered to help…
a. Supplement her protein intake for healing
b. Prevent hyperglycemic episode during the night
c. Prevent hypoglycemic episode during the night
d. Satisfy her habit of having a snack at bedtime
11. Which of the ff. is true about DM?
I. Diabetes is an acute disorder that responds only to insulin
treatment
II. Diabetes is a curable disease
III. Diabetes is not a significant
IV. Diabetes is caused by a non-functioning pancreas
a. All of the above b. 1,2,3,4 c. 2,3,4,5 d. 3,4,5 e. 3,5

12. Which of the ff. symptoms should the nurse include in her instructions to her is
explaining insulin shock? You may have…
a. Drowsiness, weakness, thirst, nausea & vomiting, dry skin, & flushed face
b. Rapid pulse & respirations, restlessness, dizziness, headache, elevated
temp, & pain
c. Heat intolerance, diarrhea, hyperexcitability, weight loss, & tachycardia
d. Trembling, irritability, confusion, hunger, profuse perspiration, poor
concentration, & blurred/double vision

13. The symptoms produced in insulin shock are due to…

a. Elevated blood sugar levels
b. Abnormality low blood sugar levels
c. Insufficient insulin to metabolize glucose
d. Excessive food intake in relationship to insulin dose

14. Aling Nena asked the nurse why her infected toe was taking so long to heal.
The nurse should understand that diabetes have difficulty healing because…
a. The food they eat is used primarily for energy
b. Most diabetes do not eat enough Vitamin C & protein
c. Insulin makes them more susceptible to infection
d. High blood glucose levels make healing difficult, also the vascular system
is affected & circulation may be poor

15. The nurse awakened her at midnight to change the dressing on her toe & give
her the antibiotic ordered. She found the patient lethargic, trembling,
perspiring profusely, & complaining of headache. She notified the clerk to call
the physician, & immediately gave the patient…
a. Regular insulin c. A salt pill with 2 glasses of water
b. Orange d. A banana

16. Understanding diabetes. Aling Nena’s symptoms of polyuria is most likely

cased by what physiologic change?
a. Glucose, acting as hypertonic agent, draws water from the extracellular
fluid into the renal tubules
b. Increased insulin levels promote a diuretic effect
c. Electrolyte changes lead to the retention of Na & K
d. Microvascular changes after the effectiveness of the kidneys
17. The transportation of glucose into the cell is done by the process called…
a. Simple diffusion c. Osmosis e. None of the above
b. Oncotic pressure d. Active transport
18. As compensatory mechanism, fats & proteins are mobilized for energy.
Oftentimes, fatty acids are rejected by the muscles, resulting in the build-up of
acids in the bloodstream. This condition is called…
a. Hypoglycemia b. Conn’s syndrome c. Diabetic ketoacidosis d.
Insulin shock

SITUATION: Ann, 30-yo, mother of 4 children, consulted ICH due to an

enlarged thyroid gland.
19. In taking the nursing history, which of the ff. is considered a risk factor in the
development of cancer of the thyroid?
a. A diet low in iodine c. History of high doses of Vitamin D

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 b. A diet high in iodine d. History of irradiation of the head & neck
20. Ann is subsequently admitted. Her initial & daily assessment will include
careful observation for which of the ff.?
a. Excessive saliva production c. Tingling around the lips
b. Muscle twitching d. Difficulty of swallowing or breathing
21. In addition to having an enlarged thyroid gland. Ann has been experiencing
symptoms suggestive of hyperthyroidism. What might these symptoms
include?
a. Fatigue, weight gain, dry skin, cold intolerance
b. Constipation, slurred speech, decreased pulse rate, cold intolerance
c. Nervousness, weight loss, tachycardia, heat intolerance

22. Ann’s lab work-up will probably indicate which of the ff.?
a. Deficiency of serum T3 & T4 c. Deficiency of serum TSH
b. Increased levels of serum T3 &/or T4 d. Increased levels of serum
ACTH

23. Ann’s hyper-functioning thyroid results in exopthalmos. NI specific for this

problem should include which of the ff.?
a. Frequent mouth care using soft toothbrush & NSS mouthwash
b. A private room w/decreased environmental stimulation & light
c. Lubricating eye drops & instructions to blink at regular intervals
d. Frequent monitoring of VS & body temperature

24. Ann was placed to a semiprivate room, because of his diagnosis you would…
a. Give her extra blankets
b. Notify admission personnel of the communicability of the disease & ask for
a private room
c. Allow her to choose the bed he wants & make no comment
d. Provide a well-ventilated room

25. A serious form of hyperthyroidism results in a condition known as…

a. Myxedema b. Cretinism c. Grave’s disease d.
Addison’s disease

26. Ann will be sent home on PTU. The purpose of giving is to…
a. Control the systemic effects of the hormone production
b. Reduce the vascularity of the thyroid gland
c. Ready the gland for surgical removal
d. Reduce production of the hormone

27. When taking PTU, Ann should report which of the ff. symptoms?
a. Sore throat c. Headache
b. Intolerance to cold d. Increased urinary output

SITUATION: Ann was readmitted several months later. His original

symptoms had not subsided & the physician decided to perform a subtotal
thyroidectomy.

28. Preop, Ann is given an iodine preparation. The purpose of giving this is to…
a. Anesthesize the throat
b. Reduce the vascularity of the thyroid gland
c. Provide an anti-microbial action on the throat to lessen the chance of
postop infection
d. Reduce the over production of thyroid hormone

29. Ff. surgery, the best position for Ann would be…
a. Prone b. Semi-Fowler’s c. Lithotomy d. Trendelenburg’s

30. Ff. thyroidectomy, the nurse frequently assess the client’s voice & ability to
speak. What is the nurse trying to evaluate?
a. Changes in level of consciousness c. Spasm or edema of vocal chords
b. Injury to the parathyroid gland d. Recovery from anesthesia
31. Postop care of the client ff. thyroidectomy includes which of the ff.?
a. Keep the head of the bed flat to prevent neck flexion

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 b. Assessing exopthalmos
c. Avoid deep-breathing to prevent injury to the suture line
d. Check the back of the neck & upper part of the back when assessing the
dressing
32. Part of the medication regimen of Ann is propranolol (Inderal). This drug is
given in order to…
a. Alleviate nausea & vomiting c. Alleviate or control tachycardia
b. Prevent exopthalmos d. Lower BP
INDEPENDENT QUESTIONS:

33. Over-secretion of growth hormone occurring before closure of the epiphyses of

long bones might lead into this condition…
a. Acromegaly b. Gigantism c. Addison’s disease d. Grave’s
disease

34. Excess estrogen in the human male may lead into…

a. Virilism b. Gynecomastia c. Homosexuality d.
Infertility

35. The ff. are S/s of hypothyroidism, EXCEPT…

a. Tachycardia b. Bradycardia c. Constipation
d. Slow hoarse voice

36. Hypofunction of anterior pituitary gland among adults may lead into…
a. Myxedema b. Acromegalyc. Simmond’s disease d. Addison’s
disease

37. A deficit in the mineralcorticoids will lead into…

a. Acromegaly b. Addison’s disease c. Diabetes insipidus d.
Myxedema

38. The endocrine gland that prepares the body for the “fight or flight” response is
the…
a. Adrenal cortex b. Adrenal medulla c. Pituitary d. Thyroid

39. A posterior lobe disorder characterized by an abnormality in water metabolism

a. Cushing’s syndrome c. Addison’s disease
b. Pheochromocytoma d. Diabetes insipidus

40. When the tissues, especially the muscle, need carbohydrates, the glycogen in
the liver is reconverted into glucose by a process called…
a. Glycogenesis b. Glycolysis c. Glucogenesis d.
Glycogenolysis

41. Glycogen may be formed by the body from non-carbohydrate sources such as
fats & proteins by a process called…
a. Glycogenesis b. Glycolysis c. Glucogenesis d.
Glycogenolysis

42. Hyperactivity of the Adrenal cortex will lead into…

a. Addison’s disease c. Cushing’s syndrome
b. D. Conn’s syndrome

43. These corticosteroids will aid in reducing inflammation ff. trauma:

a. Mineralcorticoids b. Glucocorticoids c. Androgens d. Aldosterone

44. The hormone that promotes Na & water retention in the kidney and K
secretion is…
a. Glucagon b. Rennin c. Aldosterone d. Vasopressin

45. Known as the master gland of the body:

a. Endocrine gland b. Thyroid gland c. Hypophysis d.
Pancreas

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 46. Refers to the rate of energy metabolism of the body when the individual is
lying quiet & relaxed. It represents the rate of energy metabolism required to
keep the body alive.
a. Metabolism b. Energy metabolism c. BMR d.
Anabolism
47. Known as the hormone of pregnancy:
a. Estrogen b. Progesterone c. Androgens d. Sex hormones
48. Regular insulin is classified under…
a. Long-acting insulin c. Short-acting insulin
e. Both c & d
b. Intermediate-acting insulin d. Rapid-acting insulin

SITUATION: Jace was admitted at Estevez Memorial Hospital (EMH) w/a

diagnosis of hyperthyroidism. She is scheduled for surgery – subtotal
thryoidectomy.
49. In the beginning, Jace’s preop teaching, the practical nurse would first…
a. Explain the operative procedure c. Take the height, weight & VS
b. Assess Jace’s knowledge about her surgery d. Ask her about her family
relationships
50. You want to find out how anxious Jace is about her surgery. Which of the ff.
questions would most likely provide you w/ the most info?
a. “Are you anxious about your surgery?”
b. “Are you nervous about your surgery? I’m sure you are because you’ve
never had an operation before.”
c. “How afraid are you about having surgery?”
d. “Most people are somewhat nervous about surgery. How do you feel about
it?”