🩺 Endocrine System MCQ Questions
Questions 100 | Practice for Nursing & Medical Exams
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📋 About This Test
🔹 Number of Questions: 100 MCQs
🔹 Marks: 1 Point / Correct Answer
🔹 Negative Marking: No
🔹 Difficulty: Easy • Moderate • High
🔹 Explanations: Yes
🔹 Relevance: NCLEX, AIIMS, NEET, USMLE, PLAB, ESIC, NHM & Other Nursing/Medical Exams
🔹 Marks: 1 Point / Correct Answer
🔹 Negative Marking: No
🔹 Difficulty: Easy • Moderate • High
🔹 Explanations: Yes
🔹 Relevance: NCLEX, AIIMS, NEET, USMLE, PLAB, ESIC, NHM & Other Nursing/Medical Exams
Question 1
Which gland is often called the “master gland” because it regulates the activity of other endocrine glands through the secretion of tropic hormones?
A. Pituitary gland
B. Thyroid gland
C. Adrenal gland
D. Pancreas
Explanation:
The pituitary gland, also known as the hypophysis, is called the “master gland” because it secretes tropic hormones such as TSH and ACTH that regulate the activity of other endocrine glands. These hormones control the synthesis and release of hormones from target glands, helping maintain endocrine balance throughout the body.
The pituitary gland, also known as the hypophysis, is called the “master gland” because it secretes tropic hormones such as TSH and ACTH that regulate the activity of other endocrine glands. These hormones control the synthesis and release of hormones from target glands, helping maintain endocrine balance throughout the body.
Question 2
Where are the adrenal glands located in the human body?
A. Behind the stomach
B. In the brain, hanging from the roof of the third ventricle
C. In the neck, anterior to the trachea
D. On top of the kidneys
Explanation:
The adrenal (suprarenal) glands are paired endocrine organs located on the superior surface of each kidney. Each gland consists of an outer cortex and an inner medulla, both of which secrete hormones essential for stress response, metabolism, and fluid balance.
The adrenal (suprarenal) glands are paired endocrine organs located on the superior surface of each kidney. Each gland consists of an outer cortex and an inner medulla, both of which secrete hormones essential for stress response, metabolism, and fluid balance.
Question 3
Which hormone is responsible for lowering blood glucose levels by facilitating glucose uptake into skeletal and adipose body cells?
A. Glucagon
B. Epinephrine
C. Insulin
D. Cortisol
Explanation:
Insulin is secreted by the beta cells of the pancreas. It lowers blood glucose levels by promoting glucose uptake into body cells and stimulating the liver to store excess glucose as glycogen. Insulin plays a key role in maintaining normal blood sugar levels.
Insulin is secreted by the beta cells of the pancreas. It lowers blood glucose levels by promoting glucose uptake into body cells and stimulating the liver to store excess glucose as glycogen. Insulin plays a key role in maintaining normal blood sugar levels.
Question 4
What are the three “cardinal signs” of diabetes mellitus?
A. Tachycardia, hypertension, and sweating
B. Polyuria, polydipsia, and polyphagia
C. Fever, chills, and cough
D. Weight gain, lethargy, and constipation
Explanation:
The classic cardinal signs of diabetes mellitus are polyuria (excessive urination), polydipsia (excessive thirst), and polyphagia (excessive hunger). These symptoms occur because glucose cannot be effectively utilized by the body’s cells.
The classic cardinal signs of diabetes mellitus are polyuria (excessive urination), polydipsia (excessive thirst), and polyphagia (excessive hunger). These symptoms occur because glucose cannot be effectively utilized by the body’s cells.
Question 5
Which gland produces the hormone melatonin, which helps regulate sleep-wake cycles and reproductive development?
A. Pineal gland
B. Pituitary gland
C. Thyroid gland
D. Parathyroid gland
Explanation:
The pineal gland synthesizes and secretes melatonin from serotonin. Melatonin helps regulate circadian rhythms, sleep-wake cycles, and influences reproductive development through its effects on hormonal regulation.
The pineal gland synthesizes and secretes melatonin from serotonin. Melatonin helps regulate circadian rhythms, sleep-wake cycles, and influences reproductive development through its effects on hormonal regulation.
Question 6
Which of the following is a hallmark clinical sign of Graves’ disease, a common form of hyperthyroidism?
A. Purple striae on the skin
B. Buffalo hump
C. Moon face
D. Exophthalmos (bulging eyes)
Explanation:
Exophthalmos, or protrusion of the eyeballs, is a characteristic feature of Graves’ disease. It results from autoimmune inflammation and swelling of the tissues surrounding the eyes.
Exophthalmos, or protrusion of the eyeballs, is a characteristic feature of Graves’ disease. It results from autoimmune inflammation and swelling of the tissues surrounding the eyes.
Question 7
What is the primary function of parathyroid hormone (PTH) in maintaining homeostasis?
A. To lower blood glucose levels
B. To increase basal metabolic rate
C. To regulate blood calcium levels
D. To stimulate the fight-or-flight response
Explanation:
Parathyroid hormone is the major regulator of calcium homeostasis. It increases blood calcium levels by stimulating bone resorption, enhancing calcium reabsorption in the kidneys, and increasing intestinal calcium absorption.
Parathyroid hormone is the major regulator of calcium homeostasis. It increases blood calcium levels by stimulating bone resorption, enhancing calcium reabsorption in the kidneys, and increasing intestinal calcium absorption.
Question 8
Which condition is caused by a deficiency of antidiuretic hormone (ADH), leading to massive water loss through the urine?
A. SIADH
B. Diabetes Insipidus
C. Diabetes Mellitus
D. Cushing’s Syndrome
Explanation:
Diabetes insipidus occurs when antidiuretic hormone (ADH) is deficient or ineffective. The kidneys are unable to conserve water, resulting in excessive urine production and dehydration.
Diabetes insipidus occurs when antidiuretic hormone (ADH) is deficient or ineffective. The kidneys are unable to conserve water, resulting in excessive urine production and dehydration.
Question 9
Which hormone is secreted by the adrenal medulla during the acute “fight-or-flight” response?
A. Epinephrine
B. Aldosterone
C. Cortisol
D. Thyroid hormone
Explanation:
The adrenal medulla secretes catecholamines, primarily epinephrine and norepinephrine. These hormones prepare the body for immediate action during stressful situations by increasing heart rate, blood pressure, and energy availability.
The adrenal medulla secretes catecholamines, primarily epinephrine and norepinephrine. These hormones prepare the body for immediate action during stressful situations by increasing heart rate, blood pressure, and energy availability.
Question 10
An A1C test measures average blood glucose management over what duration?
A. 24 hours
B. 1 month
C. 1 week
D. 3 months
Explanation:
The A1C (glycosylated hemoglobin) test reflects average blood glucose levels over approximately the previous 10–12 weeks, making it an important tool for monitoring long-term diabetes control.
The A1C (glycosylated hemoglobin) test reflects average blood glucose levels over approximately the previous 10–12 weeks, making it an important tool for monitoring long-term diabetes control.
Question 11
Which dietary mineral is essential for the synthesis of thyroid hormones T3 and T4?
A. Iron
B. Potassium
C. Iodine
D. Calcium
Explanation:
Iodine is an essential dietary mineral required for the synthesis of the thyroid hormones T3 (triiodothyronine) and T4 (thyroxine). An inadequate iodine intake can lead to reduced thyroid hormone production and enlargement of the thyroid gland, known as goiter.
Iodine is an essential dietary mineral required for the synthesis of the thyroid hormones T3 (triiodothyronine) and T4 (thyroxine). An inadequate iodine intake can lead to reduced thyroid hormone production and enlargement of the thyroid gland, known as goiter.
Question 12
Which condition is characterized by a “moon face” and “buffalo hump” due to hypersecretion of cortisol?
A. Hypothyroidism
B. Cushing’s Syndrome
C. Addison’s Disease
D. Diabetes Mellitus
Explanation:
Cushing’s syndrome results from excessive cortisol production. Characteristic features include a rounded “moon face,” accumulation of fat on the upper back known as a “buffalo hump,” central obesity, and thinning of the skin.
Cushing’s syndrome results from excessive cortisol production. Characteristic features include a rounded “moon face,” accumulation of fat on the upper back known as a “buffalo hump,” central obesity, and thinning of the skin.
Question 13
What is the standard first-line medication for the treatment of Type 2 Diabetes?
A. Metformin
B. Glipizide
C. Insulin Lispro
D. Pioglitazone
Explanation:
Metformin is the preferred first-line medication for most patients with Type 2 Diabetes Mellitus. It lowers blood glucose by decreasing hepatic glucose production and improving insulin sensitivity in peripheral tissues.
Metformin is the preferred first-line medication for most patients with Type 2 Diabetes Mellitus. It lowers blood glucose by decreasing hepatic glucose production and improving insulin sensitivity in peripheral tissues.
Question 14
Which hormone increases blood glucose levels by stimulating the liver to convert glycogen back into glucose?
A. Prolactin
B. Insulin
C. Calcitonin
D. Glucagon
Explanation:
Glucagon is secreted by the alpha cells of the pancreas when blood glucose levels fall. It stimulates glycogenolysis in the liver, causing stored glycogen to be converted into glucose and released into the bloodstream.
Glucagon is secreted by the alpha cells of the pancreas when blood glucose levels fall. It stimulates glycogenolysis in the liver, causing stored glycogen to be converted into glucose and released into the bloodstream.
Question 15
Addison’s disease results from the inadequate production of which adrenal hormones?
A. Thyroid hormones
B. Growth hormone
C. Cortisol and aldosterone
D. Insulin and glucagon
Explanation:
Addison’s disease is caused by insufficient production of cortisol and aldosterone by the adrenal cortex. This deficiency can lead to fatigue, weight loss, hypotension, dehydration, and electrolyte imbalances.
Addison’s disease is caused by insufficient production of cortisol and aldosterone by the adrenal cortex. This deficiency can lead to fatigue, weight loss, hypotension, dehydration, and electrolyte imbalances.
Question 16
Which type of insulin is classified as “rapid-acting” and is typically given within 15 minutes of a meal?
A. Glargine
B. Lispro
C. NPH
D. Detemir
Explanation:
Insulin Lispro is a rapid-acting insulin analog. It begins working within 15–30 minutes, peaks quickly, and is commonly administered just before meals to control postprandial blood glucose levels.
Insulin Lispro is a rapid-acting insulin analog. It begins working within 15–30 minutes, peaks quickly, and is commonly administered just before meals to control postprandial blood glucose levels.
Question 17
According to the ADA, what is the target fasting blood glucose range for most non-diabetic adults?
A. 80–130 mg/dL
B. 40–60 mg/dL
C. 140–180 mg/dL
D. 200–250 mg/dL
Explanation:
The American Diabetes Association identifies fasting blood glucose levels between 80 and 130 mg/dL as the general target range. Values consistently above this range may indicate impaired glucose regulation or diabetes.
The American Diabetes Association identifies fasting blood glucose levels between 80 and 130 mg/dL as the general target range. Values consistently above this range may indicate impaired glucose regulation or diabetes.
Question 18
Which butterfly-shaped gland is located in the neck, anterior to the trachea and just inferior to the larynx?
A. Thymus
B. Adrenal gland
C. Pituitary gland
D. Thyroid gland
Explanation:
The thyroid gland is a butterfly-shaped endocrine gland located in the anterior neck. It consists of two lobes connected by an isthmus and produces hormones that regulate metabolism, growth, and development.
The thyroid gland is a butterfly-shaped endocrine gland located in the anterior neck. It consists of two lobes connected by an isthmus and produces hormones that regulate metabolism, growth, and development.
Question 19
What is the effect of calcitonin on blood calcium levels?
A. It raises blood calcium
B. It has no effect on calcium
C. It lowers blood calcium
D. It increases calcium absorption in the gut
Explanation:
Calcitonin is secreted by the thyroid gland when blood calcium levels are elevated. It lowers calcium levels by inhibiting osteoclast-mediated bone resorption and increasing calcium excretion through the kidneys.
Calcitonin is secreted by the thyroid gland when blood calcium levels are elevated. It lowers calcium levels by inhibiting osteoclast-mediated bone resorption and increasing calcium excretion through the kidneys.
Question 20
“Moon face,” “buffalo hump,” and purple striae are characteristic assessments for which condition?
A. Addison’s Disease
B. Cushing’s Syndrome
C. Diabetes Mellitus
D. Hypothyroidism
Explanation:
Cushing’s syndrome is associated with chronic excess cortisol levels. Common clinical findings include moon face, buffalo hump, central obesity, thin skin, easy bruising, and purple abdominal striae.
Cushing’s syndrome is associated with chronic excess cortisol levels. Common clinical findings include moon face, buffalo hump, central obesity, thin skin, easy bruising, and purple abdominal striae.
Question 21
Which hormone stimulates the production of milk in females?
A. Prolactin
B. Oxytocin
C. Estrogen
D. LH
Explanation:
Prolactin (PRL), secreted by the anterior pituitary gland, stimulates the development of mammary glands and promotes milk production after childbirth. Oxytocin is responsible for milk ejection rather than milk synthesis.
Prolactin (PRL), secreted by the anterior pituitary gland, stimulates the development of mammary glands and promotes milk production after childbirth. Oxytocin is responsible for milk ejection rather than milk synthesis.
Question 22
Hypoglycemia is generally defined as a blood glucose level below:
A. 100 mg/dL
B. 120 mg/dL
C. 150 mg/dL
D. 70 mg/dL
Explanation:
Hypoglycemia is typically defined as a blood glucose level below 70 mg/dL. Symptoms may include sweating, shakiness, hunger, confusion, and dizziness. Severe hypoglycemia may require immediate assistance.
Hypoglycemia is typically defined as a blood glucose level below 70 mg/dL. Symptoms may include sweating, shakiness, hunger, confusion, and dizziness. Severe hypoglycemia may require immediate assistance.
Question 23
Which of the following is a classic clinical symptom of hypothyroidism?
A. Heat intolerance
B. Weight loss
C. Cold intolerance
D. Tachycardia
Explanation:
Hypothyroidism decreases metabolic activity, resulting in symptoms such as cold intolerance, fatigue, weight gain, dry skin, constipation, and slowed heart rate.
Hypothyroidism decreases metabolic activity, resulting in symptoms such as cold intolerance, fatigue, weight gain, dry skin, constipation, and slowed heart rate.
Question 24
Which hormone regulates sodium and potassium levels to control blood pressure?
A. Cortisol
B. Aldosterone
C. Insulin
D. Growth hormone
Explanation:
Aldosterone is a mineralocorticoid hormone produced by the adrenal cortex. It increases sodium reabsorption and potassium excretion by the kidneys, leading to water retention and increased blood pressure.
Aldosterone is a mineralocorticoid hormone produced by the adrenal cortex. It increases sodium reabsorption and potassium excretion by the kidneys, leading to water retention and increased blood pressure.
Question 25
In children, the hypersecretion of Growth Hormone (GH) results in:
A. Gigantism
B. Acromegaly
C. Dwarfism
D. Myxedema
Explanation:
Excessive secretion of growth hormone during childhood, before the closure of epiphyseal growth plates, causes gigantism. In adults, excess GH causes acromegaly rather than gigantism.
Excessive secretion of growth hormone during childhood, before the closure of epiphyseal growth plates, causes gigantism. In adults, excess GH causes acromegaly rather than gigantism.
Question 26
Which type of diabetes is an autoimmune condition where the pancreas produces little to no insulin?
A. Diabetes Insipidus
B. Type 2 Diabetes
C. Gestational Diabetes
D. Type 1 Diabetes
Explanation:
Type 1 Diabetes Mellitus is an autoimmune disorder in which the body’s immune system destroys insulin-producing beta cells of the pancreas. Patients require lifelong insulin therapy.
Type 1 Diabetes Mellitus is an autoimmune disorder in which the body’s immune system destroys insulin-producing beta cells of the pancreas. Patients require lifelong insulin therapy.
Question 27
What is the priority intervention for a conscious patient experiencing mild hypoglycemia?
A. IV Dextrose 50%
B. Glucagon IM
C. 15g of rapidly digested carbohydrates
D. High-protein snack
Explanation:
For a conscious patient who can safely swallow, the recommended treatment is 15 grams of fast-acting carbohydrate such as glucose tablets or fruit juice. Blood glucose should then be rechecked after 15 minutes.
For a conscious patient who can safely swallow, the recommended treatment is 15 grams of fast-acting carbohydrate such as glucose tablets or fruit juice. Blood glucose should then be rechecked after 15 minutes.
Question 28
Which medication is a synthetic T4 hormone used as the first-line treatment for hypothyroidism?
A. Methimazole
B. Levothyroxine
C. Propylthiouracil (PTU)
D. Radioactive Iodine
Explanation:
Levothyroxine is a synthetic form of thyroxine (T4) and is the standard first-line treatment for hypothyroidism. It restores normal thyroid hormone levels and improves metabolic function.
Levothyroxine is a synthetic form of thyroxine (T4) and is the standard first-line treatment for hypothyroidism. It restores normal thyroid hormone levels and improves metabolic function.
Question 29
The “anterior pituitary” is also known as the:
A. Adenohypophysis
B. Neurohypophysis
C. Hypothalamus
D. Epiphysis
Explanation:
The anterior pituitary gland is called the adenohypophysis. It consists of glandular tissue and secretes hormones including growth hormone (GH), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), and prolactin.
The anterior pituitary gland is called the adenohypophysis. It consists of glandular tissue and secretes hormones including growth hormone (GH), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), and prolactin.
Question 30
Which endocrine gland also has an exocrine function for digestion?
A. Adrenal
B. Thyroid
C. Pineal
D. Pancreas
Explanation:
The pancreas is a mixed gland with both endocrine and exocrine functions. Its endocrine portion secretes hormones such as insulin and glucagon, while its exocrine portion produces digestive enzymes that are released into the small intestine.
The pancreas is a mixed gland with both endocrine and exocrine functions. Its endocrine portion secretes hormones such as insulin and glucagon, while its exocrine portion produces digestive enzymes that are released into the small intestine.
Question 31
Which finding is most associated with Addison’s disease?
A. Purple striae
B. High blood pressure
C. Hyperpigmentation of the skin
D. Weight gain
Explanation:
Hyperpigmentation of the skin is a hallmark sign of primary adrenal insufficiency (Addison’s disease). Increased ACTH production stimulates melanocytes, causing darkening of the skin, particularly in skin folds, scars, and pressure areas.
Hyperpigmentation of the skin is a hallmark sign of primary adrenal insufficiency (Addison’s disease). Increased ACTH production stimulates melanocytes, causing darkening of the skin, particularly in skin folds, scars, and pressure areas.
Question 32
Which hormone, stored in the posterior pituitary, causes the uterus to contract during childbirth?
A. Prolactin
B. Oxytocin
C. Estrogen
D. Progesterone
Explanation:
Oxytocin is synthesized in the hypothalamus and stored in the posterior pituitary gland. It stimulates uterine contractions during labor and also promotes milk ejection during breastfeeding.
Oxytocin is synthesized in the hypothalamus and stored in the posterior pituitary gland. It stimulates uterine contractions during labor and also promotes milk ejection during breastfeeding.
Question 33
“Kussmaul’s respirations” are deep, rapid breaths typically seen in which metabolic complication?
A. Diabetic Ketoacidosis (DKA)
B. Hypoglycemia
C. Myxedema Coma
D. Cushing’s Syndrome
Explanation:
Kussmaul respirations are deep, labored breathing patterns seen in diabetic ketoacidosis (DKA). They help eliminate carbon dioxide and partially compensate for the metabolic acidosis caused by ketone accumulation.
Kussmaul respirations are deep, labored breathing patterns seen in diabetic ketoacidosis (DKA). They help eliminate carbon dioxide and partially compensate for the metabolic acidosis caused by ketone accumulation.
Question 34
Which hormone is the “antagonist” to Parathyroid Hormone (PTH)?
A. Insulin
B. Thyroxine
C. Aldosterone
D. Calcitonin
Explanation:
Calcitonin opposes the action of parathyroid hormone (PTH). While PTH increases blood calcium levels, calcitonin lowers blood calcium by inhibiting bone resorption and promoting calcium excretion.
Calcitonin opposes the action of parathyroid hormone (PTH). While PTH increases blood calcium levels, calcitonin lowers blood calcium by inhibiting bone resorption and promoting calcium excretion.
Question 35
What is the primary risk of stopping long-term corticosteroid therapy abruptly?
A. Thyroid Storm
B. Diabetic Ketoacidosis
C. Addisonian Crisis
D. Myxedema Coma
Explanation:
Long-term corticosteroid therapy suppresses normal adrenal gland function. Abrupt discontinuation can result in acute adrenal insufficiency (Addisonian crisis), a potentially life-threatening condition requiring immediate treatment.
Long-term corticosteroid therapy suppresses normal adrenal gland function. Abrupt discontinuation can result in acute adrenal insufficiency (Addisonian crisis), a potentially life-threatening condition requiring immediate treatment.
Question 36
Which of the following is a classic symptom of hyperglycemia?
A. Sweating and shakiness
B. Blurred vision and increased thirst
C. Bradycardia and cold skin
D. Weight gain and constipation
Explanation:
Common symptoms of hyperglycemia include increased thirst (polydipsia), frequent urination (polyuria), blurred vision, fatigue, and headache. Symptoms typically develop when blood glucose levels become significantly elevated.
Common symptoms of hyperglycemia include increased thirst (polydipsia), frequent urination (polyuria), blurred vision, fatigue, and headache. Symptoms typically develop when blood glucose levels become significantly elevated.
Question 37
The “posterior pituitary” gland stores and releases which hormones?
A. ADH and Oxytocin
B. TSH and ACTH
C. GH and Prolactin
D. Insulin and Glucagon
Explanation:
The posterior pituitary (neurohypophysis) stores and releases antidiuretic hormone (ADH) and oxytocin, both of which are synthesized in the hypothalamus and transported to the posterior pituitary for storage.
The posterior pituitary (neurohypophysis) stores and releases antidiuretic hormone (ADH) and oxytocin, both of which are synthesized in the hypothalamus and transported to the posterior pituitary for storage.
Question 38
Which diagnostic result is used to confirm a diagnosis of Diabetes Mellitus?
A. HbA1c of 5.5%
B. Random glucose of 140 mg/dL
C. FPG of 100 mg/dL
D. Fasting Plasma Glucose (FPG) of 126 mg/dL or higher
Explanation:
A diagnosis of Diabetes Mellitus can be confirmed by a fasting plasma glucose level of 126 mg/dL or greater on two separate occasions, an HbA1c of 6.5% or higher, or a random plasma glucose of 200 mg/dL or higher in a symptomatic patient.
A diagnosis of Diabetes Mellitus can be confirmed by a fasting plasma glucose level of 126 mg/dL or greater on two separate occasions, an HbA1c of 6.5% or higher, or a random plasma glucose of 200 mg/dL or higher in a symptomatic patient.
Question 39
What is the priority intervention for a patient in a severe Addisonian Crisis?
A. Oral glucose tablets
B. High-intensity exercise
C. IV Cortisol (Hydrocortisone) and fluids
D. Tapering the current steroid dose
Explanation:
Addisonian crisis is a medical emergency. Immediate treatment includes intravenous hydrocortisone replacement and aggressive fluid resuscitation with isotonic solutions to restore blood pressure and correct electrolyte imbalances.
Addisonian crisis is a medical emergency. Immediate treatment includes intravenous hydrocortisone replacement and aggressive fluid resuscitation with isotonic solutions to restore blood pressure and correct electrolyte imbalances.
Question 40
Which gland is responsible for regulating the body’s basal metabolic rate?
A. Pituitary
B. Thyroid
C. Parathyroid
D. Adrenal
Explanation:
The thyroid gland produces T3 and T4 hormones, which regulate the body’s basal metabolic rate. These hormones influence energy production, oxygen consumption, and overall metabolic activity.
The thyroid gland produces T3 and T4 hormones, which regulate the body’s basal metabolic rate. These hormones influence energy production, oxygen consumption, and overall metabolic activity.
Question 41
A patient taking Metformin is scheduled for a CT scan with IV contrast. What is the standard nursing instruction?
A. Hold Metformin for 48 hours before and after the procedure
B. Take a double dose of Metformin the day of the scan
C. Drink only fruit juice for 24 hours after the scan
D. Switch to insulin for the week of the procedure
Explanation:
Metformin is typically withheld before and after procedures involving iodinated contrast media to reduce the risk of kidney injury and lactic acidosis. Renal function should be reassessed before restarting the medication.
Metformin is typically withheld before and after procedures involving iodinated contrast media to reduce the risk of kidney injury and lactic acidosis. Renal function should be reassessed before restarting the medication.
Question 42
When is the best time for a patient to take their prescribed Levothyroxine?
A. At bedtime with a high-protein snack
B. Immediately after the largest meal of the day
C. With their morning coffee to ensure wakefulness
D. In the morning, on an empty stomach, 30–60 minutes before breakfast
Explanation:
Levothyroxine is best absorbed when taken on an empty stomach 30–60 minutes before breakfast with a full glass of water. Food and certain medications can interfere with its absorption.
Levothyroxine is best absorbed when taken on an empty stomach 30–60 minutes before breakfast with a full glass of water. Food and certain medications can interfere with its absorption.
Question 43
A patient with Type 1 Diabetes has a blood glucose of 350 mg/dL and “fruity” breath. What complication does the nurse suspect?
A. Hypoglycemia
B. HHS
C. Diabetic Ketoacidosis (DKA)
D. SIADH
Explanation:
Diabetic Ketoacidosis (DKA) is a serious complication of Type 1 Diabetes characterized by hyperglycemia, ketone production, metabolic acidosis, and a distinctive fruity breath odor caused by acetone.
Diabetic Ketoacidosis (DKA) is a serious complication of Type 1 Diabetes characterized by hyperglycemia, ketone production, metabolic acidosis, and a distinctive fruity breath odor caused by acetone.
Question 44
What is the “15/15 Rule” in hypoglycemia management?
A. Give 15g of protein and recheck in 15 minutes
B. Give 15g of fast-acting carbs and recheck in 15 minutes
C. Give 15 units of insulin and wait 15 minutes
D. Drink 15 ounces of water and wait 15 minutes
Explanation:
The 15/15 Rule recommends giving 15 grams of rapidly absorbed carbohydrates, then checking blood glucose again after 15 minutes. Treatment is repeated if blood glucose remains low.
The 15/15 Rule recommends giving 15 grams of rapidly absorbed carbohydrates, then checking blood glucose again after 15 minutes. Treatment is repeated if blood glucose remains low.
Question 45
Why is it critical to rotate insulin injection sites within the same anatomical region?
A. To prevent lipohypertrophy (thickened skin)
B. To increase the speed of insulin absorption
C. To reduce the risk of systemic infection
D. To make the injections less painful
Explanation:
Repeated insulin injections in the same location can cause lipohypertrophy, resulting in thickened fatty tissue and unpredictable insulin absorption. Rotating sites helps maintain consistent absorption.
Repeated insulin injections in the same location can cause lipohypertrophy, resulting in thickened fatty tissue and unpredictable insulin absorption. Rotating sites helps maintain consistent absorption.
Question 46
A patient with hyperthyroidism is experiencing a “Thyroid Storm.” Which medication is strictly contraindicated?
A. Propranolol
B. Acetaminophen
C. Propylthiouracil (PTU)
D. Aspirin
Explanation:
Aspirin is contraindicated during thyroid storm because it can increase circulating free thyroid hormone levels by displacing thyroid hormones from protein-binding sites. Acetaminophen is preferred for fever management.
Aspirin is contraindicated during thyroid storm because it can increase circulating free thyroid hormone levels by displacing thyroid hormones from protein-binding sites. Acetaminophen is preferred for fever management.
Question 47
Which assessment is a priority for a patient immediately after a subtotal thyroidectomy?
A. Ability to walk
B. Weight gain
C. Presence of Chvostek’s or Trousseau’s signs
D. Blood glucose levels
Explanation:
Following thyroid surgery, accidental injury or removal of the parathyroid glands may cause hypocalcemia. Positive Chvostek’s or Trousseau’s signs indicate neuromuscular irritability related to low calcium levels.
Following thyroid surgery, accidental injury or removal of the parathyroid glands may cause hypocalcemia. Positive Chvostek’s or Trousseau’s signs indicate neuromuscular irritability related to low calcium levels.
Question 48
Which of the following describes the mechanism of “Sulfonylurea” drugs (e.g., Glipizide)?
A. They decrease glucose absorption from the gut
B. They stimulate the beta cells to produce more insulin
C. They increase the body’s sensitivity to insulin
D. They increase glucose excretion through the urine
Explanation:
Sulfonylureas stimulate pancreatic beta cells to release more insulin. Because insulin secretion occurs regardless of blood glucose levels, these medications carry a significant risk of hypoglycemia.
Sulfonylureas stimulate pancreatic beta cells to release more insulin. Because insulin secretion occurs regardless of blood glucose levels, these medications carry a significant risk of hypoglycemia.
Question 49
What is the primary characteristic of HHS compared to DKA?
A. Extreme hyperglycemia (>600 mg/dL) without significant ketosis
B. Presence of large amounts of ketones
C. Rapid onset within hours
D. Affects only Type 1 diabetics
Explanation:
Hyperosmolar Hyperglycemic State (HHS) is characterized by severe hyperglycemia, profound dehydration, and minimal or absent ketosis. It most commonly occurs in older adults with Type 2 Diabetes.
Hyperosmolar Hyperglycemic State (HHS) is characterized by severe hyperglycemia, profound dehydration, and minimal or absent ketosis. It most commonly occurs in older adults with Type 2 Diabetes.
Question 50
A patient is diagnosed with Pheochromocytoma. Which symptom is most likely to be present?
A. Severe hypotension and weight gain
B. Constant thirst and polyuria
C. Cold intolerance and constipation
D. Persistent hypertension, palpitations, and sweating
Explanation:
Pheochromocytoma is a tumor of the adrenal medulla that causes excessive secretion of catecholamines. Common manifestations include severe hypertension, palpitations, headaches, anxiety, and excessive sweating.
Pheochromocytoma is a tumor of the adrenal medulla that causes excessive secretion of catecholamines. Common manifestations include severe hypertension, palpitations, headaches, anxiety, and excessive sweating.
Question 51
Which type of insulin is considered “long-acting” and typically has no pronounced peak?
A. Regular insulin
B. NPH
C. Glargine (Lantus)
D. Aspart
Explanation:
Insulin Glargine is a long-acting insulin that provides steady basal insulin coverage for approximately 24 hours with little or no pronounced peak.
Insulin Glargine is a long-acting insulin that provides steady basal insulin coverage for approximately 24 hours with little or no pronounced peak.
Question 52
For a patient with Diabetes Insipidus, which finding indicates that Desmopressin is effective?
A. Increased urine output and decreased thirst
B. Decreased urine output and increased urine specific gravity
C. Elevated blood glucose levels
D. Weight loss and increased heart rate
Explanation:
Desmopressin acts as a replacement for ADH. Effective therapy decreases urine output and produces more concentrated urine, reflected by an increased urine specific gravity.
Desmopressin acts as a replacement for ADH. Effective therapy decreases urine output and produces more concentrated urine, reflected by an increased urine specific gravity.
Question 53
A patient with SIADH would most likely require which intervention?
A. Fluid restriction and monitoring for hyponatremia
B. Rapid IV fluid boluses
C. Administration of oral glucose
D. High-sodium diet and diuretics
Explanation:
SIADH causes excessive water retention and dilutional hyponatremia. Fluid restriction and close monitoring of sodium levels are essential components of treatment.
SIADH causes excessive water retention and dilutional hyponatremia. Fluid restriction and close monitoring of sodium levels are essential components of treatment.
Question 54
Which lab value confirms a diagnosis of “Prediabetes” based on A1C?
A. 4.0%–5.0%
B. 6.5% or higher
C. 7.0% or higher
D. 5.7%–6.4%
Explanation:
An HbA1c level between 5.7% and 6.4% indicates prediabetes and signals an increased risk of developing Type 2 Diabetes Mellitus.
An HbA1c level between 5.7% and 6.4% indicates prediabetes and signals an increased risk of developing Type 2 Diabetes Mellitus.
Question 55
What is the “Dawn Phenomenon” in diabetic patients?
A. Low blood sugar at 3:00 AM followed by high blood sugar at 7:00 AM
B. Severe hypoglycemia during morning exercise
C. A normal rise in blood sugar as the body prepares to wake up
D. The feeling of extreme thirst upon waking
Explanation:
The Dawn Phenomenon refers to an early morning rise in blood glucose caused by normal circadian release of growth hormone, cortisol, and other counter-regulatory hormones.
The Dawn Phenomenon refers to an early morning rise in blood glucose caused by normal circadian release of growth hormone, cortisol, and other counter-regulatory hormones.
Question 56
Which instruction is vital for a patient starting PTU for hyperthyroidism?
A. “Double your intake of iodized salt.”
B. “Report any sore throat or fever immediately.”
C. “Take the medication only when you feel nervous.”
D. “Expect your eyes to stop bulging within 24 hours.”
Explanation:
Propylthiouracil (PTU) may rarely cause agranulocytosis. Patients must promptly report symptoms such as sore throat, fever, or signs of infection for immediate evaluation.
Propylthiouracil (PTU) may rarely cause agranulocytosis. Patients must promptly report symptoms such as sore throat, fever, or signs of infection for immediate evaluation.
Question 57
What is the role of Glucagon in an emergency kit for diabetics?
A. To raise blood sugar when the patient is unconscious from hypoglycemia
B. To lower blood sugar after a large meal
C. To prevent weight gain associated with insulin
D. To treat a thyroid storm
Explanation:
Glucagon is used in severe hypoglycemia when a patient cannot safely consume carbohydrates. It stimulates the liver to release stored glucose into the bloodstream.
Glucagon is used in severe hypoglycemia when a patient cannot safely consume carbohydrates. It stimulates the liver to release stored glucose into the bloodstream.
Question 58
A patient has Hyperparathyroidism. Which complication is the nurse most concerned about?
A. Hypoglycemia
B. Massive weight gain
C. Respiratory failure from lung congestion
D. Spontaneous bone fractures and kidney stones
Explanation:
Excess PTH causes bone demineralization and elevated blood calcium levels. This increases the risk of pathological fractures and calcium-containing kidney stones.
Excess PTH causes bone demineralization and elevated blood calcium levels. This increases the risk of pathological fractures and calcium-containing kidney stones.
Question 59
Which of the following is a common assessment finding in Hypoparathyroidism?
A. Muscle tremors and tachycardia
B. Deep, rapid respirations
C. Muscle twitching, cramping, and spasms
D. Hypertension and moon face
Explanation:
Hypoparathyroidism causes hypocalcemia, leading to increased neuromuscular excitability. Symptoms include muscle cramps, twitching, tetany, and positive Chvostek’s and Trousseau’s signs.
Hypoparathyroidism causes hypocalcemia, leading to increased neuromuscular excitability. Symptoms include muscle cramps, twitching, tetany, and positive Chvostek’s and Trousseau’s signs.
Question 60
When teaching a patient about NPH (intermediate-acting) insulin, the nurse should state it appears:
A. Clear and colorless
B. Cloudy or milky
C. Bright yellow
D. Like thick syrup
Explanation:
NPH insulin is an intermediate-acting insulin suspension and normally appears cloudy or milky. The vial should be gently rolled between the hands before administration to evenly distribute the insulin particles.
NPH insulin is an intermediate-acting insulin suspension and normally appears cloudy or milky. The vial should be gently rolled between the hands before administration to evenly distribute the insulin particles.
Question 61
Which of the following are the primary hormones produced by the Adrenal Cortex?
A. Glucocorticoids, Mineralocorticoids, and Androgens
B. Epinephrine and Norepinephrine
C. Insulin and Glucagon
D. T3, T4, and Calcitonin
Explanation:
The adrenal cortex secretes three major classes of steroid hormones: glucocorticoids (cortisol), mineralocorticoids (aldosterone), and androgens. These hormones regulate metabolism, fluid balance, and secondary sexual characteristics.
The adrenal cortex secretes three major classes of steroid hormones: glucocorticoids (cortisol), mineralocorticoids (aldosterone), and androgens. These hormones regulate metabolism, fluid balance, and secondary sexual characteristics.
Question 62
A patient is found to have a “HbA1c of 10%.” What does this indicate?
A. Normal blood sugar control for the last 3 months
B. Prediabetes and a need for lifestyle changes
C. An error in the lab test
D. Poor blood sugar control over the last 3 months
Explanation:
An HbA1c of 10% indicates significantly elevated average blood glucose levels over the previous 2–3 months and reflects poor glycemic control that requires intervention.
An HbA1c of 10% indicates significantly elevated average blood glucose levels over the previous 2–3 months and reflects poor glycemic control that requires intervention.
Question 63
Which medication should be available at the bedside for a patient following a parathyroidectomy?
A. IV Regular Insulin
B. Oral Metformin
C. IV Calcium Gluconate
D. IV Levothyroxine
Explanation:
Patients are at risk for acute hypocalcemia after parathyroid surgery. IV calcium gluconate should be readily available to manage tetany, muscle spasms, and other manifestations of severe hypocalcemia.
Patients are at risk for acute hypocalcemia after parathyroid surgery. IV calcium gluconate should be readily available to manage tetany, muscle spasms, and other manifestations of severe hypocalcemia.
Question 64
“Primary Aldosteronism” (Conn’s Syndrome) typically results in:
A. Hyperkalemia and Hypotension
B. Hypokalemia and Hypertension
C. Hyperglycemia and Weight gain
D. Hyperpigmentation and Fatigue
Explanation:
Excess aldosterone causes sodium and water retention, leading to hypertension, while increasing potassium excretion, resulting in hypokalemia.
Excess aldosterone causes sodium and water retention, leading to hypertension, while increasing potassium excretion, resulting in hypokalemia.
Question 65
What is the “Somogyi Effect”?
A. Morning hyperglycemia as a rebound response to nighttime hypoglycemia
B. Morning hyperglycemia due to high doses of GH
C. Excessive weight loss in Type 1 Diabetes
D. Rapid heartbeat after taking PTU
Explanation:
The Somogyi Effect occurs when unrecognized nocturnal hypoglycemia triggers counter-regulatory hormone release, resulting in rebound morning hyperglycemia.
The Somogyi Effect occurs when unrecognized nocturnal hypoglycemia triggers counter-regulatory hormone release, resulting in rebound morning hyperglycemia.
Question 66
Which is the only type of insulin that can be given intravenously (IV)?
A. NPH
B. Glargine
C. Detemir
D. Regular (Short-acting)
Explanation:
Regular insulin is the only insulin formulation approved for intravenous administration and is commonly used in emergencies such as diabetic ketoacidosis.
Regular insulin is the only insulin formulation approved for intravenous administration and is commonly used in emergencies such as diabetic ketoacidosis.
Question 67
Which hormone from the anterior pituitary stimulates the Adrenal Cortex to release cortisol?
A. TSH
B. ADH
C. ACTH
D. LH
Explanation:
Adrenocorticotropic Hormone (ACTH) is secreted by the anterior pituitary gland and stimulates the adrenal cortex to produce and release cortisol.
Adrenocorticotropic Hormone (ACTH) is secreted by the anterior pituitary gland and stimulates the adrenal cortex to produce and release cortisol.
Question 68
What is the priority assessment finding for a patient with a “Myxedema Coma”?
A. Hyperthermia and tachycardia
B. Hypothermia, bradycardia, and hypoventilation
C. Extreme anxiety and agitation
D. Fruity-smelling breath
Explanation:
Myxedema coma is a severe form of hypothyroidism characterized by profound metabolic slowing, including hypothermia, bradycardia, hypoventilation, and altered mental status.
Myxedema coma is a severe form of hypothyroidism characterized by profound metabolic slowing, including hypothermia, bradycardia, hypoventilation, and altered mental status.
Question 69
“Tapping the patient’s cheek” to check for a facial twitch tests for which clinical sign?
A. Chvostek’s sign
B. Trousseau’s sign
C. Kernig’s sign
D. Brudzinski’s sign
Explanation:
Chvostek’s sign is elicited by tapping the facial nerve, causing facial muscle twitching in patients with hypocalcemia and increased neuromuscular excitability.
Chvostek’s sign is elicited by tapping the facial nerve, causing facial muscle twitching in patients with hypocalcemia and increased neuromuscular excitability.
Question 70
Which endocrine disorder is characterized by “thin, fragile skin” and “purple abdominal striae”?
A. Addison’s Disease
B. Hashimoto’s Thyroiditis
C. Diabetes Insipidus
D. Cushing’s Syndrome
Explanation:
Excess cortisol causes protein breakdown and skin thinning, leading to easy bruising, fragile skin, and characteristic purple abdominal striae seen in Cushing’s syndrome.
Excess cortisol causes protein breakdown and skin thinning, leading to easy bruising, fragile skin, and characteristic purple abdominal striae seen in Cushing’s syndrome.
Question 71
Why must a patient be encouraged to “walk or exercise regularly” after an Osteoporosis diagnosis?
A. To increase blood sugar levels
B. To lower their basal metabolic rate
C. To stimulate osteoblasts and enhance bone density
D. To prevent the thyroid from enlarging
Explanation:
Weight-bearing exercise stimulates osteoblast activity and helps maintain or improve bone density, reducing the risk of fractures in patients with osteoporosis.
Weight-bearing exercise stimulates osteoblast activity and helps maintain or improve bone density, reducing the risk of fractures in patients with osteoporosis.
Question 72
Which finding is a common side effect of Metformin that often affects patient compliance?
A. Rapid weight gain
B. Gastrointestinal distress (diarrhea and nausea)
C. Severe hyperglycemia
D. Purple skin striae
Explanation:
The most frequently reported side effects of metformin are gastrointestinal, including nausea, diarrhea, abdominal discomfort, and indigestion.
The most frequently reported side effects of metformin are gastrointestinal, including nausea, diarrhea, abdominal discomfort, and indigestion.
Question 73
Which “Sick Day Rule” is most important for a Type 1 Diabetic patient?
A. “Check your blood glucose and ketones every 4 hours.”
B. “Stop taking insulin until you can eat normally again.”
C. “Avoid drinking any fluids to prevent nausea.”
D. “Switch all medications to the evening dose.”
Explanation:
During illness, patients with Type 1 Diabetes should continue insulin therapy and frequently monitor blood glucose and ketones to prevent diabetic ketoacidosis.
During illness, patients with Type 1 Diabetes should continue insulin therapy and frequently monitor blood glucose and ketones to prevent diabetic ketoacidosis.
Question 74
Which hormone is released by the Adrenal Cortex to increase blood sodium levels?
A. Epinephrine
B. Calcitonin
C. Glucagon
D. Aldosterone
Explanation:
Aldosterone promotes sodium reabsorption and water retention in the kidneys, increasing blood volume and helping maintain blood pressure.
Aldosterone promotes sodium reabsorption and water retention in the kidneys, increasing blood volume and helping maintain blood pressure.
Question 75
What is the function of “thyroid-stimulating hormone (TSH)”?
A. It lowers blood metabolic rate.
B. It decreases the size of the thyroid gland.
C. It triggers the thyroid gland to release T3 and T4.
D. It is produced by the hypothalamus.
Explanation:
TSH is secreted by the anterior pituitary gland and stimulates thyroid growth and the release of thyroid hormones T3 and T4.
TSH is secreted by the anterior pituitary gland and stimulates thyroid growth and the release of thyroid hormones T3 and T4.
Question 76
In the treatment of Thyroid Storm, what is the correct sequence for administering medications?
A. Administer thionamides (PTU) at least 1 hour before iodine solutions
B. Administer iodine solution first, then thionamides 1 hour later
C. Administer both simultaneously to maximize effect
D. PTU and iodine should never be given in the same 24-hour period
Explanation:
Thionamides such as PTU are given before iodine preparations to block new thyroid hormone synthesis and prevent iodine from being used to produce additional thyroid hormone.
Thionamides such as PTU are given before iodine preparations to block new thyroid hormone synthesis and prevent iodine from being used to produce additional thyroid hormone.
Question 77
Which pharmacological “Block-and-Replace” strategy is used in some cases of Cushing’s Syndrome?
A. High-dose steroids followed by insulin
B. PTU combined with Levothyroxine
C. High-dose insulin followed by Metformin
D. High-dose adrenal inhibitors combined with glucocorticoid replacement
Explanation:
The block-and-replace strategy suppresses endogenous cortisol production with adrenal inhibitors while providing controlled glucocorticoid replacement to maintain physiologic hormone levels.
The block-and-replace strategy suppresses endogenous cortisol production with adrenal inhibitors while providing controlled glucocorticoid replacement to maintain physiologic hormone levels.
Question 78
A patient has a “Burch-Wartofsky Point Scale” score of 50. What is the appropriate clinical action?
A. Monitor in a general ward every 8 hours
B. Discharge the patient with oral medications
C. Immediate ICU admission for aggressive treatment of Thyroid Storm
D. Repeat the lab tests in 48 hours to confirm the diagnosis
Explanation:
A Burch-Wartofsky score of 45 or higher strongly suggests thyroid storm, a life-threatening endocrine emergency that requires immediate intensive care and aggressive treatment.
A Burch-Wartofsky score of 45 or higher strongly suggests thyroid storm, a life-threatening endocrine emergency that requires immediate intensive care and aggressive treatment.
Question 79
What is the “Wolff-Chaikoff Effect” utilized in hyperthyroidism treatment?
A. Thyroid enlargement due to TSH
B. Suppression of thyroid hormone release by high doses of iodine
C. Permanent destruction of the thyroid by RAI
D. The rapid pulse associated with Graves’ disease
Explanation:
The Wolff-Chaikoff Effect refers to the temporary suppression of thyroid hormone synthesis and release following administration of high concentrations of iodine.
The Wolff-Chaikoff Effect refers to the temporary suppression of thyroid hormone synthesis and release following administration of high concentrations of iodine.
Question 80
Why is Dexamethasone preferred over Hydrocortisone for an initial treatment of Adrenal Insufficiency during a crisis?
A. It does not cross-react with cortisol assays, preserving test accuracy
B. It is more potent than Hydrocortisone
C. It helps the patient lose weight faster
D. It has a shorter half-life and acts faster
Explanation:
Dexamethasone does not interfere with serum cortisol testing, allowing diagnostic evaluation such as the Cosyntropin stimulation test to remain accurate even after treatment has begun.
Dexamethasone does not interfere with serum cortisol testing, allowing diagnostic evaluation such as the Cosyntropin stimulation test to remain accurate even after treatment has begun.
Question 81
A patient with Primary Aldosteronism must have which test pre-operatively to rule out autonomous cortisol co-secretion?
A. To check for Type 2 Diabetes
B. To ensure the patient is not allergic to steroids
C. To measure their bone density
D. 1-mg Overnight Dexamethasone Suppression Test
Explanation:
Adrenal adenomas may co-secrete aldosterone and cortisol. A 1-mg overnight dexamethasone suppression test helps identify autonomous cortisol production before surgery and prevents postoperative adrenal crisis.
Adrenal adenomas may co-secrete aldosterone and cortisol. A 1-mg overnight dexamethasone suppression test helps identify autonomous cortisol production before surgery and prevents postoperative adrenal crisis.
Question 82
Which finding on a thyroid nodule ultrasound carries the highest points in the ACR-TIRADS system?
A. A purely cystic (fluid-filled) composition
B. A smooth, well-defined margin
C. A nodule that is “taller-than-wide”
D. A horizontal shape that is wider than it is tall
Explanation:
A taller-than-wide shape is highly suspicious for thyroid malignancy and receives one of the highest scores in the ACR-TIRADS risk stratification system.
A taller-than-wide shape is highly suspicious for thyroid malignancy and receives one of the highest scores in the ACR-TIRADS risk stratification system.
Question 83
In treating Myxedema Coma, why are intravenous glucocorticoids administered alongside thyroid hormone?
A. To help the patient wake up faster
B. To treat potential co-existing adrenal insufficiency
C. To prevent the thyroid gland from growing larger
D. To lower the patient’s blood pressure
Explanation:
Thyroid hormone replacement can increase cortisol metabolism. If adrenal insufficiency is present, glucocorticoids help prevent an adrenal crisis.
Thyroid hormone replacement can increase cortisol metabolism. If adrenal insufficiency is present, glucocorticoids help prevent an adrenal crisis.
Question 84
What is the “AABBCC Framework” used for in diabetes management?
A. Differentiating between Type 1 and Type 2 Diabetes
B. Determining the correct dose of NPH insulin
C. Calculating the amount of carbs in a meal
D. Identifying the 8 rights of medication administration
Explanation:
The AABBCC framework (Age, Autoantibodies, BMI, C-peptide, Clinical Presentation) assists clinicians in accurately classifying diabetes types and guiding treatment.
The AABBCC framework (Age, Autoantibodies, BMI, C-peptide, Clinical Presentation) assists clinicians in accurately classifying diabetes types and guiding treatment.
Question 85
Which of the following describes “LADA” (Latent Autoimmune Diabetes of Adulthood)?
A. A form of Type 2 diabetes that occurs in children
B. Diabetes caused only by pregnancy
C. Dehydration caused by a lack of ADH
D. A slow-onset form of autoimmune Type 1 diabetes in adults
Explanation:
LADA is an autoimmune diabetes that develops gradually in adults and is frequently mistaken for Type 2 diabetes before insulin dependence develops.
LADA is an autoimmune diabetes that develops gradually in adults and is frequently mistaken for Type 2 diabetes before insulin dependence develops.
Question 86
A patient has a “TBR” (Time-Below-Range) of 5% on their CGM. What is the nurse’s clinical concern?
A. The patient is spending too much time in hyperglycemia
B. The patient’s A1C is too high
C. The patient is spending too much time in hypoglycemia
D. The patient’s insulin pump is malfunctioning
Explanation:
A TBR above the recommended target indicates excessive exposure to low blood glucose levels and increases the risk of hypoglycemia-related complications.
A TBR above the recommended target indicates excessive exposure to low blood glucose levels and increases the risk of hypoglycemia-related complications.
Question 87
Which “Level 3” hypoglycemia finding mandates immediate parenteral treatment?
A. A blood glucose of 65 mg/dL
B. Altered mental status or unconsciousness, regardless of the glucose level
C. Shaky hands and mild hunger
D. A fasting glucose of 110 mg/dL
Explanation:
Level 3 hypoglycemia is defined by severe neurological impairment requiring assistance from another person and immediate treatment with glucagon or IV glucose.
Level 3 hypoglycemia is defined by severe neurological impairment requiring assistance from another person and immediate treatment with glucagon or IV glucose.
Question 88
Why should Dexamethasone be avoided for long-term maintenance in Addison’s Disease?
A. Its long half-life makes titration difficult and increases Cushingoid risk
B. It is not strong enough to replace cortisol
C. It is only available in IV form
D. It causes the patient to lose too much sodium
Explanation:
Dexamethasone’s prolonged duration and potency increase the risk of over-replacement and Cushingoid effects, making hydrocortisone the preferred maintenance therapy.
Dexamethasone’s prolonged duration and potency increase the risk of over-replacement and Cushingoid effects, making hydrocortisone the preferred maintenance therapy.
Question 89
A patient is diagnosed with “Apathetic Thyroid Storm.” Which presentation does the nurse expect?
A. High fever (106°F) and extreme agitation
B. Excessive weight gain and moon face
C. Fruity-smelling breath and deep breathing
D. Muscle weakness and cardiovascular collapse without high fever
Explanation:
Apathetic thyroid storm often occurs in older adults and may present with weakness, lethargy, and cardiovascular collapse rather than classic hyperactive symptoms.
Apathetic thyroid storm often occurs in older adults and may present with weakness, lethargy, and cardiovascular collapse rather than classic hyperactive symptoms.
Question 90
Which medication is preferred for Hyperthyroidism during the first trimester of pregnancy?
A. Methimazole
B. Radioactive Iodine
C. Propylthiouracil (PTU)
D. Levothyroxine
Explanation:
PTU is preferred during the first trimester because it has a lower risk of severe congenital abnormalities compared with methimazole.
PTU is preferred during the first trimester because it has a lower risk of severe congenital abnormalities compared with methimazole.
Question 91
What is the clinical significance of the Wolff-Chaikoff Effect?
A. It causes permanent hypothyroidism in infants
B. It provides a temporary reduction in thyroid hormone synthesis
C. It explains why insulin causes weight gain
D. It is the cause of Graves’ disease
Explanation:
The Wolff-Chaikoff Effect is a temporary suppression of thyroid hormone production caused by high iodine levels and is useful in managing severe hyperthyroidism.
The Wolff-Chaikoff Effect is a temporary suppression of thyroid hormone production caused by high iodine levels and is useful in managing severe hyperthyroidism.
Question 92
Which diagnostic result confirms Primary Adrenal Insufficiency during an ACTH stimulation test?
A. Peak cortisol < 18 μg/dL (500 nmol/L)
B. Peak cortisol > 18 μg/dL
C. Random glucose of 200 mg/dL
D. TSH of 10 mIU/L
Explanation:
Failure to achieve an adequate cortisol rise after ACTH administration indicates adrenal insufficiency. Elevated ACTH levels support a diagnosis of primary adrenal failure.
Failure to achieve an adequate cortisol rise after ACTH administration indicates adrenal insufficiency. Elevated ACTH levels support a diagnosis of primary adrenal failure.
Question 93
What is the primary risk of using SGLT2 Inhibitors during periods of illness or fasting?
A. Massive weight gain
B. Severe hypertension
D. Euglycaemic DKA (DKA with normal/modest blood sugar)
C. Permanent kidney failure
Explanation:
SGLT2 inhibitors can precipitate diabetic ketoacidosis even when blood glucose levels are not markedly elevated, especially during illness, fasting, or surgery.
SGLT2 inhibitors can precipitate diabetic ketoacidosis even when blood glucose levels are not markedly elevated, especially during illness, fasting, or surgery.
Question 94
“Central Pontine Myelinolysis” is a danger of correcting which electrolyte too quickly?
A. Potassium
B. Calcium
C. Sodium
D. Magnesium
Explanation:
Rapid correction of hyponatremia can lead to osmotic demyelination syndrome, including central pontine myelinolysis, a potentially devastating neurological complication.
Rapid correction of hyponatremia can lead to osmotic demyelination syndrome, including central pontine myelinolysis, a potentially devastating neurological complication.
Question 95
Which condition is characterized by a “low TSH but normal T3 and T4 levels”?
A. Overt Hyperthyroidism
B. Subclinical Hyperthyroidism
C. Hashimoto’s Thyroiditis
D. Myxedema Coma
Explanation:
Subclinical hyperthyroidism is defined by a suppressed TSH level with circulating thyroid hormone concentrations remaining within the normal reference range.
Subclinical hyperthyroidism is defined by a suppressed TSH level with circulating thyroid hormone concentrations remaining within the normal reference range.
Question 96
A patient has Thyroid Eye Disease and hyperthyroidism. Which treatment is generally avoided?
A. Radioactive Iodine (RAI)
B. PTU
C. Thyroidectomy
D. Beta-blockers
Explanation:
Radioactive iodine therapy may worsen active thyroid eye disease, so alternative treatments are often preferred in these patients.
Radioactive iodine therapy may worsen active thyroid eye disease, so alternative treatments are often preferred in these patients.
Question 97
What is the significance of the FIB-4 Index in diabetes care?
A. It measures the risk of bone fractures
B. It calculates the correct dose of basal insulin
C. It measures the severity of retinopathy
D. It is used to screen for liver fibrosis in patients with MASLD/MASH
Explanation:
The FIB-4 Index is a non-invasive screening tool that helps identify patients at risk for advanced liver fibrosis and guides referral for further evaluation.
The FIB-4 Index is a non-invasive screening tool that helps identify patients at risk for advanced liver fibrosis and guides referral for further evaluation.
Question 98
Which finding indicates “Stage 2” Type 1 Diabetes?
A. Presence of a single autoantibody with normal glucose
B. Blood glucose of 400 mg/dL and fruity breath
C. Multiple islet autoantibodies with dysglycemia but no symptoms
D. Constant thirst and a random glucose of 200 mg/dL
Explanation:
Stage 2 Type 1 Diabetes is characterized by multiple pancreatic autoantibodies and abnormal glucose regulation without overt clinical symptoms.
Stage 2 Type 1 Diabetes is characterized by multiple pancreatic autoantibodies and abnormal glucose regulation without overt clinical symptoms.
Question 99
In the treatment of Myxedema Coma, why is the IV dose of Levothyroxine only 75% of the oral dose?
A. IV medication is less potent
B. It avoids the “first-pass” metabolism and is more directly bioavailable
C. The patient cannot tolerate full doses while unconscious
D. To prevent the patient from getting a headache
Explanation:
Intravenous levothyroxine bypasses gastrointestinal absorption and first-pass metabolism, making it more bioavailable than oral therapy and requiring a lower equivalent dose.
Intravenous levothyroxine bypasses gastrointestinal absorption and first-pass metabolism, making it more bioavailable than oral therapy and requiring a lower equivalent dose.
Question 100
Which is a critical precaution when administering “Inhaled Insulin” (Afrezza)?
A. It is contraindicated in patients with chronic lung disease (Asthma/COPD)
B. Only give it at bedtime
C. It must be followed by a gallon of water
D. It can only be used by Type 2 diabetics
Explanation:
Inhaled insulin carries a risk of acute bronchospasm and is contraindicated in patients with chronic lung diseases such as asthma and COPD. Pulmonary function testing is recommended before initiation.
Inhaled insulin carries a risk of acute bronchospasm and is contraindicated in patients with chronic lung diseases such as asthma and COPD. Pulmonary function testing is recommended before initiation.
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