NCLEX : Causes and Treatments of Endocrine Conditions

Study concepts, example questions & explanations for NCLEX

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Example Questions

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Example Question #12 : Endocrine Conditions

What hormone is elevated in Conn syndrome?

Possible Answers:

Aldosterone

Adrenocorticotropic hormone

Cortisol

Vasopressin

Correct answer:

Aldosterone

Explanation:

Conn syndrome (primary hyperaldosteronism) is hypertension due to elevated levels of aldosterone. High aldosterone causes excretion of potassium and retention of sodium, which leads to water retention and increase in blood pressure. While elevated levels of vasopressin (antidiuretic hormone) would also cause hypertension, Conn syndrome refers to the hypersecretion of aldosterone.

Example Question #13 : Endocrine Conditions

Which of the following genetic condition increases risk for development of diabetes?

Possible Answers:

Kleinfelter's syndrome

All of these

Down's syndrome

Turner syndrome

Correct answer:

All of these

Explanation:

All of these symptoms are associated with a higher risk of developing diabetes. Turner syndrome is also know as XO, where the individual is a female, and is monosomic for the X-chromosome. Individuals with Turner syndrome are also at higher risk of heart disease, and hypothyroidism, and they are sterile. Down's syndrome is caused by trisomy of chromosome 21, and involves elevated risks for mental impairment, heart disease, and certain cancers. Kleinfelter's syndrome patients have the XXY-chromosomal expression. They are at a higher risk than the classically male or female public for osteoporosis, hypogonadism, and cardiovascular disorders.

Example Question #14 : Endocrine Conditions

What is the most common cause of Cushing's disease?

Possible Answers:

Pituitary adenoma

Renal adenoma

Paraneoplastic syndrome

Corticosteroid use

Correct answer:

Pituitary adenoma

Explanation:

80% of cases of Cushing's disease are caused by adrenocorticotropic hormone (ACTH)-secreting adenomas of the anterior pituitary. High ACTH ends up causes adrenal hyperplasia, which leads to secretion of extra cortisol. Corticosteroid use is the leading cause of Cushing syndrome, rather than Cushing's disease.

Example Question #4 : Causes And Treatments Of Endocrine Conditions

How does insulin affect serum electrolytes? 

Possible Answers:

Insulin decreases the permeability of many cells to potassium, magnesium and phosphate ions

Insulin increases the permeability of many cells to chlorine, sodium and potassium ions

Insulin increases the permeability of many cells to potassium, magnesium and phosphate ions

Insulin has no effect on serum electrolyte levels

Correct answer:

Insulin increases the permeability of many cells to potassium, magnesium and phosphate ions

Explanation:

Insulin activates sodium-potassium ATPase in skeletal muscle cells causing an influx of potassium. Under certain circumstances, an incorrectly administered injection of insulin may kill patients due to its ability to acutely suppress plasma potassium concentrations.

Example Question #15 : Endocrine Conditions

What mediates intracellular transport of glucose into the beta cells of the pancreas? 

Possible Answers:

GLUT-2, an insulin-dependent glucose transporter

GLUT-4, an insulin-dependent glucose transporter

GLUT-2, an insulin-independent glucose transporter

GLUT-4, an insulin-independent glucose transporter

Correct answer:

GLUT-2, an insulin-independent glucose transporter

Explanation:

GLUT-2 is the primary carrier for glucose transport into pancreatic beta cells. It does not depend on insulin to function. It thus aids the pancreatic beta cells sense glucose levels in the blood, which are then triggered to release insulin. GLUT-4 is active primarily in adipose and muscle tissue. 

Example Question #16 : Endocrine Conditions

What is the triad of presenting symptoms of diabetes mellitus in adults?

Possible Answers:

Polydypsia, weight loss, and enuresis

Polyuria, weight loss, and polydypsia

Polyuria, polydypsia, and polyphagia

Weight gain, enuresis, and polydypsia

Correct answer:

Polyuria, polydypsia, and polyphagia

Explanation:

The first onset of diabetes is generally marked by the following three signs: polyuria - frequent urination, polydypsia - increased thirst & fluid intake, and polyphagia - increased appetite. In children with type 1 diabetes, enuresis (involuntary urination) is often the first sign noticed by parents, along with unexplained weight loss and recurrent infections.

Example Question #17 : Endocrine Conditions

Which of the following lifestyle exposures can lead to a thyroid disorder?

Possible Answers:

Diet high in oxalates

Smoking

Asbestos

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Correct answer:

Smoking

Explanation:

Smokers have higher levels of the chemical thiocyanate, a degradation product of cyanide in tobacco smoke, which can block iodine uptake by the thyroid. A high oxalate diet is associated with kidney stones, asbestos exposure is associated with mesothelioma, and nonsteroidal anti-inflammatory drugs (NSAIDs) use, while associated with several gastric disorders, has not been shown to have a significant effect on thyroid function. 

Example Question #18 : Endocrine Conditions

What is the most common cause of primary hyperparathyroidism?

Possible Answers:

Parathyroid carcinoma

Parathyroid hyperplasia

Parathyroid adenoma

None of these

Correct answer:

Parathyroid adenoma

Explanation:

Primary hyperparathyroidism is most commonly due to a parathyroid adenoma. 80-90% of cases of primary hyperparathyroidism are due to parathyroid adenoma. 10-15% cases are due to parathyroid hyperplasia, and parathyroid carcinoma accounts for 1-5% of all cases.

Example Question #19 : Endocrine Conditions

Secondary hyperparathyroidism is the result of chronically diminished levels of serum calcium. Depressed levels of serum calcium leads to a compensatory increase in the activity of the parathyroid glands. 

What is the most common cause of secondary hyperparathyroidism?

Possible Answers:

Bone cancers

Poor nutrition

Renal failure

Pituitary tumor

Correct answer:

Renal failure

Explanation:

Renal failure is by far the most common cause of secondary hyperparathyroidismIf kidneys are unable to convert vitamin D to its active form, serum vitamin D levels will drop. Lower vitamin D levels reduce the absorption of calcium in the intestines and reduce the kidneys' ability to resorb calcium from the urine. In addition, if the kidneys are unable to adequately excrete phosphate, calcium phosphate forms, which further lowers free calcium levels in the blood. Poor nutrition is not a common cause of secondary hyperparathyroidism, though low vitamin D levels due to malabsorption can be a contributing factor. Pituitary tumors can be seen with hyperparathyroidism when part of multiple endocrine neoplasia type I, but this is not as common as renal failure. Bone cancers are more often associated with elevated calcium levels, resulting in low or undetectable parathyroid hormone levels. 

Example Question #10 : Causes And Treatments Of Endocrine Conditions

A 50-year-old female client is seen in the clinic for her recent diagnosis of hypothyroidism. Which of the following instructions should be included in the nurse's teaching plan?

Possible Answers:

Explain the outcomes expected with removal of the thyroid gland

The use of antiglycemic medications

Obtain a hemoglobin A1C test

High protein, low carbohydrate diet and replacement hydrocortisone

High fiber, low calorie diet, and 5-6 small meals per day

Correct answer:

High fiber, low calorie diet, and 5-6 small meals per day

Explanation:

Hypothyroidism usually involves weight gain so a lower calorie diet with frequent small meals are recommended. High fiber, low calorie diets and stool softeners will help to alleviate these symptoms. Antiglycemics and hemoglobin A1C tests are indicated for diabetics.

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