Free Endocrine and Diabetes Nursing MCQs with Answers

• A. Intravenous isotonic fluid replacement
• B. Subcutaneous long-acting insulin
• C. Oral potassium replacement
• D. Intravenous sodium bicarbonate routinely

Explanation: Circulatory support is the immediate priority because severe dehydration causes hypovolaemia and shock in diabetic ketoacidosis.

• A. Give 15 g of rapid-acting carbohydrate
• B. Give the usual dose of rapid-acting insulin
• C. Provide a meal high in fat and protein
• D. Ask the patient to rest and recheck later

Explanation: A conscious patient who can swallow should receive about 15 g of rapidly absorbed carbohydrate, followed by a glucose recheck after about…

• A. Draw cloudy insulin before clear insulin
• B. Draw clear insulin before cloudy insulin
• C. Shake both insulin vials vigorously first
• D. Mix glargine with NPH in the same syringe

Explanation: Regular insulin is clear and NPH insulin is cloudy, so clear insulin is drawn up before cloudy insulin.

• A. Marked hyperglycaemia with little or no ketosis
• B. Abdominal pain with deep rapid respirations
• C. Positive serum ketones with metabolic acidosis
• D. A fruity odour on the patient's breath

Explanation: Hyperosmolar hyperglycaemic state usually causes extreme hyperglycaemia, profound dehydration and altered mental status with minimal…

• A. Walk barefoot indoors to strengthen the feet
• B. Inspect the feet every day using a mirror if needed
• C. Soak the feet in hot water before applying lotion
• D. Cut the nails deeply into the corners each week

Explanation: Daily inspection helps the patient identify blisters, cuts and infection before they become serious ulcers.

• A. Stop basal insulin until food intake returns
• B. Check glucose and ketones more often than usual
• C. Drink only sugar-free fluids regardless of glucose level
• D. Exercise to lower the blood glucose level

Explanation: Illness can increase counter-regulatory hormones and insulin requirements, even when the patient is eating less.

• A. Progressive autoimmune destruction of pancreatic beta cells
• B. Peripheral insulin resistance with gradual beta-cell failure
• C. Excess cortisol causing persistent insulin resistance
• D. Reduced thyroid hormone causing slow glucose absorption

Explanation: Type 1 diabetes results from destruction of pancreatic beta cells, causing little or no endogenous insulin production.

• A. Place the patient in a cool environment and assess vital signs frequently
• B. Encourage vigorous exercise to reduce nervous energy
• C. Offer a high-fibre meal before completing the assessment
• D. Apply extra blankets to prevent heat loss

Explanation: Fever, severe tachycardia and confusion may indicate thyroid storm, a life-threatening emergency.

• A. Intravenous hydrocortisone with isotonic fluid replacement
• B. Fluid restriction with a low-sodium diet
• C. Insulin infusion with potassium restriction
• D. Levothyroxine with oral calcium supplements

Explanation: These findings suggest an adrenal crisis caused by inadequate cortisol and aldosterone, with shock risk from hypovolaemia.

• A. Restrict oral fluids to prevent worsening polyuria
• B. Administer prescribed desmopressin and monitor fluid balance
• C. Give rapid-acting insulin and check urine ketones
• D. Provide a low-protein diet and limit sodium strictly

Explanation: Diabetes insipidus results from inadequate antidiuretic hormone effect, causing excessive loss of dilute water.

• A. Inject it 30 minutes before eating
• B. Inject it immediately before eating
• C. Inject it two hours after eating
• D. Inject it only at bedtime

Explanation: Insulin lispro is rapid acting and is usually given immediately before a meal so its action matches the rise in blood glucose.

• A. Absolute lack of insulin from pancreatic destruction
• B. Insulin resistance with gradual beta-cell dysfunction
• C. Autoimmune destruction beginning in childhood
• D. Permanent dependence on insulin from diagnosis

Explanation: Type 2 diabetes usually begins with insulin resistance and later includes reduced beta-cell insulin production.

• A. Continue insulin and restrict potassium intake
• B. Stop all fluids and encourage oral water
• C. Notify the provider and anticipate potassium replacement
• D. Give sodium bicarbonate before checking the ECG

Explanation: Insulin moves potassium into cells and can cause dangerous hypokalaemia during DKA treatment.

• A. Intravenous isotonic fluid replacement
• B. Oral rapid-acting carbohydrate
• C. Subcutaneous long-acting insulin only
• D. Fluid restriction to prevent cerebral oedema

Explanation: Severe dehydration and reduced circulating volume are major problems in hyperosmolar hyperglycaemic state, so isotonic intravenous fluid…

• A. Heat intolerance and frequent diarrhoea
• B. Weight loss and marked exophthalmos
• C. Cold intolerance and slowed heart rate
• D. Tremor and increased bowel movements

Explanation: Reduced thyroid hormone slows metabolic activity and commonly causes cold intolerance, weight gain, fatigue and bradycardia.

• A. Observe for signs of infection
• B. Encourage a high-sodium diet
• C. Measure for increased skin pigmentation
• D. Assess for excessive thyroid hormone activity

Explanation: Excess corticosteroid activity suppresses immune responses, so infection may develop with few obvious inflammatory signs.

• A. Encourage several litres of oral water daily
• B. Restrict fluids and monitor neurological status
• C. Administer hypotonic intravenous fluid rapidly
• D. Offer unrestricted fluids with a low-salt diet

Explanation: Excess antidiuretic hormone causes water retention and dilutional hyponatraemia, so fluid restriction and neurological assessment are…

• A. Give glucose tablets by mouth
• B. Administer prescribed intravenous dextrose
• C. Offer a glass of fruit juice
• D. Place food inside the patient's mouth

Explanation: An unconscious patient cannot safely swallow, so oral food or drink can cause aspiration.

• A. A fasting capillary glucose result
• B. A urine ketone result
• C. A glycated haemoglobin result
• D. A glucose result taken after exercise

Explanation: Glycated haemoglobin reflects the proportion of haemoglobin exposed to glucose over the life of the red blood cell, providing an estimate…

• A. I will use the same spot for every injection
• B. I will rotate sites within the same body area
• C. I will massage the area after each injection
• D. I will inject through clothing to reduce discomfort

Explanation: Rotating sites within an anatomical area helps maintain predictable absorption and reduces lipohypertrophy.