Sure, chells! I've gone through your notes to find the 100-Item Comprehensive Endocrine Exam and organized it exactly how you requested: Question, MCQ choices, and then the Correct Answer with a clear rationale.
Since you're studying Health Sciences, I’ve made sure the rationales focus on the clinical and physiological "why" to help with your review.
1. Excessive GH before epiphyseal closure is: (A) Acromegaly (B) Gigantism (C) Dwarfism (D)
Correct Answer: (B) Gigantism
Rationale: Excessive growth hormone (GH) while the epiphyseal plates (growth plates) are still open causes proportional overgrowth of long bones.
2. Which feature is classic in Acromegaly? (A) Tall stature (B) Enlarged hands and feet (C) Proportional limbs (D) Hypotension
Correct Answer: (B) Enlarged hands and feet
Rationale: Acromegaly occurs in adults after growth plates have closed; therefore, bones thicken rather than lengthen, specifically affecting the hands, feet, and face.
3. The definitive sign of Diabetes Insipidus is: (A) Low urine output (B) High specific gravity (C) Polyuria (D) Weight gain
Correct Answer: (C) Polyuria
Rationale: Diabetes Insipidus (DI) is characterized by a lack of ADH, leading to the inability of the kidneys to concentrate urine, resulting in massive output (polyuria).
4. In SIADH, the nurse expects to find: (A) Dehydration (B) Dilutional hyponatremia (C) Hypernatremia (D) Low BP
Correct Answer: (B) Dilutional hyponatremia
Rationale: SIADH involves excessive ADH, causing the body to retain water. This excess water dilutes the sodium in the blood.
5. A patient with DI has a urine specific gravity of: (A) 1.030 (B) 1.005 (C) 1.015 (D) 1.025
Correct Answer: (B) 1.005
Rationale: Because the urine is extremely dilute in DI, the specific gravity will be very low (typically < 1.005).
6. Proportionate dwarfism is usually caused by: (A) Achondroplasia (B) GH deficiency (C) Thyroid failure (D) Trauma
Correct Answer: (B) GH deficiency
Rationale: A lack of growth hormone results in a person who is small in stature but has body parts that are in proportion to one another.
7. The "Master Gland" is the: (A) Thyroid (B) Adrenal (C) Pituitary (D) Pancreas
Correct Answer: (C) Pituitary
Rationale: The pituitary gland is called the master gland because it secretes hormones that control the functions of many other endocrine glands.
8. Which medication is used for DI? (A) Insulin (B) Desmopressin (C) Methimazole (D) PTU
Correct Answer: (B) Desmopressin
Rationale: Desmopressin (DDAVP) is a synthetic form of ADH used to replace the missing hormone in Diabetes Insipidus.
9. Acromegaly affects which age group primarily? (A) Children (B) Newborns (C) Adults (D) Toddlers
Correct Answer: (C) Adults
Rationale: Acromegaly is the term for GH excess in adults; if it occurs in children, it is called gigantism.
10. Irreversible dwarfism is often: (A) Proportionate (B) Disproportionate (C) Nutrient-based (D) Stress-induced
Correct Answer: (B) Disproportionate
Rationale: Disproportionate dwarfism (like Achondroplasia) is usually genetic and cannot be treated with hormone therapy, making it irreversible in terms of stature correction.
11. Pituitary surgery (Hypophysectomy) carries a risk of: (A) Hypoglycemia (B) CSF leak (C) Hypercalcemia (D) Tachycardia
Correct Answer: (B) CSF leak
Rationale: Because the pituitary is accessed through the sphenoid sinus (transsphenoidal), there is a high risk of damaging the protective layers around the brain, causing cerebrospinal fluid to leak.
12. ADH is produced in the hypothalamus but stored in the: (A) Anterior Pituitary (B) Posterior Pituitary (C) Adrenal Medulla (D) Thyroid
Correct Answer: (B) Posterior Pituitary
Rationale: The posterior pituitary does not make its own hormones; it stores and releases ADH and Oxytocin produced by the hypothalamus.
13. A patient with DI reports extreme: (A) Hunger (B) Thirst (C) Sleepiness (D) Anger
Correct Answer: (B) Thirst
Rationale: To compensate for massive fluid loss through urine, patients with DI experience polydipsia (excessive thirst).
14. Treatment for SIADH focuses on: (A) Fluid bolus (B) Fluid restriction (C) Sodium restriction (D) High sugar diet
Correct Answer: (B) Fluid restriction
Rationale: Since the primary problem is water retention, limiting fluid intake is the most common first-line treatment to prevent further dilution of sodium.
15. GH acts directly on: (A) Skin (B) Long bones and tissues (C) Heart valves (D) Brain neurons
Correct Answer: (B) Long bones and tissues
Rationale: Growth hormone stimulates the growth of virtually all tissues in the body that are capable of growing, especially bone and cartilage.
16. Exophthalmos is most common in: (A) Hypothyroidism (B) Graves' Disease (C) Myxedema (D) Conn’s Syndrome
Correct Answer: (B) Graves' Disease
Rationale: Exophthalmos (bulging eyes) is a classic sign of Graves' disease, caused by inflammation and tissue buildup behind the eyes.
17. A life-threatening complication of hyperthyroidism is: (A) Myxedema Coma (B) Thyroid Storm (C) Addisonian Crisis (D) Tetany
Correct Answer: (B) Thyroid Storm
Rationale: Thyroid storm is an extreme state of hyperthyroidism characterized by high fever, tachycardia, and altered mental status.
18. Nursing priority post-thyroidectomy: (A) Bowel sounds (B) Airway patency (C) Ambulation (D) Diet
Correct Answer: (B) Airway patency
Rationale: Swelling or bleeding (hemorrhage) in the neck area post-surgery can compress the trachea, making airway management the absolute priority.
19. Which electrolyte is affected by thyroid surgery? (A) Potassium (B) Sodium (C) Calcium (D) Magnesium
Correct Answer: (C) Calcium
Rationale: The parathyroid glands (which control calcium) are located behind the thyroid and are often accidentally damaged or removed during thyroid surgery.
20. Myxedema refers to: (A) Severe Hyperthyroidism (B) Severe Hypothyroidism (C) Adrenal failure (D) GH excess
Correct Answer: (B) Severe Hypothyroidism
Rationale: Myxedema is the term for advanced hypothyroidism, often characterized by non-pitting edema and a slowed metabolic rate.
21. Signs of "Thyroid Storm" include: (A) Bradycardia (B) High fever and tachycardia (C) Weight gain (D) Lethargy
Correct Answer: (B) High fever and tachycardia
Rationale: These are the hallmark signs of the hypermetabolic state seen in thyroid crisis.
22. Levothyroxine should be taken: (A) With dinner (B) On an empty stomach (C) Only when symptomatic (D) With milk
Correct Answer: (B) On an empty stomach
Rationale: Absorption of thyroid hormone is best when taken 30-60 minutes before breakfast to avoid interference from food or other meds.
23. PTU (Propylthiouracil) works by: (A) Replacing T4 (B) Inhibiting thyroid hormone synthesis (C) Increasing iodine (D) Destroying the gland
Correct Answer: (B) Inhibiting thyroid hormone synthesis
Rationale: PTU is an antithyroid medication that prevents the thyroid gland from creating new T3 and T4.
24. A "goiter" can be found in: (A) Only Hypo (B) Only Hyper (C) Both Hypo and Hyper (D) Neither
Correct Answer: (C) Both Hypo and Hyper
Rationale: A goiter is an enlarged thyroid gland; it can occur due to overstimulation (hyper) or as a compensatory mechanism to trap more iodine (hypo).
25. Calcitonin is produced by: (A) Parathyroid (B) Thyroid (C) Adrenal (D) Pituitary
Correct Answer: (B) Thyroid
Rationale: Specifically, the parafollicular cells (C-cells) of the thyroid gland produce calcitonin.
26. Calcitonin’s main effect is to: (A) Raise blood calcium (B) Lower blood calcium (C) Raise blood sugar (D) Lower blood sugar
Correct Answer: (B) Lower blood calcium
Rationale: Calcitonin "tones down" blood calcium by inhibiting bone breakdown and encouraging calcium storage in the bones.
27. A husky voice post-op thyroidectomy may indicate: (A) Infection (B) Nerve damage (C) Dehydration (D) Normal healing
Correct Answer: (B) Nerve damage
Rationale: Persistent hoarseness or a husky voice may indicate damage to the laryngeal nerve during surgery.
28. Patients with hyperthyroidism should have a diet: (A) Low calorie (B) High calorie/High protein (C) Low protein (D) Low carbohydrate
Correct Answer: (B) High calorie/High protein
Rationale: Because the metabolic rate is so high, patients need extra calories and protein to prevent severe weight loss and muscle wasting.
29. To assess for hypocalcemia, the nurse checks: (A) Babinski (B) Chvostek’s sign (C) Romberg (D) Brudzinski
Correct Answer: (B) Chvostek’s sign
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) indicates increased neuromuscular excitability due to low calcium.
30. Methimazole is contraindicated in: (A) Men (B) Elderly (C) Pregnancy (D) Athletes
Correct Answer: (C) Pregnancy
Rationale: Methimazole can cause fetal harm (teratogenic effects); PTU is usually preferred in the first trimester if antithyroid meds are necessary.
31. The primary cause of Graves' disease is: (A) Iodine lack (B) Autoimmune (C) Tumor (D) Infection
Correct Answer: (B) Autoimmune
Rationale: In Graves' disease, the body produces antibodies that mimic TSH and overstimulate the thyroid gland.
32. Which lab is elevated in primary hypothyroidism? (A) T3 (B) T4 (C) TSH (D) GH
Correct Answer: (C) TSH
Rationale: In primary hypothyroidism, the thyroid isn't producing T3/T4, so the pituitary sends out massive amounts of TSH to try and stimulate it.
33. Cretinism is hypothyroidism found in: (A) Infants (B) Teens (C) Elderly (D) Pregnant women
Correct Answer: (A) Infants
Rationale: Cretinism (congenital hypothyroidism) occurs from birth and can lead to severe physical and mental growth delays if untreated.
34. A complication of Myxedema is: (A) Hypertension (B) Respiratory failure (C) Excessive energy (D) Heat intolerance
Correct Answer: (B) Respiratory failure
Rationale: Myxedema coma causes severe depression of the central nervous system and metabolism, leading to hypoventilation and respiratory failure.
35. Radioactive Iodine (RAI) therapy requires: (A) Shared bathrooms (B) Distance from pregnant women (C) High iodine diet (D) Vigorous exercise
Correct Answer: (B) Distance from pregnant women
Rationale: RAI makes the patient emit radiation; they must maintain distance from others, especially vulnerable groups like pregnant women and children.
36. Post-op thyroidectomy position: (A) Flat (B) Semi-Fowler’s (C) Prone (D) Trendelenburg
Correct Answer: (B) Semi-Fowler’s
Rationale: Keeping the head of the bed elevated reduces swelling in the neck and assists with breathing.
37. The "thyroid scan" uses: (A) X-rays (B) Radioactive isotope (C) Ultrasound only (D) MRI
Correct Answer: (B) Radioactive isotope
Rationale: A thyroid scan involves swallowing or injecting radioactive iodine or technetium to see how the gland "takes up" the material.
38. Heat intolerance is a sign of: (A) Hypo (B) Hyper (C) Addison’s (D) DI
Correct Answer: (B) Hyper
Rationale: In hyperthyroidism, the body’s "internal furnace" is running too high, making the patient feel hot even in cool environments.
39. "Moon face" is NOT associated with the thyroid, but with: (A) Pituitary (B) Adrenal Cortex (C) Pancreas (D) Ovary
Correct Answer: (B) Adrenal Cortex
Rationale: Moon face is caused by excessive cortisol, which is produced by the adrenal cortex (Cushing’s).
40. Tracheostomy set should be: (A) In the pharmacy (B) At the bedside post-thyroidectomy (C) Only if requested (D) In the ER
Correct Answer: (B) At the bedside post-thyroidectomy
Rationale: Due to the risk of sudden airway obstruction from swelling or hematoma, emergency airway equipment must be immediately available.
41. PTH (Parathyroid Hormone) increases blood: (A) Sodium (B) Calcium (C) Sugar (D) Water
Correct Answer: (B) Calcium
Rationale: PTH raises blood calcium levels by pulling it from the bones, increasing absorption in the gut, and reducing loss in the kidneys.
42. Hypoparathyroidism leads to: (A) Tetany (B) Weak bones (C) Kidney stones (D) Polyuria
Correct Answer: (A) Tetany
Rationale: Low PTH leads to low calcium, which causes muscle spasms and irritability known as tetany.
43. Hyperparathyroidism increases risk of: (A) Diarrhea (B) Fractures/Stones (C) Obesity (D) Growth
Correct Answer: (B) Fractures/Stones
Rationale: High PTH pulls too much calcium out of bones (making them weak/fracture-prone) and into the blood (leading to kidney stones).
44. Trousseau’s sign is: (A) Facial twitch (B) Carpal spasm with BP cuff (C) Knee jerk (D) Pupil dilation
Correct Answer: (B) Carpal spasm with BP cuff
Rationale: Inflating a BP cuff above systolic pressure for 3 minutes causes a carpal spasm in patients with hypocalcemia.
45. The relationship between Calcium and Phosphorus is: (A) Direct (B) Inverse (C) Non-existent (D) Identical
Correct Answer: (B) Inverse
Rationale: When calcium levels go up, phosphorus levels typically go down, and vice versa.
46. Parathyroid glands are located: (A) Above the kidneys (B) Behind the thyroid (C) In the brain (D) Near the pancreas
Correct Answer: (B) Behind the thyroid
Rationale: There are usually four small parathyroid glands embedded in the posterior surface of the thyroid gland.
47. Treatment for acute hypocalcemia: (A) Oral calcium (B) IV Calcium Gluconate (C) Vitamin D only (D) Insulin
Correct Answer: (B) IV Calcium Gluconate
Rationale: Acute hypocalcemia is a medical emergency; IV calcium is required to prevent seizures and cardiac issues.
48. PTH acts on which organs? (A) Bones, Kidneys, Intestines (B) Heart, Lungs (C) Skin, Eyes (D) Muscles
Correct Answer: (A) Bones, Kidneys, Intestines
Rationale: PTH stimulates bones to release calcium, kidneys to reabsorb it, and intestines (via Vit D) to absorb more from food.
49. Hypercalcemia can cause: (A) Muscle twitching (B) Constipation and lethargy (C) Diarrhea (D) Tachycardia
Correct Answer: (B) Constipation and lethargy
Rationale: High calcium levels act as a sedative to the nervous system, slowing down GI motility and causing sluggishness.
50. Vitamin D is necessary for: (A) PTH release (B) Calcium absorption (C) Iodine uptake (D) GH production
Correct Answer: (B) Calcium absorption
Rationale: Calcium cannot be effectively absorbed from the gastrointestinal tract without the presence of active Vitamin D.
51. Cushing’s Syndrome is caused by: (A) Cortisol lack (B) Cortisol excess (C) Adrenaline excess (D) ADH lack
Correct Answer: (B) Cortisol excess
Rationale: Cushing’s is the clinical state resulting from long-term exposure to high levels of cortisol.
52. Addison’s Disease sign: (A) Weight gain (B) Moon face (C) Bronze skin (D) Hypertension
Correct Answer: (C) Bronze skin
Rationale: Low cortisol levels trigger a rise in ACTH, which also stimulates melanocytes, leading to hyperpigmentation or "bronzing."
53. Cushing’s labs often show: (A) Hyperglycemia (B) Hyponatremia (C) Hyperkalemia (D) Hypoglycemia
Correct Answer: (A) Hyperglycemia
Rationale: Cortisol is a glucocorticoid; it increases blood glucose levels by promoting gluconeogenesis.
54. Addisonian Crisis is triggered by: (A) Exercise (B) Stress/Infection (C) Sleep (D) High salt diet
Correct Answer: (B) Stress/Infection
Rationale: In Addison's, the body cannot produce the extra cortisol needed to handle stress, leading to a life-threatening collapse.
55. Aldosterone’s job is to: (A) Dump sodium (B) Save sodium and water (C) Save potassium (D) Lower BP
Correct Answer: (B) Save sodium and water
Rationale: Aldosterone acts on the kidneys to reabsorb sodium (and water follows) while excreting potassium.
56. Conn’s Syndrome is also called: (A) Hypoaldosteronism (B) Hyperaldosteronism (C) Addison's (D) Graves'
Correct Answer: (B) Hyperaldosteronism
Rationale: Conn’s is specifically the primary overproduction of aldosterone, usually by an adrenal tumor.
57. Primary symptom of Conn’s: (A) Weight loss (B) Hypertension (C) Fever (D) Hypoglycemia
Correct Answer: (B) Hypertension
Rationale: Excessive aldosterone causes massive sodium and water retention, leading to high blood pressure.
58. In Cushing’s, fat redistributes to: (A) Legs (B) Abdomen and Buffalo hump (C) Hands (D) Feet
Correct Answer: (B) Abdomen and Buffalo hump
Rationale: High cortisol levels cause fat to move from the extremities to the central body trunk and the back of the neck.
59. Long-term steroid use causes: (A) Stronger bones (B) Thinner skin and bruising (C) Better immunity (D) Weight loss
Correct Answer: (B) Thinner skin and bruising
Rationale: Steroids inhibit collagen synthesis, leading to fragile skin and easy bruising (ecchymosis).
60. Adrenal insufficiency (Addison's) leads to: (A) Hypernatremia (B) Hyponatremia and Hyperkalemia (C) Low potassium (D) High sugar
Correct Answer: (B) Hyponatremia and Hyperkalemia
Rationale: Without aldosterone, the body dumps sodium (low Na) and holds onto potassium (high K).
61. Cushing’s nursing care: (A) Increase salt (B) Skin care and infection prevention (C) High sugar diet (D) Fluid bolus
Correct Answer: (B) Skin care and infection prevention
Rationale: Steroids suppress the immune system and make skin fragile, so preventing injury and infection is critical.
62. "SSS" stands for: (A) Sugar, Salt, Sex (B) Sleep, Sit, Stand (C) Sodium, Sugar, Skin (D) Salt, Sweat, Sex
Correct Answer: (A) Sugar, Salt, Sex
Rationale: A mnemonic for the three types of adrenal cortex hormones: Glucocorticoids (Sugar), Mineralocorticoids (Salt), and Androgens (Sex).
63. Addison’s diet should be: (A) Low salt (B) High salt/High protein (C) No salt (D) Low protein
Correct Answer: (B) High salt/High protein
Rationale: Patients with Addison's lose sodium easily, so they need a high-salt diet to maintain fluid balance.
64. Steroid medications should NEVER be: (A) Taken with food (B) Stopped abruptly (C) Taken in the morning (D) Split in half
Correct Answer: (B) Stopped abruptly
Rationale: Abruptly stopping steroids can cause an Addisonian Crisis because the body’s own adrenal production has been suppressed.
65. Adrenal Cortex hormones include: (A) Epinephrine (B) Glucocorticoids, Mineralocorticoids, Androgens (C) T3/T4 (D) PTH
Correct Answer: (B) Glucocorticoids, Mineralocorticoids, Androgens
Rationale: These are the three main classes of steroid hormones produced by the layers of the adrenal cortex.
66. Cushing’s patients are at high risk for: (A) Dehydration (B) Infection (C) Low BP (D) Weight loss
Correct Answer: (B) Infection
Rationale: High cortisol levels are immunosuppressive, meaning these patients may not even show typical signs of infection like fever.
67. "Buffalo hump" refers to fat on: (A) Hips (B) Upper back (C) Thighs (D) Face
Correct Answer: (B) Upper back
Rationale: This is a classic fat redistribution pattern seen in Cushing's Syndrome.
68. In Conn’s, potassium is usually: (A) High (B) Low (C) Normal (D) Fluctuating
Correct Answer: (B) Low
Rationale: Since aldosterone makes the body dump potassium, patients with hyperaldosteronism often suffer from hypokalemia.
69. Glucocorticoids affect: (A) Metabolism and stress response (B) Water only (C) Sex traits only (D) Heart rate only
Correct Answer: (A) Metabolism and stress response
Rationale: Glucocorticoids (like cortisol) regulate glucose metabolism and are essential for the body's ability to respond to physical stress.
70. Addison’s patients have "bronze skin" because of: (A) Tanning (B) High ACTH (C) Low iron (D) Liver failure
Correct Answer: (B) High ACTH
Rationale: The lack of cortisol feedback causes the pituitary to overproduce ACTH; ACTH contains a sequence similar to MSH (melanocyte-stimulating hormone).
71. A patient with Cushing’s has "purple striae" on the: (A) Tongue (B) Abdomen (C) Fingernails (D) Eyes
Correct Answer: (B) Abdomen
Rationale: These are "stretch marks" caused by rapid weight gain and weakened skin tissue due to high cortisol.
72. Spironolactone is used in Conn’s because it: (A) Dumps sodium (B) Saves potassium (C) Increases cortisol (D) Lowers TSH
Correct Answer: (B) Saves potassium
Rationale: Spironolactone is an aldosterone antagonist; it blocks aldosterone's effects, helping the body dump salt while retaining potassium.
73. Cushing’s can be caused by: (A) Pituitary tumor (B) Adrenal tumor (C) Steroid meds (D) All of the above
Correct Answer: (D) All of the above
Rationale: Cushing’s can be ACTH-dependent (pituitary tumor), ACTH-independent (adrenal tumor), or iatrogenic (prescribed steroids).
74. The test for Addison's is: (A) TSH test (B) ACTH stimulation test (C) Water deprivation (D) Fasting glucose
Correct Answer: (B) ACTH stimulation test
Rationale: Synthetic ACTH is given; if the adrenal glands are working, cortisol should rise. If they are failing (Addison's), cortisol stays low.
75. Steroid "tapering" prevents: (A) Cushing’s (B) Adrenal Crisis (C) Weight gain (D) Insomnia
Correct Answer: (B) Adrenal Crisis
Rationale: Tapering allows the adrenal glands time to "wake up" and start producing their own cortisol again after being suppressed by meds.
76. Pheochromocytoma is a tumor of the: (A) Cortex (B) Medulla (C) Pituitary (D) Thyroid
Correct Answer: (B) Medulla
Rationale: This is a rare tumor of the adrenal medulla that causes the overproduction of catecholamines.
77. Main secretion of the Medulla: (A) Cortisol (B) Catecholamines (Epi/Norepi) (C) T4 (D) PTH
Correct Answer: (B) Catecholamines (Epi/Norepi)
Rationale: The adrenal medulla is responsible for the "fight or flight" hormones, epinephrine and norepinephrine.
78. Key sign of Pheochromocytoma: (A) Persistent hypotension (B) Episodic severe hypertension (C) Bradycardia (D) Weight gain
Correct Answer: (B) Episodic severe hypertension
Rationale: Sudden "paroxysms" of very high blood pressure are the hallmark of this condition due to bursts of adrenaline.
79. In Pheochromocytoma, avoid: (A) Eating (B) Palpating the abdomen (C) Sleeping (D) Standing
Correct Answer: (B) Palpating the abdomen
Rationale: Physical pressure on the tumor (during palpation) can trigger a massive, dangerous release of catecholamines.
80. Symptoms include "The 5 Ps": Pressure, Pain, Palpitations, Perspiration, and: (A) Pallor (B) Polyuria (C) Paresthesia (D) Ptosis
Correct Answer: (A) Pallor
Rationale: Adrenaline causes peripheral vasoconstriction, leading to pale skin (pallor) during an episode.
81. Diagnosis is often made via: (A) 24-hour urine for VMA/Metanephrines (B) Blood sugar (C) Ultrasound of the neck (D) Reflex test
Correct Answer: (A) 24-hour urine for VMA/Metanephrines
Rationale: Catecholamines break down into VMA and metanephrines; a 24-hour urine collection catches these elevated levels.
82. Definitive treatment for Pheochromocytoma: (A) Life-long meds (B) Adrenalectomy (C) Thyroidectomy (D) Radiation only
Correct Answer: (B) Adrenalectomy
Rationale: Surgical removal of the affected adrenal gland is the only way to cure the condition.
83. Pre-op for Pheochromocytoma involves: (A) Alpha-blockers (B) Beta-blockers only (C) Exercise (D) High caffeine
Correct Answer: (A) Alpha-blockers
Rationale: Alpha-blockers must be given first to control BP. If beta-blockers are given alone first, they can cause "unopposed alpha stimulation," worsening the hypertension.
84. Catecholamines trigger the: (A) Rest and digest (B) Fight or flight (C) Growth (D) Sleep cycle
Correct Answer: (B) Fight or flight
Rationale: These hormones prepare the body for immediate physical action (increased HR, BP, and glucose).
85. Pain in Pheochromocytoma is usually a: (A) Foot ache (B) Severe headache (C) Back pain (D) Joint pain
Correct Answer: (B) Severe headache
Rationale: The massive spikes in blood pressure cause severe, pounding headaches.
86. Agranulocytosis is a side effect of: (A) Steroids (B) Methimazole (C) Levothyroxine (D) Insulin
Correct Answer: (B) Methimazole
Rationale: Antithyroid drugs can cause a dangerous drop in white blood cells (agranulocytosis), making patients susceptible to infection.
87. First action for Addisonian Crisis: (A) Oral sugar (B) IV Fluids and Hydrocortisone (C) Bed rest only (D) Ice pack
Correct Answer: (B) IV Fluids and Hydrocortisone
Rationale: The patient is in shock; they need immediate volume expansion and hormone replacement to survive.
88. Patient on steroids should watch for: (A) Low sugar (B) Hyperglycemia (C) Weight loss (D) Brittle hair
Correct Answer: (B) Hyperglycemia
Rationale: Steroids increase glucose production; diabetic patients often need more insulin while taking steroids.
89. In Thyroid Storm, do NOT give: (A) PTU (B) Aspirin (C) Fluids (D) Oxygen
Correct Answer: (B) Aspirin
Rationale: Aspirin can displace thyroid hormone from its binding proteins, potentially increasing the levels of "free" active hormone and worsening the storm.
90. Desmopressin (DDAVP) is used for: (A) Graves' (B) DI (C) Conn’s (D) Cushing’s
Correct Answer: (B) DI
Rationale: It is the primary replacement therapy for central Diabetes Insipidus.
91. Calcium Gluconate is the antidote for: (A) High potassium (B) Magnesium toxicity/Hypocalcemia (C) High sodium (D) Steroid overdose
Correct Answer: (B) Magnesium toxicity/Hypocalcemia
Rationale: Calcium antagonizes the effects of magnesium on the heart and is the replacement for low calcium levels.
92. Florinef (Fludrocortisone) replaces: (A) Cortisol (B) Aldosterone (C) T3 (D) GH
Correct Answer: (B) Aldosterone
Rationale: Florinef is a mineralocorticoid used to treat Addison’s by helping the body retain sodium and water.
93. A "Struma" is another word for: (A) Tumor (B) Goiter (C) Hormone (D) Gland
Correct Answer: (B) Goiter
Rationale: Struma is the medical term for any enlargement of the thyroid gland.
94. VMA test (24h urine) requires avoiding: (A) Water (B) Vanilla, chocolate, coffee (C) Meat (D) Bread
Correct Answer: (B) Vanilla, chocolate, coffee
Rationale: These foods can cause false elevations in the test results for catecholamine metabolites.
95. Syndrome of "Too Much ADH" is: (A) DI (B) SIADH (C) Conn’s (D) Cushing’s
Correct Answer: (B) SIADH
Rationale: SIADH stands for Syndrome of Inappropriate Antidiuretic Hormone, characterized by excessive water retention.
96. If a post-thyroidectomy patient develops a positive Trousseau’s sign, the nurse should anticipate administering: (A) IV Potassium Chloride (B) IV Calcium Gluconate (C) Oral Levothyroxine (D) Subcutaneous Insulin
Correct Answer: (B) IV Calcium Gluconate
Rationale: Trousseau’s sign indicates hypocalcemia. IV Calcium Gluconate is the emergency treatment to prevent tetany or seizures.
97. Following a total bilateral adrenalectomy, the patient will require which of the following for the rest of their life? (A) Potassium supplements (B) Hormone replacement therapy (C) Low-protein diet (D) Daily radiation therapy
Correct Answer: (B) Hormone replacement therapy
Rationale: Removing both glands removes the body's source of cortisol and aldosterone, requiring lifelong replacement.
98. Central obesity, "buffalo hump," and thin, bruised skin are clinical markers for which endocrine disorder? (A) Hyperthyroidism (B) Hypothyroidism (C) Cushing’s Syndrome (D) Diabetes Insipidus
Correct Answer: (C) Cushing’s Syndrome
Rationale: These are the classic "Cushingoid" features caused by excessive cortisol levels.
99. A patient in Myxedema Coma is extremely hypothermic. Warming should be done: (A) Rapidly with a heating lamp (B) Slowly to prevent shock (C) Not at all (D) Only by increasing room temp to 90 degrees
Correct Answer: (B) Slowly to prevent shock
Rationale: Rapid warming can cause sudden vasodilation, leading to a drop in blood pressure and circulatory collapse (shock).
100. Endocrine glands differ from exocrine glands because they: (A) Use ducts (B) Secrete directly into the bloodstream (C) Only function during puberty (D) Are located only in the brain
Correct Answer: (B) Secrete directly into the bloodstream
Rationale: Endocrine glands are ductless; they release hormones directly into the blood to travel to target organs.
This comprehensive list was compiled based on your notes Saved assistant message 2026-02-19 18:27 and the detailed rationales in Saved assistant message 2026-02-19 18:32.
Good luck with your studying, chells! You've got this! đź©şđź“–