NCLEX-RN Med-Surg — Endocrine & Renal flashcards
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DKA vs HHS, hypoglycemia, insulin and sick-day teaching, thyroid and adrenal disorders, thyroidectomy care, AKI and CKD, dialysis access, UTI, kidney stones and TURP bladder irrigation for the NCLEX-RN.
Learn deck · part of NCLEX-RN · written against: NCSBN 2026 NCLEX-RN Test Plan, in effect from 1 April 2026 (Next Generation NCLEX; client-needs categories and percentages unchanged from 2023, fact-checked 2026-10-11). Updated 2026-10-10.
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How does the nurse tell diabetic ketoacidosis (DKA) from hyperosmolar hyperglycemic state (HHS) at the bedside?DKA is usually type 1, develops over hours to a day, and brings ketones, metabolic acidosis, and Kussmaul respirations with fruity breath. HHS is usually type 2 in older adults, develops over days, and brings a far higher glucose and severe dehydration with little or no ketosis or acidosis.Diabetes Emergencies
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Why does the nurse teach clients to rotate insulin injection sites within one body area?Repeated injections into the same spot cause lipohypertrophy — fatty lumps that absorb insulin unpredictably. Rotating within one region, such as around the abdomen, keeps absorption consistent while sparing each exact site.Diabetes Self-Care
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Which findings point to hypothyroidism?Everything slows down: fatigue, cold intolerance, weight gain, constipation, dry skin, brittle hair, bradycardia, and slowed thinking. Long-standing disease causes facial and periorbital puffiness (myxedema).Thyroid
Watch out: in older adults hypothyroidism is easily mistaken for depression or dementia. -
What signs suggest Addison's disease?Fatigue, weight loss, hypotension, salt craving, bronze hyperpigmentation of the skin, hyponatremia, hyperkalemia, and hypoglycemia — all from low cortisol and aldosterone.Adrenal
Watch out: Addison's is the mirror of Cushing's: low sodium, high potassium, and low glucose instead of the reverse. -
A client after transsphenoidal pituitary surgery reports clear fluid dripping from the nose. What does the nurse do?Suspect a cerebrospinal fluid leak: report it, keep the head of the bed elevated, and collect the drainage for testing as ordered (CSF screens positive for glucose; beta-2 transferrin confirms it).Pituitary
Watch out: Teach the client not to blow the nose, cough hard, or bend at the waist. -
What are the three categories of acute kidney injury by cause, with an example of each?Acute Kidney Injury
- Prerenal — reduced blood flow to the kidneys (hypovolemia, heart failure, shock);
- Intrarenal — damage to the kidney tissue itself (nephrotoxic drugs, contrast dye, prolonged ischemia);
- Postrenal — blocked urine outflow (enlarged prostate, stones).
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Which dietary restrictions are usually taught to a client with chronic kidney disease who is not yet on dialysis?Limit sodium, limit potassium and phosphorus when their blood levels run high, restrict fluid if the client is retaining it, and keep protein moderate as prescribed to reduce the waste load on the kidneys.Chronic Kidney Disease
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What does the nurse assess at a hemodialysis arteriovenous fistula, and what is normal?Palpate for a thrill (a buzzing vibration) and auscultate for a bruit (a whooshing sound); both show blood flowing through the access. If either is absent, the access may have clotted, and the nurse reports it immediately.Dialysis
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What teaching helps a woman prevent recurrent urinary tract infections?Drink adequate fluids, void regularly and soon after intercourse, wipe front to back, and avoid irritants such as douches and scented products. Finish the full antibiotic course even when symptoms clear.Urinary Tract
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Which symptoms suggest benign prostatic hyperplasia?Obstructive urinary symptoms: hesitancy, a weak stream, dribbling, straining, a feeling of incomplete emptying, and nocturia. Severe enlargement can cause acute urinary retention.BPH & TURP
Watch out: over-the-counter decongestants and antihistamines can tip an enlarged prostate into acute urinary retention.
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About these cards
Review status: Second-reader reviewed, with corrections applied.
Checked against:
- Checked against Open RN Health Alterations and Open RN Nursing Pharmacology, 2e (Chippewa Valley Technical College, CC BY 4.0) and MedlinePlus (U.S. National Library of Medicine); reference only, no text copied.
- OpenStax Anatomy and Physiology 2e, consulted as a reference; no text copied.
- Diabetes emergency and sick-day principles cross-checked against American Diabetes Association patient guidance; kidney diet teaching against NIDDK (public domain); reference only.
- Complication screening and hypoglycemia unawareness checked against the current ADA Standards of Care in Diabetes; CAUTI prevention against CDC/HICPAC guidance (public domain); transplant and peritoneal dialysis teaching against NIDDK (public domain); reference only, no text copied.
- Kidney diet potassium teaching checked against the KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of CKD; reference only, no text copied.
- Contrast-associated kidney injury checked against the 2020 ACR–NKF consensus statements on intravenous iodinated contrast in kidney disease; erythropoiesis-stimulating agent safety against the FDA epoetin alfa prescribing information; propylthiouracil liver warning against the FDA label and 2010 Drug Safety Communication; reference only, no text copied.
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