A diabetic patient is drowsy, sweaty and cannot swallow safely. Capillary glucose is 2.4 mmol/L (43 mg/dL). The priority action is to:

Give IV dextrose as prescribed and recheck glucose

Give orange juice by mouth slowly

Give the scheduled insulin dose now

Wait 30 minutes and then recheck it

Gastrointestinal, renal and endocrine nursing

70 Staff nurse recruitment practice questions on Gastrointestinal, renal and endocrine nursing, part of Medical-Surgical Nursing. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Hard
Soluble insulin 50 units made up to 50 mL saline runs by syringe pump at 6 mL/hour. What hourly dose is given?
1. A12 units/hour
2. B6 units/hour
3. C3 units/hour
4. D0.6 units/hour
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Answer: B · 6 units/hour
The concentration is 50 units / 50 mL = 1 unit per mL. At 6 mL/hour the dose is 6 units/hour. Checking concentration first avoids tenfold errors. Hourly glucose checks guide changes.
- A: 12 units/hour would need 2 units/mL.
- C: 3 units/hour would need 0.5 unit/mL.
- D: 0.6 units/hour is a tenfold decimal error.
Question 2 · Hard
A diabetic patient is drowsy, sweaty and cannot swallow safely. Capillary glucose is 2.4 mmol/L (43 mg/dL). The priority action is to:
1. AGive IV dextrose as prescribed and recheck glucose
2. BGive orange juice by mouth slowly
3. CGive the scheduled insulin dose now
4. DWait 30 minutes and then recheck it
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Answer: A · Give IV dextrose as prescribed and recheck glucose
An unsafe swallow rules out oral sugar because of aspiration risk. IV dextrose, often 10% or 20%, or IM glucagon if no access, raises glucose fast. Recheck after 10-15 minutes. Give a longer-acting carbohydrate once alert.
- B: Oral fluids risk aspiration in a drowsy patient.
- C: Insulin worsens hypoglycaemia.
- D: Waiting risks seizures and brain injury.
Question 3 · Easy
Where should the nurse hang a catheterised patient's collection bag?
1. AOn the floor
2. BBelow the level of the bladder
3. COn the bed beside the patient
4. DAt the level of the chest
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Answer: B · Below the level of the bladder
The bag is kept below bladder level so urine drains by gravity and does not flow back. It must not touch the floor, which contaminates the outlet. The closed system is not broken unnecessarily. These steps lower catheter-associated urinary tract infection.
- A: The floor contaminates the drainage tap.
- C: On the bed it may sit level with the bladder and reflux.
- D: Chest level allows backflow into the bladder.
Question 4 · Easy
Contaminated drinking water in a monsoon outbreak most often carries which hepatitis virus?
1. AHepatitis C
2. BHepatitis D (delta)
3. CHepatitis A
4. DHepatitis B
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Answer: C · Hepatitis A
Hepatitis A, like hepatitis E, spreads through contaminated food and water. It causes an acute illness without a chronic carrier state. Hand hygiene and safe water prevent it, and a vaccine is available. Hepatitis B, C and D spread through blood and body fluids.
- A: Hepatitis C spreads mainly by blood, such as shared needles.
- B: Hepatitis D needs hepatitis B and spreads by blood.
- D: Hepatitis B spreads by blood, sex and from mother to baby.
Question 5 · Medium
Which hepatitis B marker shows the patient is currently infected?
1. AAnti-HBs
2. BHBsAg
3. CAnti-HBs after vaccination
4. DAnti-HAV IgG
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Answer: B · HBsAg
HBsAg, the surface antigen, is present in acute and chronic infection. Its persistence beyond six months means chronic hepatitis B. Anti-HBs means immunity from vaccine or recovery. Anti-HAV IgG shows past hepatitis A.
- A: Anti-HBs indicates immunity, not current infection.
- C: Post-vaccination anti-HBs shows protection, not infection.
- D: Anti-HAV IgG relates to hepatitis A.
Question 6 · Easy
The diet usually advised for a patient with ascites due to cirrhosis is:
1. ALow in salt
2. BHigh in salt
3. CVery high in fluid
4. DFree of all protein
Answer and explanation in LearnFree account
Question 7 · Easy
A normal finding over a working arteriovenous fistula is:
1. AA palpable thrill
2. BCold pale fingers
3. CNo sound on auscultation
4. DAbsent pulse
Answer and explanation in LearnFree account
Question 8 · Hard
A patient with cirrhosis becomes confused after an episode of GI bleeding. The bleeding most likely worsened encephalopathy by:
1. ARaising serum albumin and oncotic pressure
2. BIncreasing protein load in the gut and ammonia production
3. CLowering blood ammonia levels sharply
4. DImproving blood flow through the liver
Answer and explanation in LearnFree account
Question 9 · Hard
A patient with a catheter for five days develops fever 38.6 C, cloudy foul urine and suprapubic pain. Besides informing the doctor, the nurse should:
1. AStart a bladder washout
2. BTake urine from the drainage bag
3. CSend a urine sample from the sampling port before antibiotics
4. DDisconnect the catheter to collect urine
Answer and explanation in LearnFree account
Question 10 · Medium
A cirrhotic patient has a prolonged prothrombin time. Which nursing precaution follows?
1. AGive intramuscular injections freely
2. BUse a straight razor
3. CEncourage vigorous nose blowing
4. DUse a soft toothbrush and apply pressure after injections
Answer and explanation in LearnFree account
Question 11 · Hard
A patient after thyroidectomy has temperature 40.1 C, pulse 150/min, agitation and vomiting. The nurse suspects:
1. AThyroid storm
2. BSimple wound infection
3. CMyxoedema coma
4. DHypocalcaemic tetany
Answer and explanation in LearnFree account
Question 12 · Medium
Before inserting a urinary catheter, the step that most reduces infection risk is:
1. AClamping the catheter for training
2. BRoutine bladder washouts
3. CStrict aseptic technique and a closed system
4. DUsing the largest catheter size
Answer and explanation in LearnFree account
Question 13 · Medium
A patient admitted with appendicitis says the pain has suddenly gone, but now has fever and a rigid abdomen. The nurse should suspect:
1. AResolution of appendicitis
2. BConstipation
3. CRupture with peritonitis
4. DUrinary tract infection
Answer and explanation in LearnFree account
Question 14 · Medium
A catheterised patient's urine output has dropped to nil for two hours, with a full, tender bladder. The first action is to:
1. ARemove the catheter immediately
2. BCheck the tubing for kinks or blockage
3. CGive a diuretic
4. DIncrease IV fluid rate
Answer and explanation in LearnFree account
Question 15 · Hard
A patient has an ileostomy with output of 2 litres a day, dry tongue and low urine output. The priority nursing concern is:
1. AStoma prolapse
2. BConstipation
3. CFluid and electrolyte deficit
4. DBody image only
Answer and explanation in LearnFree account
Question 16 · Hard
A CKD patient has: K+ 6.9 mmol/L, peaked T waves, pH 7.28. Which order should the nurse give first?
1. AIV calcium gluconate
2. BFurosemide orally
3. COral sodium polystyrene resin
4. DLow-potassium diet
Answer and explanation in LearnFree account
Question 17 · Medium
A patient with type 1 diabetes on insulin skips lunch. What is the patient most at risk of?
1. AHyperosmolar state
2. BDiabetic ketoacidosis
3. CHypoglycaemia
4. DThyroid storm
Answer and explanation in LearnFree account
Question 18 · Medium
A patient started on carbimazole develops sore throat and fever. The nurse should:
1. AWithhold the drug and report for a blood count
2. BGive paracetamol and continue
3. CAdvise warm salt gargles only
4. DDouble the dose
Answer and explanation in LearnFree account
Question 19 · Medium
In the oliguric phase of acute kidney injury, daily fluid intake is usually limited to:
1. AUnlimited oral fluids as desired
2. BA fixed three litres every day
3. CPrevious day's output plus about 500 mL
4. DNil fluids by any route for a week
Answer and explanation in LearnFree account
Question 20 · Easy
Normal fasting plasma glucose in adults is below:
1. A7.8 mmol/L (140 mg/dL)
2. B5.6 mmol/L (100 mg/dL)
3. C3.9 mmol/L (70 mg/dL)
4. D11.1 mmol/L (200 mg/dL)
Answer and explanation in LearnFree account
Question 21 · Medium
A diabetic patient plans to fast during Ramadan. The nurse's best advice is to:
1. AKeep fasting even if glucose falls below 3.9 mmol/L
2. BStop all diabetes drugs during the month
3. CDiscuss dose timing changes with the doctor before Ramadan
4. DTake the full morning dose before dawn and skip checks
Answer and explanation in LearnFree account
Question 22 · Medium
Just before a doctor taps ascitic fluid from the abdomen, which request does the nurse make of the patient?
1. ADrink a litre of water
2. BLie prone
3. CTake a laxative
4. DEmpty the bladder
Answer and explanation in LearnFree account
Question 23 · Medium
Which laboratory pattern is typical of primary hypothyroidism?
1. AHigh TSH, low free T4
2. BNormal TSH, high free T3
3. CLow TSH, high free T4
4. DLow TSH, low free T4
Answer and explanation in LearnFree account
Question 24 · Medium
A nurse sustains a needle-stick injury from an HBsAg-positive patient. The first action is to:
1. AApply bleach to the skin
2. BSqueeze and suck the wound
3. CWait for the result of own tests
4. DWash the site with soap and water
Answer and explanation in LearnFree account
Question 25 · Medium
A patient with cirrhosis vomits bright red blood. Which history makes oesophageal varices the most likely cause?
1. ALong-term levothyroxine use
2. BKnown portal hypertension
3. CRecent appendicectomy
4. DRecent urinary catheter
Answer and explanation in LearnFree account

45 more Gastrointestinal, renal and endocrine nursing questions

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Gastrointestinal, renal and endocrine nursing

Soluble insulin 50 units made up to 50 mL saline runs by syringe pump at 6 mL/hour. What hourly dose is given?

A diabetic patient is drowsy, sweaty and cannot swallow safely. Capillary glucose is 2.4 mmol/L (43 mg/dL). The priority action is to:

Where should the nurse hang a catheterised patient's collection bag?

Contaminated drinking water in a monsoon outbreak most often carries which hepatitis virus?

Which hepatitis B marker shows the patient is currently infected?

The diet usually advised for a patient with ascites due to cirrhosis is:

A normal finding over a working arteriovenous fistula is:

A patient with cirrhosis becomes confused after an episode of GI bleeding. The bleeding most likely worsened encephalopathy by:

A patient with a catheter for five days develops fever 38.6 C, cloudy foul urine and suprapubic pain. Besides informing the doctor, the nurse should:

A cirrhotic patient has a prolonged prothrombin time. Which nursing precaution follows?

A patient after thyroidectomy has temperature 40.1 C, pulse 150/min, agitation and vomiting. The nurse suspects:

Before inserting a urinary catheter, the step that most reduces infection risk is:

A patient admitted with appendicitis says the pain has suddenly gone, but now has fever and a rigid abdomen. The nurse should suspect:

A catheterised patient's urine output has dropped to nil for two hours, with a full, tender bladder. The first action is to:

A patient has an ileostomy with output of 2 litres a day, dry tongue and low urine output. The priority nursing concern is:

A CKD patient has: K+ 6.9 mmol/L, peaked T waves, pH 7.28. Which order should the nurse give first?

A patient with type 1 diabetes on insulin skips lunch. What is the patient most at risk of?

A patient started on carbimazole develops sore throat and fever. The nurse should:

In the oliguric phase of acute kidney injury, daily fluid intake is usually limited to:

Normal fasting plasma glucose in adults is below:

A diabetic patient plans to fast during Ramadan. The nurse's best advice is to:

Just before a doctor taps ascitic fluid from the abdomen, which request does the nurse make of the patient?

Which laboratory pattern is typical of primary hypothyroidism?

A nurse sustains a needle-stick injury from an HBsAg-positive patient. The first action is to:

A patient with cirrhosis vomits bright red blood. Which history makes oesophageal varices the most likely cause?