Endocrine Tumors Practice Questions
20 free Endocrine Tumors practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
Which tumour is most likely to present with episodes of headache, sweating, and palpitations along with persistent hypertension?
- A Thyroid follicular carcinoma
- B Pheochromocytoma
- C Papillary thyroid carcinoma
- D Medullary thyroid carcinoma
Correct answer: Pheochromocytoma
Pheochromocytoma is a tumour of the adrenal medulla secreting excess catecholamines leading to episodic headache, diaphoresis, tachycardia/palpitations, and hypertension.
Which diagnostic test is most definitive for a suspected pheochromocytoma?
- A Serum thyroid-stimulating hormone level
- B 24-hour urinary metanephrines and catecholamines
- C Fine-needle aspiration biopsy of the adrenal gland
- D Radioactive iodine uptake scan of the gland
Correct answer: 24-hour urinary metanephrines and catecholamines
Elevated 24-hour urinary metanephrines and catecholamines are the standard biochemical confirmation of pheochromocytoma, prior to imaging.
Why must an alpha-adrenergic blockade be given before a beta-blocker in pheochromocytoma management?
- A To prevent reflex tachycardia from the blockade
- B Beta blockade alone leaves unopposed alpha vasoconstriction
- C Because alpha-adrenergic receptors are not involved
- D Because beta-blockade alone will cure the tumour
Correct answer: Beta blockade alone leaves unopposed alpha vasoconstriction
If a beta-blocker is given before alpha blockade, unopposed alpha-adrenergic stimulation may lead to extreme vasoconstriction and hypertensive crisis in pheochromocytoma.
What should the nurse anticipate following a total thyroidectomy for differentiated thyroid cancer?
- A No need for hormone replacement afterwards
- B Lifelong thyroid hormone replacement
- C Only short-term monitoring of thyroid function
- D Thyroid hormone therapy is optional
Correct answer: Lifelong thyroid hormone replacement
Following total thyroidectomy, patients lose thyroid hormone production and therefore require lifelong thyroid hormone replacement to maintain metabolism and prevent hypothyroidism.
Which syndrome should the nurse consider screening for in a patient preparing for surgery for medullary thyroid carcinoma?
- A Cushing’s syndrome
- B Multiple endocrine neoplasia type 2 (MEN2)
- C Addison’s disease
- D Type 2 diabetes mellitus
Correct answer: Multiple endocrine neoplasia type 2 (MEN2)
Medullary thyroid carcinoma is associated with MEN2 (multiple endocrine neoplasia type 2), which includes pheochromocytoma; screening for pheochromocytoma is critical pre-surgery.
What does new-onset hoarseness of voice in a patient with suspected thyroid cancer most likely suggest?
- A Benign thyroid nodule only
- B Involvement of the recurrent laryngeal nerve
- C Only vocal strain
- D Hypothyroidism
Correct answer: Involvement of the recurrent laryngeal nerve
Hoarseness in thyroid cancer suggests possible invasion of the recurrent laryngeal nerve, a sign of more advanced disease requiring prompt evaluation.
What is the most common subtype of thyroid cancer?
- A Abdominal palpation or manipulation of the tumour
- B Drinking an ordinary glass of plain water
- C Walking gently for routine daily exercise
- D Eating a recommended low-tyramine diet
Correct answer: Abdominal palpation or manipulation of the tumour
Papillary thyroid carcinoma accounts for ~80% of thyroid malignancies, making it the most common subtype.
Which trigger might precipitate a hypertensive crisis in a patient with pheochromocytoma?
- A Inadequate post-operative analgesia control
- B Loss of catecholamine excess causing vasodilation and low glucose
- C Accidental overdose of administered insulin
- D Onset of an unrecognized thyroid storm
Correct answer: Loss of catecholamine excess causing vasodilation and low glucose
Manipulation of the tumour or adrenal gland may release massive catecholamines, causing hypertensive crisis in pheochromocytoma.
What is the most likely cause of hypotension and hypoglycemia post-operatively in a patient after surgery for pheochromocytoma?
- A Avoid all contact with other people for only 2 hours
- B Limit close contact, sleep alone, and avoid pregnant women and children for a few days
- C No special radiation precautions are necessary
- D Take high-dose iodine supplements every day
Correct answer: Limit close contact, sleep alone, and avoid pregnant women and children for a few days
Removal of excessive catecholamine secretion removes the vasoconstrictive and hyperglycaemic effect; resulting vasodilation and withdrawal of hyperglycemia may cause hypotension and hypoglycemia post-operatively.
What is the most appropriate instruction for a patient who had radioactive iodine therapy for thyroid cancer?
- A No special pre-operative preparation is required
- B Teach neck support and watch for post-op hypocalcemia
- C Teach the patient to follow a high-sodium diet only
- D Instruct the patient to stop all medications permanently
Correct answer: Teach neck support and watch for post-op hypocalcemia
After thyroidectomy the parathyroid glands may be injured, causing hypocalcemia; teaching neck support and the signs of hypocalcemia (tingling, numbness, muscle cramps) is essential pre-operatively.
Which laboratory finding is most likely to be elevated in a patient with pheochromocytoma?
- A Serum thyroid-stimulating hormone (TSH)
- B Plasma free metanephrine concentration
- C Serum calcitonin from the thyroid
- D Urinary iodine excretion level
Correct answer: Plasma free metanephrine concentration
Pheochromocytoma secretes catecholamines which are metabolized to metanephrines; elevated plasma free metanephrine is a key diagnostic marker.
What pre-operative nursing action is especially important for a patient scheduled for thyroidectomy due to thyroid cancer?
- A Painful diffuse swelling of the thyroid gland
- B Rapid nodule growth, hoarseness, and node spread
- C Gradual weight gain with persistent fatigue
- D Heat intolerance with excessive sweating
Correct answer: Rapid nodule growth, hoarseness, and node spread
After thyroidectomy, the parathyroid glands may be damaged, causing hypocalcemia; teaching about signs (tingling, numbness, muscle cramps) and neck support is essential.
Which symptom is characteristic of thyroid cancer rather than benign thyroid disease?
- A Painful thyroid swelling
- B Rapid growth of nodule, hoarseness, lymph node metastasis
- C Weight gain and fatigue
- D Heat intolerance
Correct answer: Rapid growth of nodule, hoarseness, lymph node metastasis
Features such as rapid nodule growth, hoarseness (nerve involvement), and enlarged cervical nodes are more suggestive of thyroid malignancy rather than benign nodules.
What vital sign change is most likely before tumour removal in a patient with pheochromocytoma?
- A Sustained bradycardia with steady hypotension
- B Episodic hypertension with tachycardia
- C Persistently normal blood pressure throughout
- D Constant low blood pressure with no fluctuation
Correct answer: Episodic hypertension with tachycardia
The hallmark of pheochromocytoma is episodic (paroxysmal) hypertension along with tachycardia from excessive catecholamine release.
What should a nurse suspect if a patient after thyroidectomy for thyroid cancer has hoarse voice and difficulty speaking?
- A Temporary postoperative vocal fatigue
- B Injury to the recurrent laryngeal nerve
- C Onset of postoperative hypothyroidism
- D Onset of postoperative hyperthyroidism
Correct answer: Injury to the recurrent laryngeal nerve
Hoarseness after thyroid surgery may indicate damage to the recurrent laryngeal nerve, which controls vocal cord function; prompt evaluation is required.
Which genetic mutation is closely associated with medullary thyroid carcinoma and pheochromocytoma in the context of MEN2?
- A RET proto-oncogene mutation
- B BRAF V600E activating mutation
- C TP53 tumour suppressor mutation
- D BRCA1 germline mutation
Correct answer: RET proto-oncogene mutation
The RET proto-oncogene mutation is associated with MEN2 syndromes which include medullary thyroid carcinoma and pheochromocytoma.
For thyroid cancers that do not take up radioactive iodine, which treatment may be used?
- A No effective treatment is available
- B External beam radiation or targeted therapy
- C Increasing dietary iodine intake alone
- D TSH suppression therapy used on its own
Correct answer: External beam radiation or targeted therapy
When thyroid cancers are non-iodine-avid (like some medullary or anaplastic types), external beam radiation or targeted drugs may be used.
What is the most appropriate nursing action for an anxious and tremulous patient with pheochromocytoma before surgery?
- A Palpate the abdomen to estimate tumour size
- B Monitor blood pressure and ensure alpha blockade
- C Withhold all antihypertensive medications
- D Ignore symptoms since surgery will resolve them
Correct answer: Monitor blood pressure and ensure alpha blockade
Pre-operative management of pheochromocytoma includes achieving stable blood pressure with alpha blockade; frequent monitoring is vital to prevent hypertensive crisis.
Which symptom would indicate hypocalcemia after thyroidectomy for thyroid cancer?
- A Sudden rise in blood pressure
- B Tingling around the mouth, fingers and toes
- C Markedly increased appetite and hunger
- D Excessive and frequent urination
Correct answer: Tingling around the mouth, fingers and toes
Hypocalcemia from parathyroid gland removal or injury may present with perioral numbness/tingling, tingling of fingers/toes, or muscle cramps; monitoring is essential after thyroid surgery.
What is the appropriate nursing education for a patient with benign familial pheochromocytoma syndrome post-treatment?
- A No further follow-up is required after treatment
- B Lifelong periodic BP and catecholamine monitoring
- C Monitoring only if symptoms recur in future
- D Permanent discontinuation of all medications
Correct answer: Lifelong periodic BP and catecholamine monitoring
Pheochromocytomas may recur, especially in hereditary syndromes like MEN2, so patients need lifelong follow-up with periodic catecholamine and blood pressure monitoring even after tumour removal.