NR601/NR 601 Final Exam Questions with CORRECT Answers
____ 1. An elderly client presents with a new onset of feeling
B her heart race and fatigue. An EKG reveals
atrial fibrillation with rate >110. The patient also has a new
fine tremor of both hands. Which of the
following would the nurse practitioner suspect?
A. Hypothyroidism
B.Hyperthyroidism
C. Congestive heart failure
D. Type 2 diabetes mellitus
____ 2. A 62-year-old female complains of fatigue and lack
B of energy. Constipation has increased and the patient has
gained ten pounds in the past 3 months. Depression is
denied although the patient reports a lack of interest
in usual hobbies. Vital signs are within normal limits and
the patient's skin is dry and cool. Which of the following
must be included in the differential?
A. Hyperthyroidism
B.Hypothyroidism
C. Hyperparathyroidism
D.Grave's disease
____ 3. Mrs. Black, an 87-year-old patient, has been taking
B 100 mcg of Synthroid for 10 years. She comes to
your office for a routine follow-up, feeling well. Her heart
rate is 90. Your first response is to:
A. Increase the Synthroid
B.Order TSH
C. Start a beta-blocker
D.Order thyroid scan
,____ 4. Which patient is most likely to have osteoporosis? A
A. An 80-year-old underweight male who smokes and
has been on steroids for
psoriasis
B. A 90-year-old female with no family
history of osteoporosis who is on hormone
replacement therapy
C.A 68-year-old overweight female who drinks 1-2
drinks alcohol/day
D. An 82-year-old female with a normal BMI
takes calcium and performs weight-
bearing exercise daily
____ 5. When evaluating the expected outcome for a 5. ANS: B
hypothyroid elderly patient placed on levothyroxine, PTS: 1
the nurse practitioner will:
A. Assess a weekly TSH
B. Assess the TSH in 4-6 weeks
C.Ask the patient if the symptoms have subsided
and adjust dosage accordingly
D.Decrease the dosage should a cardiac event occur
____ 6. A postmenopausal woman with osteoporosis is 6. ANS: B
taking a bisphosphonate daily by mouth. What action PTS: 1
information statement would indicate the patient
understood the nurse practitioner's instructions
regarding this medication?
A. Takes medication at bedtime with a full glass of water
B. Takes medication with a full glass of water when up in
a.m. 30 minutes prior to
other food and medications
C. Takes medication when up in a.m. with a glass of
orange juice to increase
absorption
D. Takes medication sitting up and with a meal to avoid
gastrointestinal distress
____ 7. The primary reason levothyroxine sodium is initiated 7. ANS:
A at a low dose in an elderly patient with PTS: 1
hypothyroidism is to prevent which of the following
untoward effects?
A. Angina and arrhythmia
B. Nausea and diarrhea
C. Confusion and delirium
D. Osteoporosis and muscle weakness
, ____ 8. Six months ago an elderly patient was diagnosed 8. ANS: B
with subclinical hypothyroidism. Today the patient PTS: 1
returns and has a TSH of 11.0 and complains of fatigue. He
has taken Synthroid 25 mcg daily as
prescribed. What is the best course of action for the
nurse practitioner?
A. Assess further for a cause of fatigue
B.Double the dose of Synthroid
C. Discontinue the Synthroid
D.Prescribe Liotrix (T3 & T4 combination)
____ 9. A fluoroquinolone (Ciprofloxin) is prescribed for a 9. ANS: B
male patient with a UTI. What should the nurse PTS: 1
practitioner teach the patient regarding taking this
medication?
A. It must be taken on an empty stomach
B.Its effectiveness is decreased by antacids, iron, or
caffeine ingestion
C. It may cause a metallic aftertaste
D.Its effectiveness is not a concern and it can be
taken with any medications
____ 10. A patient has been prescribed metformin 10. ANS: B
(Glucophage). One week later he returns with PTS: 1
lowered blood sugars but complains of some loose stools
during the week. How should the nurse practitioner
respond?
A. Discontinue the medication immediately
B.Reassure the patient that this is an anticipated
side effect
C. Double the dosage of medication and have patient
return in 1 week
D.Order a chem. 7 to check for lactic acidosis
____ 11. Which of the following signs of hyperthyroidism 11. ANS: D
commonly manifest in younger populations, but is PTS: 1
notably lacking in the elderly?
A. Weight gain
B.Constipation
C. Bradycardia
D.Exophthalmos
____ 12. A 60-year-old obese male client has type 2 B
diabetes mellitus and a lipid panel of TC = 250, HDL =
32, LDL = 165. The nurse practitioner teaches the patient
about his modifiable cardiac risk factors,
which include:
A. Advancing age, diabetes, hyperlipidemia, and
male gender
B.Diabetes, obesity, and hyperlipidemia
C. Hyperlipidemia, smoking, and family history of heart
disease
D.Male with age > 45, diabetes mellitus,
and hyperlipidemia
____ 1. An elderly client presents with a new onset of feeling
B her heart race and fatigue. An EKG reveals
atrial fibrillation with rate >110. The patient also has a new
fine tremor of both hands. Which of the
following would the nurse practitioner suspect?
A. Hypothyroidism
B.Hyperthyroidism
C. Congestive heart failure
D. Type 2 diabetes mellitus
____ 2. A 62-year-old female complains of fatigue and lack
B of energy. Constipation has increased and the patient has
gained ten pounds in the past 3 months. Depression is
denied although the patient reports a lack of interest
in usual hobbies. Vital signs are within normal limits and
the patient's skin is dry and cool. Which of the following
must be included in the differential?
A. Hyperthyroidism
B.Hypothyroidism
C. Hyperparathyroidism
D.Grave's disease
____ 3. Mrs. Black, an 87-year-old patient, has been taking
B 100 mcg of Synthroid for 10 years. She comes to
your office for a routine follow-up, feeling well. Her heart
rate is 90. Your first response is to:
A. Increase the Synthroid
B.Order TSH
C. Start a beta-blocker
D.Order thyroid scan
,____ 4. Which patient is most likely to have osteoporosis? A
A. An 80-year-old underweight male who smokes and
has been on steroids for
psoriasis
B. A 90-year-old female with no family
history of osteoporosis who is on hormone
replacement therapy
C.A 68-year-old overweight female who drinks 1-2
drinks alcohol/day
D. An 82-year-old female with a normal BMI
takes calcium and performs weight-
bearing exercise daily
____ 5. When evaluating the expected outcome for a 5. ANS: B
hypothyroid elderly patient placed on levothyroxine, PTS: 1
the nurse practitioner will:
A. Assess a weekly TSH
B. Assess the TSH in 4-6 weeks
C.Ask the patient if the symptoms have subsided
and adjust dosage accordingly
D.Decrease the dosage should a cardiac event occur
____ 6. A postmenopausal woman with osteoporosis is 6. ANS: B
taking a bisphosphonate daily by mouth. What action PTS: 1
information statement would indicate the patient
understood the nurse practitioner's instructions
regarding this medication?
A. Takes medication at bedtime with a full glass of water
B. Takes medication with a full glass of water when up in
a.m. 30 minutes prior to
other food and medications
C. Takes medication when up in a.m. with a glass of
orange juice to increase
absorption
D. Takes medication sitting up and with a meal to avoid
gastrointestinal distress
____ 7. The primary reason levothyroxine sodium is initiated 7. ANS:
A at a low dose in an elderly patient with PTS: 1
hypothyroidism is to prevent which of the following
untoward effects?
A. Angina and arrhythmia
B. Nausea and diarrhea
C. Confusion and delirium
D. Osteoporosis and muscle weakness
, ____ 8. Six months ago an elderly patient was diagnosed 8. ANS: B
with subclinical hypothyroidism. Today the patient PTS: 1
returns and has a TSH of 11.0 and complains of fatigue. He
has taken Synthroid 25 mcg daily as
prescribed. What is the best course of action for the
nurse practitioner?
A. Assess further for a cause of fatigue
B.Double the dose of Synthroid
C. Discontinue the Synthroid
D.Prescribe Liotrix (T3 & T4 combination)
____ 9. A fluoroquinolone (Ciprofloxin) is prescribed for a 9. ANS: B
male patient with a UTI. What should the nurse PTS: 1
practitioner teach the patient regarding taking this
medication?
A. It must be taken on an empty stomach
B.Its effectiveness is decreased by antacids, iron, or
caffeine ingestion
C. It may cause a metallic aftertaste
D.Its effectiveness is not a concern and it can be
taken with any medications
____ 10. A patient has been prescribed metformin 10. ANS: B
(Glucophage). One week later he returns with PTS: 1
lowered blood sugars but complains of some loose stools
during the week. How should the nurse practitioner
respond?
A. Discontinue the medication immediately
B.Reassure the patient that this is an anticipated
side effect
C. Double the dosage of medication and have patient
return in 1 week
D.Order a chem. 7 to check for lactic acidosis
____ 11. Which of the following signs of hyperthyroidism 11. ANS: D
commonly manifest in younger populations, but is PTS: 1
notably lacking in the elderly?
A. Weight gain
B.Constipation
C. Bradycardia
D.Exophthalmos
____ 12. A 60-year-old obese male client has type 2 B
diabetes mellitus and a lipid panel of TC = 250, HDL =
32, LDL = 165. The nurse practitioner teaches the patient
about his modifiable cardiac risk factors,
which include:
A. Advancing age, diabetes, hyperlipidemia, and
male gender
B.Diabetes, obesity, and hyperlipidemia
C. Hyperlipidemia, smoking, and family history of heart
disease
D.Male with age > 45, diabetes mellitus,
and hyperlipidemia
