Nurs 615 Exam IV Questions With All Correct Detailed Answers A+ Pass
QUESTIONS AND ANSWER
1. How will you prescribe lipase, protease, and amylase components?
ANSWER Pa- tients with cystic fibrosis are often prescribed enzyme replacement
for pancreatic secretions each replacement drug has amylase, lipase and
protease components, however the drug is prescribed in units of lipase
2. What is the medication of choice for hypertensive crisis with pheochro-
mocytoma? ANSWER Surgical resection of the tumor is the first treatment of
choice either my open laparotomy or laparoscopy either surgical option requires
prior treatment of nonspecific irreversible adrenergic adraonoreceptor blocker
phenoxybenzamine or a shorter acting alpha antagonists, prazosin, terazosin, and
doxazosin. Mainly use phenozibenamine in practice. Doing so promotes the
surgery to proceed while minimizing the likelihood of severe intraoperative
hypertension which is likely when the tumor is manipulated.
3. What is the onset of action, peak of action, and duration of action of each
insulin preparation? ANSWER (Intermediate Acting) NPH
Onset-60-90 min after administration,
Peak 48 hrs
Duration 10-18 hrs.
(Short Acting) Regular Onset 30-60 min
Peak 2-4 hrs
Duration 6-10 hrs
(Long Acting) Aspart, Lispro, Glulisine
Onset less than 15 min
Peak 1-2 hrs
Duration 3-6 hrs
(Long Acting) Glargine, Detemir
Onset 1-2 hrs
Peak NO PEAK
Duration 24 hrs
4. Identify the symptoms of hypoglycemia, hyperglycemia, and ketoacidosis.-
ANSWER Hypoglycemia- dizziness, confusion, diaphoresis, tachycardia
Hyperglycemia- polyphagia, polydipsia, polyuria, blurred vision, and fatigue
Ketoacidosis- hallmark symptoms include acetone breath like nail polish remover or
fruity breath. Also abdominal pain, nausea, vomiting and sob.
5. When changing from NPH to glargine insulin, how will you adjust the
patient's dose? ANSWER The initial dose of glargine is reduced by 20% to
prevent hypo- glycemia.
, Nurs 615 Exam IV Questions With All Correct Detailed Answers A+ Pass
QUESTIONS AND ANSWER
6. How does metformin work? ANSWER Decreases hyperglycemia by
decreasing hepatic glucose production called hepatic gluconeogenesis. The
average person with type 2 diabetes has three times the rate of gluconeogenesis,
metformin treatment reduces this by over 1/3rd. The molecular mechanism of
metformin isn't completely under- stood. In addition to suppressing hepatic
glucose production, metformin increases insulin sensitivity, enhances peripheral
glucose uptake by inducing the phosphoril- ization of glu4 enhancer factor,
decreases insulin induced suppression of fatty acid oxidation, and decreases
absorption of glucose from the GI tract. Also of note** Metformin helps reduce LDL
cholesterol and triglyceride levels and is not associated with weight gain, in some
people it helps promote weight loss**
7. What diagnostic testing is required before and throughout therapy with
metformin? ANSWER Metformin is not metabolized, it is cleared from the body by
tubular secretion and is secreted unchanged in the urine. Metformin is undetectable
in blood plasma within 24 hrs of a single oral dose the average elimination half-life in
plasma is 6.2 hrs as it is secreted in the urine you should check a serum crt to
assess renal function.
8. What is the action of gliptin? ANSWER The mechanism of DDP-4 inhibitors is
to increase incretin levels incretin are GLP1 and GIP which inhibit glucagon
release in which in turn increases insulin secretion, decreases gastric emptying,
and decreases blood glucose levels
9. How do GLP agonists work? ANSWER They bind directly to a receptor in the
pancreatic beta cell. These agents work in the same pathway as the DPP-4
inhibitors as mentioned above but are generally considered more potent.
10. When should exenatide be administered? ANSWER 60 minutes prior to
the morning and evening meal
11. How will you assess for granulocytopenia? ANSWER Signs of a Cold or
flu including fever and sore throat
12. What are the adverse effects of propylthiouracil? ANSWER
Agranulocytosis, thrombo- cytopenia, and fulminant liver failure as stated above, pt's
on PTU when they develop fever or sore throat, it would be important to check a
CBC preferably with a smear and a diff.
13. What are the adverse effects of levothyroxine? ANSWER Tachycardia
and angina in the elderly
14. A patient develops a toxic goiter. What is the recommended treatment?
ANSWER -
Methimazole for one month then radioactive iodine (p. 641)
15. What are the adverse effects of PTU and methimazole? ANSWER PTU-
Fatal agranu- locytopenia look for fever and sore throat and TEMPORARY
, Nurs 615 Exam IV Questions With All Correct Detailed Answers A+ Pass
QUESTIONS AND ANSWER
ALOPECIA
16. What is the action of biphosphonates? ANSWER Bone undergoes
constant turnover and is kept in balance by osteoblasts creating bone and
osteoclasts destroying
QUESTIONS AND ANSWER
1. How will you prescribe lipase, protease, and amylase components?
ANSWER Pa- tients with cystic fibrosis are often prescribed enzyme replacement
for pancreatic secretions each replacement drug has amylase, lipase and
protease components, however the drug is prescribed in units of lipase
2. What is the medication of choice for hypertensive crisis with pheochro-
mocytoma? ANSWER Surgical resection of the tumor is the first treatment of
choice either my open laparotomy or laparoscopy either surgical option requires
prior treatment of nonspecific irreversible adrenergic adraonoreceptor blocker
phenoxybenzamine or a shorter acting alpha antagonists, prazosin, terazosin, and
doxazosin. Mainly use phenozibenamine in practice. Doing so promotes the
surgery to proceed while minimizing the likelihood of severe intraoperative
hypertension which is likely when the tumor is manipulated.
3. What is the onset of action, peak of action, and duration of action of each
insulin preparation? ANSWER (Intermediate Acting) NPH
Onset-60-90 min after administration,
Peak 48 hrs
Duration 10-18 hrs.
(Short Acting) Regular Onset 30-60 min
Peak 2-4 hrs
Duration 6-10 hrs
(Long Acting) Aspart, Lispro, Glulisine
Onset less than 15 min
Peak 1-2 hrs
Duration 3-6 hrs
(Long Acting) Glargine, Detemir
Onset 1-2 hrs
Peak NO PEAK
Duration 24 hrs
4. Identify the symptoms of hypoglycemia, hyperglycemia, and ketoacidosis.-
ANSWER Hypoglycemia- dizziness, confusion, diaphoresis, tachycardia
Hyperglycemia- polyphagia, polydipsia, polyuria, blurred vision, and fatigue
Ketoacidosis- hallmark symptoms include acetone breath like nail polish remover or
fruity breath. Also abdominal pain, nausea, vomiting and sob.
5. When changing from NPH to glargine insulin, how will you adjust the
patient's dose? ANSWER The initial dose of glargine is reduced by 20% to
prevent hypo- glycemia.
, Nurs 615 Exam IV Questions With All Correct Detailed Answers A+ Pass
QUESTIONS AND ANSWER
6. How does metformin work? ANSWER Decreases hyperglycemia by
decreasing hepatic glucose production called hepatic gluconeogenesis. The
average person with type 2 diabetes has three times the rate of gluconeogenesis,
metformin treatment reduces this by over 1/3rd. The molecular mechanism of
metformin isn't completely under- stood. In addition to suppressing hepatic
glucose production, metformin increases insulin sensitivity, enhances peripheral
glucose uptake by inducing the phosphoril- ization of glu4 enhancer factor,
decreases insulin induced suppression of fatty acid oxidation, and decreases
absorption of glucose from the GI tract. Also of note** Metformin helps reduce LDL
cholesterol and triglyceride levels and is not associated with weight gain, in some
people it helps promote weight loss**
7. What diagnostic testing is required before and throughout therapy with
metformin? ANSWER Metformin is not metabolized, it is cleared from the body by
tubular secretion and is secreted unchanged in the urine. Metformin is undetectable
in blood plasma within 24 hrs of a single oral dose the average elimination half-life in
plasma is 6.2 hrs as it is secreted in the urine you should check a serum crt to
assess renal function.
8. What is the action of gliptin? ANSWER The mechanism of DDP-4 inhibitors is
to increase incretin levels incretin are GLP1 and GIP which inhibit glucagon
release in which in turn increases insulin secretion, decreases gastric emptying,
and decreases blood glucose levels
9. How do GLP agonists work? ANSWER They bind directly to a receptor in the
pancreatic beta cell. These agents work in the same pathway as the DPP-4
inhibitors as mentioned above but are generally considered more potent.
10. When should exenatide be administered? ANSWER 60 minutes prior to
the morning and evening meal
11. How will you assess for granulocytopenia? ANSWER Signs of a Cold or
flu including fever and sore throat
12. What are the adverse effects of propylthiouracil? ANSWER
Agranulocytosis, thrombo- cytopenia, and fulminant liver failure as stated above, pt's
on PTU when they develop fever or sore throat, it would be important to check a
CBC preferably with a smear and a diff.
13. What are the adverse effects of levothyroxine? ANSWER Tachycardia
and angina in the elderly
14. A patient develops a toxic goiter. What is the recommended treatment?
ANSWER -
Methimazole for one month then radioactive iodine (p. 641)
15. What are the adverse effects of PTU and methimazole? ANSWER PTU-
Fatal agranu- locytopenia look for fever and sore throat and TEMPORARY
, Nurs 615 Exam IV Questions With All Correct Detailed Answers A+ Pass
QUESTIONS AND ANSWER
ALOPECIA
16. What is the action of biphosphonates? ANSWER Bone undergoes
constant turnover and is kept in balance by osteoblasts creating bone and
osteoclasts destroying
