NUR 6121 ACTUAL EXAM 2 QUESTIONS AND 100%
CORRECT DETAILED ANSWERS | ALREADY GRADED
+A
1. You have determined that a 35 y/o woman is hypothyroid. In order to determine how much t4
replacement a patient needs to establish a euthyroid state, the APN considers the patient’s: body
weight
- based on the patient’s weight, age, and overall health.
2. Which laboratory abnormality very commonly occurs with hypothyroidism? Dyslipidemia or low T4
& elevated TSH
Dyslipidemia should not be treated until TSH decreases to 10.
3. When serum-free T4 concentration falls? The TSH rises.
4. When is the best time to measure TSH after initiating thyroid replacement therapy? Typically 6-8 weeks
5. A 75-year-old patient with no other significant medical history has been diagnosed with
hypothyroidism. The patient weighs 155 pounds. What medication and appropriate dosage should the
patient be on? Levothyroxine 50 mcg/day or even 25
- Lower dosage for older adults is usually lower than for younger patients.
6. A 70-year-old woman presents with symptoms of weight loss, palpitation, and constipation. TSH
0.03, T4 33. Your next step to evaluate the thyroid is: repeat blood tests (to confirm initial results),
thyroid scan and uptake (determine nature of the problem), thyroid ultrasound (identify enlargement
or nodules), fine needle aspiration biopsy (r/o ca id nodules are present)
Hyper: low TSH, high T3 T4
7. What is the most sensitive laboratory assay for screening ambulatory patients for primary
hypothyroidism? TSH
8. Bariatric surgery for weight loss is recommended for patients with? BMI is 40 or >, BMI 35 and
complicated by 1 or more: HTN, DMT2, HF or OSA
-BMI 35 RR 10
9. The diagnostic criteria for metabolic syndrome include all of the ff except: waist circumference of >
35 for men and >30 for women.
Metabolic syndromes includes: HTN, Dyslipidemia, DM1
Criteria for metabolic syndrome: abdl obesity (waist circ >40 men & >35 for women) (central or
visceral), dyslipidemia (trigly >150, hdl <40), HTN, insulin resistance with hyperinsulinemia (fasting
>110)
10. In patients with metabolic syndrome and expected last finding would include: CV disease, T2DM,
kidney disease, non-alcoholic fatty liver disease & PCOS
11. The meglitinide analogs (Prandin) are particularly helpful adjuncts in type 3 DM care to minimize the
risk of? Postprandial hyperglycemia
12. A 40-year-old newly diagnosed type 2 DM patient was started on metformin. The dose has been
titrated to 1000 mg BID his latest HgbA1c was 8.1% which of the ff is an appropriate next step?
Adding a 2nd line agent, the choice of agent is individualized:
, - Glimepiride sulfonylureas, DPP-4 inhibitors, GLP-1 receptor agonists, insulin
13. An active 72 year old patient with type 2 DM is feeling well with no symptoms. He is on metformin
500 mg BID and has a follow-up HgbA1c up 7.4% you would: continue to monitor. Appropriate a1c
while on metformin between 7-8%
14. A thiazolidinedione TZD drug can be prescribed to which of the ff patients? T2 DM
CORRECT DETAILED ANSWERS | ALREADY GRADED
+A
1. You have determined that a 35 y/o woman is hypothyroid. In order to determine how much t4
replacement a patient needs to establish a euthyroid state, the APN considers the patient’s: body
weight
- based on the patient’s weight, age, and overall health.
2. Which laboratory abnormality very commonly occurs with hypothyroidism? Dyslipidemia or low T4
& elevated TSH
Dyslipidemia should not be treated until TSH decreases to 10.
3. When serum-free T4 concentration falls? The TSH rises.
4. When is the best time to measure TSH after initiating thyroid replacement therapy? Typically 6-8 weeks
5. A 75-year-old patient with no other significant medical history has been diagnosed with
hypothyroidism. The patient weighs 155 pounds. What medication and appropriate dosage should the
patient be on? Levothyroxine 50 mcg/day or even 25
- Lower dosage for older adults is usually lower than for younger patients.
6. A 70-year-old woman presents with symptoms of weight loss, palpitation, and constipation. TSH
0.03, T4 33. Your next step to evaluate the thyroid is: repeat blood tests (to confirm initial results),
thyroid scan and uptake (determine nature of the problem), thyroid ultrasound (identify enlargement
or nodules), fine needle aspiration biopsy (r/o ca id nodules are present)
Hyper: low TSH, high T3 T4
7. What is the most sensitive laboratory assay for screening ambulatory patients for primary
hypothyroidism? TSH
8. Bariatric surgery for weight loss is recommended for patients with? BMI is 40 or >, BMI 35 and
complicated by 1 or more: HTN, DMT2, HF or OSA
-BMI 35 RR 10
9. The diagnostic criteria for metabolic syndrome include all of the ff except: waist circumference of >
35 for men and >30 for women.
Metabolic syndromes includes: HTN, Dyslipidemia, DM1
Criteria for metabolic syndrome: abdl obesity (waist circ >40 men & >35 for women) (central or
visceral), dyslipidemia (trigly >150, hdl <40), HTN, insulin resistance with hyperinsulinemia (fasting
>110)
10. In patients with metabolic syndrome and expected last finding would include: CV disease, T2DM,
kidney disease, non-alcoholic fatty liver disease & PCOS
11. The meglitinide analogs (Prandin) are particularly helpful adjuncts in type 3 DM care to minimize the
risk of? Postprandial hyperglycemia
12. A 40-year-old newly diagnosed type 2 DM patient was started on metformin. The dose has been
titrated to 1000 mg BID his latest HgbA1c was 8.1% which of the ff is an appropriate next step?
Adding a 2nd line agent, the choice of agent is individualized:
, - Glimepiride sulfonylureas, DPP-4 inhibitors, GLP-1 receptor agonists, insulin
13. An active 72 year old patient with type 2 DM is feeling well with no symptoms. He is on metformin
500 mg BID and has a follow-up HgbA1c up 7.4% you would: continue to monitor. Appropriate a1c
while on metformin between 7-8%
14. A thiazolidinedione TZD drug can be prescribed to which of the ff patients? T2 DM
