2024 Nurs 623 Exam With 260+ Questions & Correct
Answers
A newly diagnosed client with diabetes who has an HbA1c of 7.5 is started on
therapeutic lifestyle changes (TLC) and medical nutritional therapy (MNT). Which
oral antidiabetic agent is recommended as monotherapy? - ANSWER-metformin
An elderly client with hyperthyroidism may present with atypical symptoms.
Which of the following manifestations are commonly seen in the elderly with
hyperthyroidism? - ANSWER-a-fib, depression, weight loss
Diane has had Cushing's disease for 20 years and has been taking hydrocortisone
since her diagnosis. Today, she appears with a thick trunk and thin extremities. She
has a "moon face," a "buffalo hump," thin skin with visible capillaries, and a
number of bruises that appear to be slow in healing. To what do you attribute these
symptoms? - ANSWER-excessive levels of cortisol
The following is a client's self-monitoring blood glucose log. The client receives
20 units Novolin 70/30 in the morning (a.m.) and 20 units Novolin 70/30 in the
evening (p.m.): Fasting a.m. pre-dinner: 90, 150, 105, 144, 101, 172, 98, 201. What
changes would you make? - ANSWER-increase A.M. insulin
Dan, age 45, is obese and has type 2 diabetes. He has been having trouble getting
his glycohemoglobin under control. He's heard that exenatide (Byetta) causes
weight loss and wants to try it. What do you tell him? - ANSWER-"Let's try it.
You're glycohemoglobin will be lowered and you may lose weight."
Which is the only treatment option that is curative for primary
hyperparathyroidism? - ANSWER-parathyroidectomy
,The most common worldwide cause of hypothyroidism is: - ANSWER-iodine
deficiency
What should be assessed for during exam on pt with HYPOparathyroidism? -
ANSWER-chvostek's sign
Morton has Type 2 diabetes. His treatment, which includes diet, exercise, and oral
antidiabetic agents, is insufficient to achieve acceptable glycemic control. Your
next course of action is to - ANSWER-ADD LONG-ACTING INSULIN
Joy has gout. In teaching her about her disease, which food do you tell her is
allowed in her diet? - ANSWER-Broccoli
What controls the amount of calcium in the blood? - ANSWER-Parathyroid
Thyroid hormones regulate - ANSWER-metabolism
Which tests should you order to confirm a diagnosis of hypothyroidism? -
ANSWER-t3 & Free T4 (preferred over T4)
What are the hallmark signs of Grave's disease? - ANSWER-enlarged thyroid and
increased T3
What is the gold standard screening for thyroid TUMOR/NODULE? - ANSWER-
ULTRASOUND
What is the diagnostic screening for thyroid cancer? - ANSWER-FINE NEEDLE
BIOPSY
,What is the preferred treatment of Grave's disease in pregnancy - ANSWER-
Propylthiouracil (PTU):
Before starting anti-thyroid meds what should be checked? - ANSWER-LIVER
FUNCTIONS
what is the goal of thyroid treatment - ANSWER-euthyroid state
What are signs and symptoms of hypothyroidism overtreatment? - ANSWER-
hyperglycemia; cardiac arrhythmias (Afib); adrenal insufficiency; increased
myxedema.
Hyperthyroidism causes an excessive secretion of which thyroid hormones? -
ANSWER-T3 & T4
What are S/S of hyperthyroidism? - ANSWER-"Hot/buldging/fast" heat
intolerance, eye buldge, tachycardia, weight loss, diarrhea, systolic HTN, enlarged
thyroid
What are S/S of HYPOthyroidism? - ANSWER-"cold, slow, tired" cold
intolerance, slow speech, fatigue, lethargy, weight gain, constipation, brittle
nail/hair
What is the most common cause of hyperthyroidism? - ANSWER-Graves disease
Name the two thyroid hormones produced by the thyroid gland? - ANSWER-T3 &
T4
, Name the hormone produced by the pituitary gland, state the purpose of the
hormone - ANSWER-TSH; regulate the production of hormones by the thyroid
gland
IN GRAVES DISEASE THE THE TSH IS _________ AND THE T3/T4 ARE
__________ - ANSWER-LOW; HIGH
IN HASHIMOTO'S DISEASE THE THE TSH IS _________ AND THE T3/T4
ARE __________ - ANSWER-HIGH; LOW
WHAT allows the resolution of hyperthyroidism, although patients then become
hypothyroid and require thyroid replacement therapy for life - ANSWER-
ABLATIVE DOSE IODINE
According to the American Association of Clinical Endocrinologists, the usual
dose of levothyroxine per day for full replacement? - ANSWER-1.6 mcg/kg per
day 50-100 MCG DAY
what pt education do you give with levothyroxine? - ANSWER-take meds on
empty stomach 30 mins before morning meal (may cause insomnia if taken at
night)
How would you alter the dose for initiating synthetic thyroid replacement with an
older patient with hx of cardiac issues? - ANSWER-Begin with one-half of the
expected replacement dose or 25 to50 mcg/day PO, increasing the dose gradually
by 25 mcg/day once every 4 to 6 weeks; cardiac start at 12.5 mcg/day
What is the long standing effects of HYPERthyroidism? - ANSWER-
OSTEOPOROSIS CONSIDER BONE DENSITY TESTING, VIT D, &
CALCIUM SUPPLEMENTS IN OLDER PT
Answers
A newly diagnosed client with diabetes who has an HbA1c of 7.5 is started on
therapeutic lifestyle changes (TLC) and medical nutritional therapy (MNT). Which
oral antidiabetic agent is recommended as monotherapy? - ANSWER-metformin
An elderly client with hyperthyroidism may present with atypical symptoms.
Which of the following manifestations are commonly seen in the elderly with
hyperthyroidism? - ANSWER-a-fib, depression, weight loss
Diane has had Cushing's disease for 20 years and has been taking hydrocortisone
since her diagnosis. Today, she appears with a thick trunk and thin extremities. She
has a "moon face," a "buffalo hump," thin skin with visible capillaries, and a
number of bruises that appear to be slow in healing. To what do you attribute these
symptoms? - ANSWER-excessive levels of cortisol
The following is a client's self-monitoring blood glucose log. The client receives
20 units Novolin 70/30 in the morning (a.m.) and 20 units Novolin 70/30 in the
evening (p.m.): Fasting a.m. pre-dinner: 90, 150, 105, 144, 101, 172, 98, 201. What
changes would you make? - ANSWER-increase A.M. insulin
Dan, age 45, is obese and has type 2 diabetes. He has been having trouble getting
his glycohemoglobin under control. He's heard that exenatide (Byetta) causes
weight loss and wants to try it. What do you tell him? - ANSWER-"Let's try it.
You're glycohemoglobin will be lowered and you may lose weight."
Which is the only treatment option that is curative for primary
hyperparathyroidism? - ANSWER-parathyroidectomy
,The most common worldwide cause of hypothyroidism is: - ANSWER-iodine
deficiency
What should be assessed for during exam on pt with HYPOparathyroidism? -
ANSWER-chvostek's sign
Morton has Type 2 diabetes. His treatment, which includes diet, exercise, and oral
antidiabetic agents, is insufficient to achieve acceptable glycemic control. Your
next course of action is to - ANSWER-ADD LONG-ACTING INSULIN
Joy has gout. In teaching her about her disease, which food do you tell her is
allowed in her diet? - ANSWER-Broccoli
What controls the amount of calcium in the blood? - ANSWER-Parathyroid
Thyroid hormones regulate - ANSWER-metabolism
Which tests should you order to confirm a diagnosis of hypothyroidism? -
ANSWER-t3 & Free T4 (preferred over T4)
What are the hallmark signs of Grave's disease? - ANSWER-enlarged thyroid and
increased T3
What is the gold standard screening for thyroid TUMOR/NODULE? - ANSWER-
ULTRASOUND
What is the diagnostic screening for thyroid cancer? - ANSWER-FINE NEEDLE
BIOPSY
,What is the preferred treatment of Grave's disease in pregnancy - ANSWER-
Propylthiouracil (PTU):
Before starting anti-thyroid meds what should be checked? - ANSWER-LIVER
FUNCTIONS
what is the goal of thyroid treatment - ANSWER-euthyroid state
What are signs and symptoms of hypothyroidism overtreatment? - ANSWER-
hyperglycemia; cardiac arrhythmias (Afib); adrenal insufficiency; increased
myxedema.
Hyperthyroidism causes an excessive secretion of which thyroid hormones? -
ANSWER-T3 & T4
What are S/S of hyperthyroidism? - ANSWER-"Hot/buldging/fast" heat
intolerance, eye buldge, tachycardia, weight loss, diarrhea, systolic HTN, enlarged
thyroid
What are S/S of HYPOthyroidism? - ANSWER-"cold, slow, tired" cold
intolerance, slow speech, fatigue, lethargy, weight gain, constipation, brittle
nail/hair
What is the most common cause of hyperthyroidism? - ANSWER-Graves disease
Name the two thyroid hormones produced by the thyroid gland? - ANSWER-T3 &
T4
, Name the hormone produced by the pituitary gland, state the purpose of the
hormone - ANSWER-TSH; regulate the production of hormones by the thyroid
gland
IN GRAVES DISEASE THE THE TSH IS _________ AND THE T3/T4 ARE
__________ - ANSWER-LOW; HIGH
IN HASHIMOTO'S DISEASE THE THE TSH IS _________ AND THE T3/T4
ARE __________ - ANSWER-HIGH; LOW
WHAT allows the resolution of hyperthyroidism, although patients then become
hypothyroid and require thyroid replacement therapy for life - ANSWER-
ABLATIVE DOSE IODINE
According to the American Association of Clinical Endocrinologists, the usual
dose of levothyroxine per day for full replacement? - ANSWER-1.6 mcg/kg per
day 50-100 MCG DAY
what pt education do you give with levothyroxine? - ANSWER-take meds on
empty stomach 30 mins before morning meal (may cause insomnia if taken at
night)
How would you alter the dose for initiating synthetic thyroid replacement with an
older patient with hx of cardiac issues? - ANSWER-Begin with one-half of the
expected replacement dose or 25 to50 mcg/day PO, increasing the dose gradually
by 25 mcg/day once every 4 to 6 weeks; cardiac start at 12.5 mcg/day
What is the long standing effects of HYPERthyroidism? - ANSWER-
OSTEOPOROSIS CONSIDER BONE DENSITY TESTING, VIT D, &
CALCIUM SUPPLEMENTS IN OLDER PT
