NR601 FINAL EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED

NR601 FINAL EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED Terms in this set (324) ____ 1. An elderly client presents with a new onset of feeling 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 B ____ 2. A 62-year-old female complains of fatigue and lack 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 B ____ 3. Mrs. Black, an 87-year-old patient, has been taking 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 B ____ 4. Which patient is most likely to have osteoporosis? 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 A ____ 5. When evaluating the expected outcome for a hypothyroid elderly patient placed on levothyroxine, 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 5. ANS: B PTS: 1 ____ 6. A postmenopausal woman with osteoporosis is taking a bisphosphonate daily by mouth. What action 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 6. ANS: B PTS: 1 ____ 7. The primary reason levothyroxine sodium is initiated at a low dose in an elderly patient with 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 7. ANS: A PTS: 1 ____ 8. Six months ago an elderly patient was diagnosed with subclinical hypothyroidism. Today the patient 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) 8. ANS: B PTS: 1 ____ 9. A fluoroquinolone (Ciprofloxin) is prescribed for a male patient with a UTI. What should the nurse 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 9. ANS: B PTS: 1 ____ 10. A patient has been prescribed metformin (Glucophage). One week later he returns with 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 10. ANS: B PTS: 1 ____ 11. Which of the following signs of hyperthyroidism commonly manifest in younger populations, but is notably lacking in the elderly? A. Weight gain B. Constipation C. Bradycardia D. Exophthalmos 11. ANS: D PTS: 1 ____ 12. A 60-year-old obese male client has type 2 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 B