FNP Review Dunphy
FNP Review Dunphy-Chapter 17 Endocrine and
Metabolic Problems Exam Guide 2025
Which of the following medications can impact the functioning of the thyroid gland?
A. Amiodarone, lithium, and interferon-alpha
B. Labetolol, lisinopril, and losartan
C. HCTZ, chlorthalidone, and losartan
D. Omeprazole, atorvastatin, and lisinopril -Correct Answer ✔A. Amiodarone can cause
hyperthyroidism or hypothyroidism. Lithium and interferon-alpha can cause thyroid
dysfunction. Should have thyroid assessed periodically.
Early-morning increases in blood glucose concentration that occur with no
corresponding hypoglycemia during the night are referred to as:
a. the Somogyi phenomenon
b. insulin shock
c. diabetic ketoacidosis
d. the dawn phenomenon. -Correct Answer ✔D
Diabetes and coronary artery disease (CAD) have a close interrelationship. Which of the
following statements about the relationship between diabetes and CAD is true?
A. Hyperinsulinemia decreases sympathetic tone and cardiac contractility by increasing
plasma catecholamines, epinephrine, and norepinephrine
B. An increase of glucose causes the distal nephrons of the kidneys to absorb less
sodium, resulting in more fluid, expanding the intravascular volume, and increasing the
blood pressure
C. Hyperinsulinemia causes a large number of vascular smooth muscle cells to be formed
and deposited on the walls of vessels, eventually decreasing space for blood flow
FNP Review Dunphy
,FNP Review Dunphy
D. An increase in glucose stimulates more secretion of epinephrine, thus raising the
blood pressure -Correct Answer ✔C
Hyperinsulinemia causes a large number of vascular smooth muscle cells to be formed
and deposited on the walls of vessels, causing buildup and eventual blockage, reducing
blood flow; hyperinsulinemia increases (not decreases) sympathetic tone and cardiac
contractility by increasing plasma catecholamine, epinephrine, and norepinephrine
levels; and an increase in the glucose level causes the distal nephrons of the kidneys to
absorb more (not less) sodium, resulting in more fluid, expanding the intravascular
volume and increasing blood pressure
What is the medication of choice for an initial acute attack of gout?
A. An NSAID
B. Colchicine
C. A corticosteroid
D. Allopurinol (Zyloprim) -Correct Answer ✔A
Indomethacin (Indocin) is more commonly prescribed. An initial dose of 50-75mg is
given, followed by 25-50mg every 8 hours for 5-10 days. Naproxen is 750 mg, followed
by 250 mg every 8 hours for 5-10 days.
Marsha, age 24, is preparing for radioactive iodine therapy for her Graves' disease.
Which test must she undergo first?
A. Beta human chorionic gonadotropin
B. Basal metabolism rate
C. Lithium level
D. Serum calcium -Correct Answer ✔A
Contraindicated during pregnancy
When teaching Marcy how to use her new insulin pump, you tell her that she needs to
monitor her blood glucose level
FNP Review Dunphy
,FNP Review Dunphy
A. at least once a day
B. only occasionally because glycemic levels are maintained very steadily
C. at least four times a day
D. on an as-needed basis when she feels she needs to give herself an extra dose of
insulin -Correct Answer ✔C
Joan has severe asthma and has been on high doses of oral corticosteroids for 2 years.
She has been reading some home remedy books and stops all of her medications. What
condition may she develop?
a. myxedema crisis
b. diabetes insipidus
c. hypoparathyroidism
d. addisonian crisis -Correct Answer ✔D
If a client has hepatitis, abdominal pain in the right upper quadrant is a result of what
patho-physiological basis?
A. Reduced prothrombin synthesis by injured hepatic cells
B. Bile salt accumulation
C. Release of pyrogens
D. Stretching of Glisson's capsule -Correct Answer ✔D
How long after the acute illness of hepatitis A do immunoglobulin M anti-hepatitis A
virus titers disappear?
A. 1 week
B. 3 to 6 months
C. 1 year
D. 2 years -Correct Answer ✔B
FNP Review Dunphy
, FNP Review Dunphy
Which of the following individuals would not be a candidate for a thiazolidinedione such
as pioglitazone (Actos)?
A. A client with a history of hyperuricemia
B. A client with asthma
C. A client with heart failure
D. A client with sulfa allergy -Correct Answer ✔C
Can exacerbate heart failure (Black Box warning)
An elderly client with hyperthyroidism may present with atypical symptoms. Which of
the following manifestations are commonly seen in the elderly with hyperthyroidism?
A. Adrenergic findings such as tachycardia
B. Weight gain, depression, and heat intolerance
C. Atrial fibrillation, depression, and weight loss
D. Heat intolerance, hyperreflexia, and anorexia -Correct Answer ✔C
Referred to as apathetic hyperthyroidism of the elderly
Which of the following statements is true about insulin lispro (Humalog)?
A. It works faster than regular insulin because its amino acid composition has been
slightly modified
B. It should be injected 30 minutes before a meal
C. Its duration of action is about 6 to 8 hours
D. It is taken with the first bite of food -Correct Answer ✔A
Insulin lispro is a rapid-acting human insulin whose amino acid composition has been
slightly modified to make it work faster. Administered 5-10 minutes before a meal
Hyperthyroidism is seen in which of the following lab results?
FNP Review Dunphy
FNP Review Dunphy-Chapter 17 Endocrine and
Metabolic Problems Exam Guide 2025
Which of the following medications can impact the functioning of the thyroid gland?
A. Amiodarone, lithium, and interferon-alpha
B. Labetolol, lisinopril, and losartan
C. HCTZ, chlorthalidone, and losartan
D. Omeprazole, atorvastatin, and lisinopril -Correct Answer ✔A. Amiodarone can cause
hyperthyroidism or hypothyroidism. Lithium and interferon-alpha can cause thyroid
dysfunction. Should have thyroid assessed periodically.
Early-morning increases in blood glucose concentration that occur with no
corresponding hypoglycemia during the night are referred to as:
a. the Somogyi phenomenon
b. insulin shock
c. diabetic ketoacidosis
d. the dawn phenomenon. -Correct Answer ✔D
Diabetes and coronary artery disease (CAD) have a close interrelationship. Which of the
following statements about the relationship between diabetes and CAD is true?
A. Hyperinsulinemia decreases sympathetic tone and cardiac contractility by increasing
plasma catecholamines, epinephrine, and norepinephrine
B. An increase of glucose causes the distal nephrons of the kidneys to absorb less
sodium, resulting in more fluid, expanding the intravascular volume, and increasing the
blood pressure
C. Hyperinsulinemia causes a large number of vascular smooth muscle cells to be formed
and deposited on the walls of vessels, eventually decreasing space for blood flow
FNP Review Dunphy
,FNP Review Dunphy
D. An increase in glucose stimulates more secretion of epinephrine, thus raising the
blood pressure -Correct Answer ✔C
Hyperinsulinemia causes a large number of vascular smooth muscle cells to be formed
and deposited on the walls of vessels, causing buildup and eventual blockage, reducing
blood flow; hyperinsulinemia increases (not decreases) sympathetic tone and cardiac
contractility by increasing plasma catecholamine, epinephrine, and norepinephrine
levels; and an increase in the glucose level causes the distal nephrons of the kidneys to
absorb more (not less) sodium, resulting in more fluid, expanding the intravascular
volume and increasing blood pressure
What is the medication of choice for an initial acute attack of gout?
A. An NSAID
B. Colchicine
C. A corticosteroid
D. Allopurinol (Zyloprim) -Correct Answer ✔A
Indomethacin (Indocin) is more commonly prescribed. An initial dose of 50-75mg is
given, followed by 25-50mg every 8 hours for 5-10 days. Naproxen is 750 mg, followed
by 250 mg every 8 hours for 5-10 days.
Marsha, age 24, is preparing for radioactive iodine therapy for her Graves' disease.
Which test must she undergo first?
A. Beta human chorionic gonadotropin
B. Basal metabolism rate
C. Lithium level
D. Serum calcium -Correct Answer ✔A
Contraindicated during pregnancy
When teaching Marcy how to use her new insulin pump, you tell her that she needs to
monitor her blood glucose level
FNP Review Dunphy
,FNP Review Dunphy
A. at least once a day
B. only occasionally because glycemic levels are maintained very steadily
C. at least four times a day
D. on an as-needed basis when she feels she needs to give herself an extra dose of
insulin -Correct Answer ✔C
Joan has severe asthma and has been on high doses of oral corticosteroids for 2 years.
She has been reading some home remedy books and stops all of her medications. What
condition may she develop?
a. myxedema crisis
b. diabetes insipidus
c. hypoparathyroidism
d. addisonian crisis -Correct Answer ✔D
If a client has hepatitis, abdominal pain in the right upper quadrant is a result of what
patho-physiological basis?
A. Reduced prothrombin synthesis by injured hepatic cells
B. Bile salt accumulation
C. Release of pyrogens
D. Stretching of Glisson's capsule -Correct Answer ✔D
How long after the acute illness of hepatitis A do immunoglobulin M anti-hepatitis A
virus titers disappear?
A. 1 week
B. 3 to 6 months
C. 1 year
D. 2 years -Correct Answer ✔B
FNP Review Dunphy
, FNP Review Dunphy
Which of the following individuals would not be a candidate for a thiazolidinedione such
as pioglitazone (Actos)?
A. A client with a history of hyperuricemia
B. A client with asthma
C. A client with heart failure
D. A client with sulfa allergy -Correct Answer ✔C
Can exacerbate heart failure (Black Box warning)
An elderly client with hyperthyroidism may present with atypical symptoms. Which of
the following manifestations are commonly seen in the elderly with hyperthyroidism?
A. Adrenergic findings such as tachycardia
B. Weight gain, depression, and heat intolerance
C. Atrial fibrillation, depression, and weight loss
D. Heat intolerance, hyperreflexia, and anorexia -Correct Answer ✔C
Referred to as apathetic hyperthyroidism of the elderly
Which of the following statements is true about insulin lispro (Humalog)?
A. It works faster than regular insulin because its amino acid composition has been
slightly modified
B. It should be injected 30 minutes before a meal
C. Its duration of action is about 6 to 8 hours
D. It is taken with the first bite of food -Correct Answer ✔A
Insulin lispro is a rapid-acting human insulin whose amino acid composition has been
slightly modified to make it work faster. Administered 5-10 minutes before a meal
Hyperthyroidism is seen in which of the following lab results?
FNP Review Dunphy
