NR667 Chamberlain Week 8 CEA Exit Exam 2025 | Comprehensive
Review Guide with Clinical Practice Scenarios, Final Exam Questions,
Answers & Rationales | CEA Mastery for AGACNP, FNP, PMHNP,
DNP, and MSN Students
What are the 5 traits of metabolic syndrome? (Need to have 3 for a diagnosis)
-Male waist >40in or female waist > 35 in
-HTN: BP >130/80
-Trigylcerides >150
-Serum HDL < 40 in males or < 50 in females
-Hyperglycemia: fasting glucose > 100
What is the BP goal for patients with diabetes?
130/80 (to protect the kidneys)
What condition causes a blood sugar >600 (600-1200), hyperosmolality, and often causes neuro
impairment?
Hyperglycemia Hyperosmolar State (HHS)
What A1C reading indicates diabetes?
6.5% or greater
When a patient has diabetes, what should their A1C be to be considered "well controlled"?
7.0%
What should the A1C be before adding a second medication?
8.0%
What is the first-line treatment (medication) for a patient with Type 2 diabetes?
Biguanides (Metformin)
Which diabetic medication class is often used as a 2nd line treatment but causes hypoglyccemia?
Sulfonylureas (glupizide, glyburide, glimepiride)
What class of diabetic medication is contra-indicated with a personal or family history of thyroid
carcinoma?
GLP-1
Which class of diabetic medications cause glucose to be excreted through the bladder and has a side effect
of frequent UTIs and yeast infections?
SGLT2 inhibitors (end in "gliflozin")
, What insulin is long acting?
Lantus (20-24 + hours)
S/S of hypothyroidism
fatigue, difficulty losing weight, constipation, cold intolerance, menorrhagia, coarse nails, brittle hair, delayed
relaxation phase of DTRs, hypothermia, goiter
What will labs look like for hypothyroidism?
Elevated TSH and decreased T4
Treatment of hypothyroidism
Levothyroxine
Therapeutic/starting doses of levothyroxine
Therapeutic is typically 1mcg/kg/day
Start low (25-50mcg) and increase as needed
When should thyroid levels be checked after starting levothyroxine?
6-8 weeks
What lab is checked to check for autoimmune hypothyroidism/Hashimoto's?
Anti-PTO
S/S of hyperthyroidism
fatigue, insomnia, anxiety, nervousness, weight loss, palpitations, diarrhea, heat intolerance, menorrhagia,
coarse nails, brittle hair, brisk reflexes, hyperthermia, tachycardia, tremors, eye sx (exophthalmos), diaphoresis,
goiter, new onset a-fib
What will labs look for hyperthyroidism?
Low TSH, elevated T4
What should you do if both TSH and T4 are elevated?
Scan the brain (brain tumor, etc)
Treatment for hyperthyroidism
methimazole, PTU, radioactive iodine ablation, surgery/thyroidectomy (rare)
What medication can be used to manage the symptoms/tachycardia in hyperthyroid patients?
propanolol
Longstanding, untreated hyperthyroid can lead to:
Thyroid storm
Sx of thyroid storm
Review Guide with Clinical Practice Scenarios, Final Exam Questions,
Answers & Rationales | CEA Mastery for AGACNP, FNP, PMHNP,
DNP, and MSN Students
What are the 5 traits of metabolic syndrome? (Need to have 3 for a diagnosis)
-Male waist >40in or female waist > 35 in
-HTN: BP >130/80
-Trigylcerides >150
-Serum HDL < 40 in males or < 50 in females
-Hyperglycemia: fasting glucose > 100
What is the BP goal for patients with diabetes?
130/80 (to protect the kidneys)
What condition causes a blood sugar >600 (600-1200), hyperosmolality, and often causes neuro
impairment?
Hyperglycemia Hyperosmolar State (HHS)
What A1C reading indicates diabetes?
6.5% or greater
When a patient has diabetes, what should their A1C be to be considered "well controlled"?
7.0%
What should the A1C be before adding a second medication?
8.0%
What is the first-line treatment (medication) for a patient with Type 2 diabetes?
Biguanides (Metformin)
Which diabetic medication class is often used as a 2nd line treatment but causes hypoglyccemia?
Sulfonylureas (glupizide, glyburide, glimepiride)
What class of diabetic medication is contra-indicated with a personal or family history of thyroid
carcinoma?
GLP-1
Which class of diabetic medications cause glucose to be excreted through the bladder and has a side effect
of frequent UTIs and yeast infections?
SGLT2 inhibitors (end in "gliflozin")
, What insulin is long acting?
Lantus (20-24 + hours)
S/S of hypothyroidism
fatigue, difficulty losing weight, constipation, cold intolerance, menorrhagia, coarse nails, brittle hair, delayed
relaxation phase of DTRs, hypothermia, goiter
What will labs look like for hypothyroidism?
Elevated TSH and decreased T4
Treatment of hypothyroidism
Levothyroxine
Therapeutic/starting doses of levothyroxine
Therapeutic is typically 1mcg/kg/day
Start low (25-50mcg) and increase as needed
When should thyroid levels be checked after starting levothyroxine?
6-8 weeks
What lab is checked to check for autoimmune hypothyroidism/Hashimoto's?
Anti-PTO
S/S of hyperthyroidism
fatigue, insomnia, anxiety, nervousness, weight loss, palpitations, diarrhea, heat intolerance, menorrhagia,
coarse nails, brittle hair, brisk reflexes, hyperthermia, tachycardia, tremors, eye sx (exophthalmos), diaphoresis,
goiter, new onset a-fib
What will labs look for hyperthyroidism?
Low TSH, elevated T4
What should you do if both TSH and T4 are elevated?
Scan the brain (brain tumor, etc)
Treatment for hyperthyroidism
methimazole, PTU, radioactive iodine ablation, surgery/thyroidectomy (rare)
What medication can be used to manage the symptoms/tachycardia in hyperthyroid patients?
propanolol
Longstanding, untreated hyperthyroid can lead to:
Thyroid storm
Sx of thyroid storm
