1
NR 566 Midterm Exam
2025(Form A & B) | Actual
Graded A+ Questions with
Verified Detailed Answers
ase
Drugs associated risk for bone loss which should be monitored
--- -----
ANS ------Aromat
inhibitors
Thyroid hormones
Glucocorticoids
PPIs
SSRIs
Clinical signs and symptoms--------
DM ANS ------Increased thirst
Frequent urination
Extreme hunger
Unexplained weight loss
Presence of ketone
s in the urine (ke
tones are a byproducthe
of breakdown
t of muscle and fat that happens when
there's not enough
available insulin)
Fatigue
Irritability
Blurred vision
Slow-healing sores
Frequent infections, such as gums or skin infections and vaginal infections
Bioavailability of bisphosphonate drugs and appropriate patient
education --------ANS-----Histamine2 blocking agents double
alendronate bioavailability, but the impact is unknown. Aspirin may
,2
decrease the bioavailability of tiludronate by up to 50% when taken 2
hours after the tiludronate. Although indomethacin increases the
bioavailability of tiludronate by 2- to 4-fold, the bioavailability is not
significantly altered by diclofenac; therefore, each NSAID must be
considered individually.
Adverse effects associated with long-term use of bisphonates --------
ANS------Etidronate has also been associated with fractures in patients
with Paget's disease when they are given high doses or when therapy
lasted longer than 6 months. These patients must be carefully monitored
with x-rays and laboratory work to assess for these lesions. The
development of a rare form of subtrochanteric femur fracture in non-
Paget's patients using bisphosphonates is under close scrutiny and has
contributed to movement away from osteopenia prevention care to only
osteoporosis therapy (FDA, 2010a).
Specifics about administration and education regarding pancreatic
enzymes --------ANS------All doses are taken immediately before or with
meals or snacks with a fatty component. Fruit, hard candy, fruit juice
like drinks, tea or coffee, or popsicles do not require enzymes (CFF,
2009). Capsules may be opened and sprinkled on food. Capsules with
enteric-coated beads should not be chewed. They may be sprinkled on
soft acidic food that is not hot and that can be swallowed without
chewing, such as applesauce or gelatin. Swallow immediately because
the proteolytic enzymes may irritate the mucosa. Following with a glass
of water or juice or eating immediately after taking the drug helps to
ensure that the medication is swallowed and does not remain in contact
with the mouth and esophagus for long periods. Pancrelipase is
destroyed by acid. Proton pump inhibitors, sodium bicarbonate, or
aluminum-based antacids may be used with preparations without enteric
coating to neutralize gastric pH. Calcium- and magnesium-based
antacids should not be used for this purpose because they interfere with
drug action. Entericcoated beads are designed to withstand the acid pH
,3
of the stomach. Enteric-coated formulations should not be mixed with
alkaline food or the coating will be destroyed.
Common adverse effects with aromatase inhibitors --------ANS------
Adverse effects for the drug class include various pain syndromes,
vertigo, insomnia resulting in daytime sleepiness and confusion,
increased risk of blood clots, and hair loss. A key concern is the loss of
bone mass. Bone loss can be significant when considering the
concurrent osteoporotic risks of postmenopause. Closer monitoring is
required. All patients should be on calcium and vitamin D
supplementation. A relative leukopenia can occur, but the incidence of
viral and bacteria infections is not considered greater than matched
groups (about 10%). Hypertension occurs in 10% of patients. A life-
threatening
Diagnostic criteria increase
of DM --------in bloodANSWER
CORRECT clotting can result in MI, stroke, or
concentration ≥200 mg/dL.
pulmonary embolus. Hot flashes can be intense.
Risk factors & associated complications of DM --------ANS------
Complications: stroke, heart attack, peripheral artery disease, diabetic
retinopathy, cataracts, glaucoma, diabetic nephropathy, peripheral
neuropathy, diabetic foot.
Risk factors: >45 years old, physical inactivity, 1st degree relative
relative with DM, high risk ethic group (african american, hispanic,
native american, asian american, and pacific islander), hx of gest DM,
htn, HDL < 35, triglycerides >250, polycystic ovarian syndrome,
acanthosis nigricans, hx of cardiovascular disease.
------Acute symptoms of diabetes plus casual plasma glucose
*Casual is defined as any time of day without regard to time since last
meal. The classic symptoms of diabetes are polyuria, polydipsia, and
unexplained weight loss.
, 4
Fasting plasma glucose ≥126 mg/dL. * Fasting is defined as no caloric
intake for at least 8 h.
2-h postload plasma glucose in an oral glucose tolerance test ≥200
mg/dL. The test uses a glucose load containing the equivalent of 75 g
anhydrous glucose dissolved in water.
Hb A1c ≥6.5%.
PRE-DIABETES:
Fasting plasma glucose 100-125 mg/dL (IFG) or
plasma glucose 140-199 mg/dL (IGT) 2 hr post-ingestion
of standard glucose load (75 g) or Hb A1c 5.7%-6.4%
Criteria for screening asymptomatic adults --------ANS------Individuals
≥45 yr and who have a BMI ≥25 kg/m2 should be tested. If normal, the
test should be repeated at 3 yr intervals.
Individuals <45 yr and who have a BMI ≥25 kg/m2 and have additional
risk factors should have more frequent testing.
Additional risk factors are the following:
• Physically inactive
• First-degree relative with diabetes
• Members of high-risk ethnic group (African American, Hispanic,
Native American, Asian American, Pacific Islander)
• Delivered a baby weighing >9 lb or previously diagnosed with GDM
• Hypertensive (B/P ≥140/90 mm Hg)
• HDL cholesterol ≤35 mg/dL and/or triglyceride level ≥250 mg/dL
• Have polycystic ovary syndrome (PCOS)
• IGT or IFG on previous testing
• Have other clinical conditions associated with insulin resistance (PCOS
or acanthosis nigricans)
• History of CVD
Insulin Treatment Algorithm for Type 1 DM --------ANS------Total daily
insulin requirement is 0.3
NR 566 Midterm Exam
2025(Form A & B) | Actual
Graded A+ Questions with
Verified Detailed Answers
ase
Drugs associated risk for bone loss which should be monitored
--- -----
ANS ------Aromat
inhibitors
Thyroid hormones
Glucocorticoids
PPIs
SSRIs
Clinical signs and symptoms--------
DM ANS ------Increased thirst
Frequent urination
Extreme hunger
Unexplained weight loss
Presence of ketone
s in the urine (ke
tones are a byproducthe
of breakdown
t of muscle and fat that happens when
there's not enough
available insulin)
Fatigue
Irritability
Blurred vision
Slow-healing sores
Frequent infections, such as gums or skin infections and vaginal infections
Bioavailability of bisphosphonate drugs and appropriate patient
education --------ANS-----Histamine2 blocking agents double
alendronate bioavailability, but the impact is unknown. Aspirin may
,2
decrease the bioavailability of tiludronate by up to 50% when taken 2
hours after the tiludronate. Although indomethacin increases the
bioavailability of tiludronate by 2- to 4-fold, the bioavailability is not
significantly altered by diclofenac; therefore, each NSAID must be
considered individually.
Adverse effects associated with long-term use of bisphonates --------
ANS------Etidronate has also been associated with fractures in patients
with Paget's disease when they are given high doses or when therapy
lasted longer than 6 months. These patients must be carefully monitored
with x-rays and laboratory work to assess for these lesions. The
development of a rare form of subtrochanteric femur fracture in non-
Paget's patients using bisphosphonates is under close scrutiny and has
contributed to movement away from osteopenia prevention care to only
osteoporosis therapy (FDA, 2010a).
Specifics about administration and education regarding pancreatic
enzymes --------ANS------All doses are taken immediately before or with
meals or snacks with a fatty component. Fruit, hard candy, fruit juice
like drinks, tea or coffee, or popsicles do not require enzymes (CFF,
2009). Capsules may be opened and sprinkled on food. Capsules with
enteric-coated beads should not be chewed. They may be sprinkled on
soft acidic food that is not hot and that can be swallowed without
chewing, such as applesauce or gelatin. Swallow immediately because
the proteolytic enzymes may irritate the mucosa. Following with a glass
of water or juice or eating immediately after taking the drug helps to
ensure that the medication is swallowed and does not remain in contact
with the mouth and esophagus for long periods. Pancrelipase is
destroyed by acid. Proton pump inhibitors, sodium bicarbonate, or
aluminum-based antacids may be used with preparations without enteric
coating to neutralize gastric pH. Calcium- and magnesium-based
antacids should not be used for this purpose because they interfere with
drug action. Entericcoated beads are designed to withstand the acid pH
,3
of the stomach. Enteric-coated formulations should not be mixed with
alkaline food or the coating will be destroyed.
Common adverse effects with aromatase inhibitors --------ANS------
Adverse effects for the drug class include various pain syndromes,
vertigo, insomnia resulting in daytime sleepiness and confusion,
increased risk of blood clots, and hair loss. A key concern is the loss of
bone mass. Bone loss can be significant when considering the
concurrent osteoporotic risks of postmenopause. Closer monitoring is
required. All patients should be on calcium and vitamin D
supplementation. A relative leukopenia can occur, but the incidence of
viral and bacteria infections is not considered greater than matched
groups (about 10%). Hypertension occurs in 10% of patients. A life-
threatening
Diagnostic criteria increase
of DM --------in bloodANSWER
CORRECT clotting can result in MI, stroke, or
concentration ≥200 mg/dL.
pulmonary embolus. Hot flashes can be intense.
Risk factors & associated complications of DM --------ANS------
Complications: stroke, heart attack, peripheral artery disease, diabetic
retinopathy, cataracts, glaucoma, diabetic nephropathy, peripheral
neuropathy, diabetic foot.
Risk factors: >45 years old, physical inactivity, 1st degree relative
relative with DM, high risk ethic group (african american, hispanic,
native american, asian american, and pacific islander), hx of gest DM,
htn, HDL < 35, triglycerides >250, polycystic ovarian syndrome,
acanthosis nigricans, hx of cardiovascular disease.
------Acute symptoms of diabetes plus casual plasma glucose
*Casual is defined as any time of day without regard to time since last
meal. The classic symptoms of diabetes are polyuria, polydipsia, and
unexplained weight loss.
, 4
Fasting plasma glucose ≥126 mg/dL. * Fasting is defined as no caloric
intake for at least 8 h.
2-h postload plasma glucose in an oral glucose tolerance test ≥200
mg/dL. The test uses a glucose load containing the equivalent of 75 g
anhydrous glucose dissolved in water.
Hb A1c ≥6.5%.
PRE-DIABETES:
Fasting plasma glucose 100-125 mg/dL (IFG) or
plasma glucose 140-199 mg/dL (IGT) 2 hr post-ingestion
of standard glucose load (75 g) or Hb A1c 5.7%-6.4%
Criteria for screening asymptomatic adults --------ANS------Individuals
≥45 yr and who have a BMI ≥25 kg/m2 should be tested. If normal, the
test should be repeated at 3 yr intervals.
Individuals <45 yr and who have a BMI ≥25 kg/m2 and have additional
risk factors should have more frequent testing.
Additional risk factors are the following:
• Physically inactive
• First-degree relative with diabetes
• Members of high-risk ethnic group (African American, Hispanic,
Native American, Asian American, Pacific Islander)
• Delivered a baby weighing >9 lb or previously diagnosed with GDM
• Hypertensive (B/P ≥140/90 mm Hg)
• HDL cholesterol ≤35 mg/dL and/or triglyceride level ≥250 mg/dL
• Have polycystic ovary syndrome (PCOS)
• IGT or IFG on previous testing
• Have other clinical conditions associated with insulin resistance (PCOS
or acanthosis nigricans)
• History of CVD
Insulin Treatment Algorithm for Type 1 DM --------ANS------Total daily
insulin requirement is 0.3
