MED SURG 1- LPN
QUESTIONS AND AND
ANSWERS UPDATED 2026
GlycosuriaBappearsBwhenBtheBbloodBglucoseBlevelBrisesBaboveB-BAnswerB180Bmg/dL
AtBthisBleveBrenalBthresholdBtheBabilityBtoBreabsorbBglucoseBandBreturnBitBtoBtheBbl
oodstream,BisBimpaired.
Ideally,BwithBfingerBtesting,BtheBbloodBsugarBshouldBmeasureB90BtoB130Bmg/dLBbefor
eBmealsBandB-BAnswerB<180Bmg/dLB1BtoB2BhoursBafterBmeals.
TightBglucoseBcontrolBinvolvesBmaintainingBnear-
normalBbloodBglucoseBlevelsBbyBtakingBshort-actingBinsulinBthroughoutBtheBdayBandB-
BAnswerBintermediate-
actingBinsulinBatBbedtime.BControllingBbloodBglucoseBlevelsBcanBdelayBtheBonsetBofBc
omplicationsBassociatedBwithBdiabetes.
TheBresultsBofBthisBA1cBtestBreflectBtheBamountBofBglucoseBthatBisBstoredBinBtheBhe
moglobinBmoleculeBduringBitsBlifeBspanBofB120BdaysB-
BAnswerBtheBhemoglobinBmoleculeBduringBitsBlifeBspanBofB120Bdays.BNormally,BtheBl
evelBofBglycosylatedBhemoglobinBisBlessBthanB7%.
aBhemoglobinBA1cBofB7%BisBtheBequivalentBofBanBaverageBbloodBglucoseBlevelBofB15
0.B8%BorBgreaterBindicateBthatBcontrolBofBtheBclient'sBbloodBglucoseBlevelBhasBbeenB
inadequateBduringBtheBpreviousB2BtoB3Bmonths.
OralBantidiabeticBdrugsBalsoBknownBasBhypoglycemicBagentsBareBprescribedBforBclients
BwithBtypeB2BdiabetesBwhoBmeetBtheBfollowingBcriteria:B-
BAnswerBFastingBbloodBglucoseBlevelBlessBthanB200Bmg/dL
InsulinBrequirementBofBlessBthanB40Bunits/day
NoBketoacidosis
NoBrenalBorBhepaticBdisease
,UseBofBalcoholBwithBsomeBoralBhypoglycemicBdrugsBmayBresultBinB-
BAnswerBabdominalBcramps,Bnausea,Bflushing,Bheadache,BandBhypoglycemia.
.BWhenBoversecretionBofBgrowthBhormoneB(GH)BoccursBbeforeBpubertyB(whenBtheBen
dsB[epiphyses]BofBtheBlongBbonesBareBnotByetBfullyBunited),B-
BAnswerBgigantismBresults
WhenBsecretionBofBGHBduringBchildhoodBisBinsufficient,B-BAnswerBdwarfismBoccurs
OversecretionBofBGHBduringBadulthoodBresultsBinB-BAnswerBacromegaly.
anBabsenceBofBpituitaryBhormonalBactivityBcausesBpanhypopituitarism,BorB-
BAnswerBSimmonds'Bdisease.
insulin-likeBgrowthBfactorB1B(IGF-1).BIGF-1,BaBhormoneBreleasedBbyBtheBliver,B-
BAnswerBstimulatesBtheBgrowthBofBbonesBandBtissue
UncheckedBGHBallowsBsustainedBproductionBofBIGF-1,BleadingBtoB-
BAnswerBlengtheningBandBwideningBofBbones,BorganBenlargement,BincreasedBbloodBgl
ucoseBlevels,BandBhyperlipidemia.
SkullBradiography,BmagneticBresonanceBimagingB(MRI),BandBcomputedBtomographyB(CT
)BrevealB-BAnswerBpituitaryBenlargement
ABglucoseBtoleranceBtestBinBcombinationBwithBaBGHBmeasurementBisBtheBmostBreliab
leBmethodBofBconfirmingB-BAnswerBacromegaly
IngestionBofBaBbolusBofBglucoseBshouldBlowerBGHBlevels,B-
BAnswerBbutBGHBlevelsBremainBelevatedBinBpersonsBwithBacromegaly
, HypophysectomyBisBtheBtreatmentBofBchoiceBforBacromegalyB-
BAnswerBsurgicalBremovalBofBtheBpituitaryBgland,BwhichBliesBwithinBtheBsellaBturcica,B
aBsaddle-
shapedBdepressionBinBtheBsphenoidBbone.BTheBglandBisBremovedBbyBpiercingBtheBsph
enoidBwithBeitherBaBsublabialB(underBtheBupperBlip)Bapproach
BromocriptineBandBcabergolineBareBusedBaloneBorBinBconjunctionBwithBpituitaryBirradi
ationBorBsurgeryBtoB-BAnswerBreduceBtheBserumBGHBgrowthBhormoneBlevel;
inhibitBtheBreleaseBofBGHBinBclientsBwithBacromegaly
DeficiencyBofBthyroid-stimulatingBhormoneB(TSH)BrequiresBreplacementBwithB-
BAnswerBlevothyroxineB(Synthroid)BorBliothyronineB(Cytomel)BforBtheBclient'sBlifetime
ForBSimmondBDiseaseBtheBnurseB-BAnswerB-administersBallBhormoneBreplacements.
-TeachBtheBclientBtoBadhereBtoBtheBmedicationBscheduleB&BneverBtoBomitBaBdose
-monitorsBbloodBhormoneBlevels
&BassessesBmentalBstatus,BemotionalBstate,BenergyBlevel,B
&Bappetite.
-alertBtoBanyBalterationsBinBnutrition.
MostBclientsBwithBSimmonds'BdiseaseBtolerateB-
BAnswerBfourBtoBsixBsmallBmealsBperBdayBbetterBthanBthreeBregularBmeals.
TheBdifferenceBinBnephrogenicB&BneurogenicBDiabeteBInipidusBis,inBnephrogenicBDiabe
tesBinsipidusBtheBsecretionBofBADHBisB-
BAnswerBnormal,BbutBtheBreceptorsBinBtheBrenalBtubulesBpartiallyBorBcompletelyBfailB
toBrespondBtoBtheBhormone.
ADHB(alsoBknownBasBvasopressinB-BAnswerB
QUESTIONS AND AND
ANSWERS UPDATED 2026
GlycosuriaBappearsBwhenBtheBbloodBglucoseBlevelBrisesBaboveB-BAnswerB180Bmg/dL
AtBthisBleveBrenalBthresholdBtheBabilityBtoBreabsorbBglucoseBandBreturnBitBtoBtheBbl
oodstream,BisBimpaired.
Ideally,BwithBfingerBtesting,BtheBbloodBsugarBshouldBmeasureB90BtoB130Bmg/dLBbefor
eBmealsBandB-BAnswerB<180Bmg/dLB1BtoB2BhoursBafterBmeals.
TightBglucoseBcontrolBinvolvesBmaintainingBnear-
normalBbloodBglucoseBlevelsBbyBtakingBshort-actingBinsulinBthroughoutBtheBdayBandB-
BAnswerBintermediate-
actingBinsulinBatBbedtime.BControllingBbloodBglucoseBlevelsBcanBdelayBtheBonsetBofBc
omplicationsBassociatedBwithBdiabetes.
TheBresultsBofBthisBA1cBtestBreflectBtheBamountBofBglucoseBthatBisBstoredBinBtheBhe
moglobinBmoleculeBduringBitsBlifeBspanBofB120BdaysB-
BAnswerBtheBhemoglobinBmoleculeBduringBitsBlifeBspanBofB120Bdays.BNormally,BtheBl
evelBofBglycosylatedBhemoglobinBisBlessBthanB7%.
aBhemoglobinBA1cBofB7%BisBtheBequivalentBofBanBaverageBbloodBglucoseBlevelBofB15
0.B8%BorBgreaterBindicateBthatBcontrolBofBtheBclient'sBbloodBglucoseBlevelBhasBbeenB
inadequateBduringBtheBpreviousB2BtoB3Bmonths.
OralBantidiabeticBdrugsBalsoBknownBasBhypoglycemicBagentsBareBprescribedBforBclients
BwithBtypeB2BdiabetesBwhoBmeetBtheBfollowingBcriteria:B-
BAnswerBFastingBbloodBglucoseBlevelBlessBthanB200Bmg/dL
InsulinBrequirementBofBlessBthanB40Bunits/day
NoBketoacidosis
NoBrenalBorBhepaticBdisease
,UseBofBalcoholBwithBsomeBoralBhypoglycemicBdrugsBmayBresultBinB-
BAnswerBabdominalBcramps,Bnausea,Bflushing,Bheadache,BandBhypoglycemia.
.BWhenBoversecretionBofBgrowthBhormoneB(GH)BoccursBbeforeBpubertyB(whenBtheBen
dsB[epiphyses]BofBtheBlongBbonesBareBnotByetBfullyBunited),B-
BAnswerBgigantismBresults
WhenBsecretionBofBGHBduringBchildhoodBisBinsufficient,B-BAnswerBdwarfismBoccurs
OversecretionBofBGHBduringBadulthoodBresultsBinB-BAnswerBacromegaly.
anBabsenceBofBpituitaryBhormonalBactivityBcausesBpanhypopituitarism,BorB-
BAnswerBSimmonds'Bdisease.
insulin-likeBgrowthBfactorB1B(IGF-1).BIGF-1,BaBhormoneBreleasedBbyBtheBliver,B-
BAnswerBstimulatesBtheBgrowthBofBbonesBandBtissue
UncheckedBGHBallowsBsustainedBproductionBofBIGF-1,BleadingBtoB-
BAnswerBlengtheningBandBwideningBofBbones,BorganBenlargement,BincreasedBbloodBgl
ucoseBlevels,BandBhyperlipidemia.
SkullBradiography,BmagneticBresonanceBimagingB(MRI),BandBcomputedBtomographyB(CT
)BrevealB-BAnswerBpituitaryBenlargement
ABglucoseBtoleranceBtestBinBcombinationBwithBaBGHBmeasurementBisBtheBmostBreliab
leBmethodBofBconfirmingB-BAnswerBacromegaly
IngestionBofBaBbolusBofBglucoseBshouldBlowerBGHBlevels,B-
BAnswerBbutBGHBlevelsBremainBelevatedBinBpersonsBwithBacromegaly
, HypophysectomyBisBtheBtreatmentBofBchoiceBforBacromegalyB-
BAnswerBsurgicalBremovalBofBtheBpituitaryBgland,BwhichBliesBwithinBtheBsellaBturcica,B
aBsaddle-
shapedBdepressionBinBtheBsphenoidBbone.BTheBglandBisBremovedBbyBpiercingBtheBsph
enoidBwithBeitherBaBsublabialB(underBtheBupperBlip)Bapproach
BromocriptineBandBcabergolineBareBusedBaloneBorBinBconjunctionBwithBpituitaryBirradi
ationBorBsurgeryBtoB-BAnswerBreduceBtheBserumBGHBgrowthBhormoneBlevel;
inhibitBtheBreleaseBofBGHBinBclientsBwithBacromegaly
DeficiencyBofBthyroid-stimulatingBhormoneB(TSH)BrequiresBreplacementBwithB-
BAnswerBlevothyroxineB(Synthroid)BorBliothyronineB(Cytomel)BforBtheBclient'sBlifetime
ForBSimmondBDiseaseBtheBnurseB-BAnswerB-administersBallBhormoneBreplacements.
-TeachBtheBclientBtoBadhereBtoBtheBmedicationBscheduleB&BneverBtoBomitBaBdose
-monitorsBbloodBhormoneBlevels
&BassessesBmentalBstatus,BemotionalBstate,BenergyBlevel,B
&Bappetite.
-alertBtoBanyBalterationsBinBnutrition.
MostBclientsBwithBSimmonds'BdiseaseBtolerateB-
BAnswerBfourBtoBsixBsmallBmealsBperBdayBbetterBthanBthreeBregularBmeals.
TheBdifferenceBinBnephrogenicB&BneurogenicBDiabeteBInipidusBis,inBnephrogenicBDiabe
tesBinsipidusBtheBsecretionBofBADHBisB-
BAnswerBnormal,BbutBtheBreceptorsBinBtheBrenalBtubulesBpartiallyBorBcompletelyBfailB
toBrespondBtoBtheBhormone.
ADHB(alsoBknownBasBvasopressinB-BAnswerB