Ben, a client with type 1 diabetes, is hospitalized with an admitting diagnosis of diabetic
NR 511 Differential Diagnosis ketoacidosis (DKA). Which of the following signs and symptoms would be consistent with this
condition?
And Primary Care Practicum Ketonuria and polyuria.
Contents
NR 511 Week 6 ............................................................................................................................................ 1
Mary, age 72, has been taking insulin for several years. She just called you because she realized
NR 511 Differential Diagnosis And Primary Care Practicum Questions with complete solutions.............. 13 that yesterday she put her short-acting insulin in the long-acting insulin box and vice versa. She
NR 511 Week 8 Final Exam .....................................................................................................................64 just took 22 units of regular insulin when she was supposed to take only 5 units. She says that
NR 511 Week 7 Exam Questions and answers .....................................................................................154 she tried to do a fingerstick to test her glucose level but was unable to obtain any blood. She
states that she feels fine. What do you tell her to do first?
NR511-All quiz/exam questions................................................................................................................171
NR511 Davis Edge Final 370 Questions..................................................................................................... 202 "Drink four ounces of fruit juice."
NR511 Final exam ..................................................................................................................................... 313
A 35-year-old male presents to your office complaining of fatigue, weight loss, nausea, and
abdominal pain. On physical exam, you notice he has orthostatic hypotension and
NR 511 Week 6 hyperpigmented skin. You do a morning cortisol level, which is low. The plasma
You suspect that Sharon has hypoparathyroidism because, in addition to her other signs and adrenocorticotropic hormone (ACTH) is elevated. How would you treat this patient?
symptoms, she has:
Hydrocortisone.
Elevated serum phosphate levels.
Tamika, who has diabetes, states that she heard fiber is especially good to include in her diet.
Which of the following statements about hypothyroidism is not true? How do you respond?
The rate of hypothyroidism decreases with age. "Fiber, especially soluble fiber, helps improve carbohydrate metabolism, so it is more important
in the diet of persons with diabetes."
Jenny, age 46, has hypertension that has been controlled with hydrochlorothiazide 50 mg every
day for the past 3 years. She is 5 ft 8 in tall and weighs 220 lb. Her fasting blood sugar (FBS) is Betty, age 40, has had type 1 diabetes for 20 years and takes a combination of neutral protamine
300 mg/dL, serum cholesterol level is 250 mg/dL, serum potassium level is 3.4 mEq, and she has Hagedorn (NPH) and regular insulin every day. She comes to the office because she has
4+ glucosuria. Your next course of action would be to: developed a severe upper respiratory infection with chills, fever, and production of yellow
Repeat her FBS and do a glycated hemoglobin (HbA1c). sputum. Because of her acute infection, you know that Betty is likely to require:
An increase in her daily insulin dosage.
, Previous
Jay has had diabetes for 10 years. He recently had a physical and was told he has some evidence Play
of nephropathy. What is the first manifestation of this condition?
Next
Microalbuminuria.
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A low thyroid-stimulating hormone (TSH) can lead to:
0:13
Osteoporosis.
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0:15
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Which of the following is not a risk factor for diabetes mellitus type 2?
Brainpower
Caucasian race.
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Mary, age 72, has been taking insulin for several years. She just called you because she realized
that yesterday she put her short-acting insulin in the long-acting insulin box and vice versa. She
just took 22 units of regular insulin when she was supposed to take only 5 units. She says that
A patient presents to your primary care office complaining of polydipsia, polyuria, and
she tried to do a fingerstick to test her glucose level but was unable to obtain any blood. She
polyphagia. Which of the following diagnoses would not be in your differential diagnosis?
states that she feels fine. What do you tell her to do first?
Hyperthyroidism.
"Drink four ounces of fruit juice."
Which of the following conditions is a common pathological cause of hirsutism?
The most common cause of hyperthyroidism is:
Polycystic ovary syndrome.
Graves disease.
Joan has severe asthma and has been on high doses of oral corticosteroids for 2 years. She has
Marie, age 50, has type 1 diabetes and checks her blood glucose level several times every day.
been reading some home remedy books and stops all of her medications. What condition may
Her blood glucose level ranges from 250 to 280 mg/dL in the morning and is usually about 140
she develop?
at lunch, about 120 at dinner, and about 100 at bedtime. In the morning, she takes 30 units of
Addisonian crisis. neutral protamine Hagedorn (NPH) insulin and 4 units of regular insulin, and before dinner she
takes 18 units of NPH insulin and 4 units of regular insulin. Although she has had her insulin
dose adjusted several times in the past month, it has had no effect on her high morning blood
glucose level. What is your next course of action?
Have her check her blood glucose level between 2 am and 4 am for the next several days.
, describes which of the following tests and is associated with which of the following lab
abnormalities?
Chvostek sign, hypocalcemia
Steve, age 42, has never been hypertensive but appears today in the office with a blood pressure
of 162/100 mm Hg. He also complains of "attacks" of headache, perspiration, and palpitations,
with frequent bouts of nausea, pain, weakness, dyspnea, and visual disturbances. He has lost 10
lb over the past 2 months and seems very anxious today. Your next action would be to:
Martin, age 62, has acute nontransient abdominal pain that grows steadily worse in the epigastric
Obtain a 24-hour urine test for catecholamines.
area and radiates straight through to the back. The pain has lasted for days. He is also
complaining of nausea, vomiting, sweating, weakness, and pallor. Physical examination reveals
abdominal tenderness and distention and a low-grade fever. What do you suspect?
Acute pancreatitis.
A client with hyperthyroidism presents with a complaint of a "gritty" feeling in her eyes. Over
the past week, her visual acuity has diminished, and her ability to see colors has changed. She
also has a feeling of pressure behind her eyes. The next step for the nurse practitioner is to:
Refer the client for immediate evaluation by an ophthalmologist.
Dan, age 45, is obese and has type 2 diabetes. He has been having trouble getting his
glycohemoglobin under control. He has heard that exenatide (Byetta) causes weight loss and
wants to try it. What do you tell him?
"Let's try it. Your glycohemoglobin will be lowered and you may lose weight."
What is the medication of choice for an initial acute attack of gout?
A non steroidal anti-inflammatory drug (NSAID)
Which class of antihypertensive agents may be problematic for clients with diabetes?
Beta blockers.
Morris has had type 1 diabetes for 10 years. Several recent urinalysis reports have shown
microalbuminuria. Your next step would be to:
Start him on an angiotensin-converting enzyme (ACE) inhibitor.
Harriet, age 62, has type 1 diabetes that is well controlled by insulin. Recently, she has been
having marital difficulties that have left her emotionally upset. As a result of this stress, it is
possible that she will:
What is the primary pathological irregularity associated with diabetes mellitus type 1?
Have an increased blood sugar level.
Nonfunctioning beta cells.
Sadie, age 40, has just been given a diagnosis of Graves disease. She has recently lost 25 lb, has
A patient presents to your primary care office with abnormal lab results. On physical exam, you palpitations, is very irritable, feels very warm, and has a noticeable bulge on her neck. The most
tap the patient's facial nerve around the zygomatic arch, just anterior to the earlobe. This likely cause of her increased thyroid function is:
An autoimmune response.
, Mr. Reynolds is on the antithyroid drug (ATD) methimazole (Tapazole), so you make it a point The major risk factor for thyroid cancer is:
to check his:
Exposure to radiation.
Complete blood count (CBC) and liver transaminases.
What is the most common cause of Cushing disease?
Jeffrey, age 17, has gynecomastia. You should also assess him for:
Pituitary adenoma.
Testicular cancer
Lynne has Cushing syndrome. You would expect her to have or develop:
When teaching Marcy how to use her new insulin pump, you tell her that she needs to monitor
Onychomycosis.
her blood glucose level:
At least 4 times a day.
Sara, age 40, has diabetes and is now experiencing anhidrosis on the hands and feet, increased
sweating on the face and trunk, dysphagia, anorexia, and heartburn. Which complication of
A client with diabetes on a sulfonylurea and metformin with a glycated hemoglobin (HbA1c) of diabetes do you suspect?
6.5% is complaining of episodes of low blood sugar. Which of the following changes would be
Autonomic neuropathies.
the most appropriate?
Decreasing the dosage of the sulfonylurea.
We have an expert-written solution to this problem!
The process of aging results in:
When you inspect the integumentary system of clients with endocrine disorders, a finding of
coarse hair may be an indicator of: A decreased absorption of fat-soluble vitamins.
Hypothyroidism.
A 55-year-old Asian male presents with a history of severe left great toe pain. He states he
cannot even touch the toe with a sheet without it causing pain. He denies trauma but states he
To reduce the incidence of flares, foods high in what amino acid need to be limited in the diets of
cannot ambulate without pain. He admits to drinking alcohol but not to excess. On physical
patients with gout?
exam, he has normal vital signs, and you note erythema of the great toe at the interphalangeal
Purine. (IP) joint. Which of the following is the gold standard for diagnosis of this problem?
