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NR565 Final EXAM LATEST ACTUL QUESTIONS AND CORRECT DETAILED ANSWERS GRADED A+
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NR565 Final EXAM LATEST ACTUL QUESTIONS AND CORRECT DETAILED ANSWERS GRADED A+
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NR565 Final EXAM LATEST 2024-2025 ACTULQUESTIONS AND CORRECT DETAILED ANSWERS
GRADED A+
A1c general goals - ASNWER-<7, patients that experience severe
hypoglycemia/have a limited life expectancy may have an A1C goal of <8.
A1c older adults - ASNWER-<8, those with multiple coexisting chronic illnesses,
cognitive impairment, or functional dependence should have less stringent
glycemic goals such as <8.0-8.5.
When should insulin be considered? - ASNWER-For treatment of persistent
hyperglycemia starting at a threshold of >180.
Early introduction of insulin should be considered if there is evidence of ongoing
weight loss, if symptoms of hyperglycemia are present, or whenA1C levels >10%
or BGS >300
At what time interval should A1c be re-checked?
,How often should an A1C be monitored when stable or when unstable? -
ASNWER-Every 2-3 months and max of 4 times a year. If <7, every 6 months.
What labs are used to diagnose hypo/hyper thyroid? - ASNWER-TSH, T3, and T4.
High TSH = hypo and low TSH = hyper. Opposites.
Timeframe for re-check of labs after starting levothyroxine - ASNWER-6-8 weeks
(long half-life). Yearly after stable.
Signs and symptoms of hypothyroidism - ASNWER-Dry hair, puffy face, goiter in
the neck, slow heartbeat, weight gain, constipation, infertility, increased risk of
miscarriages, irregular menstrual cycle, cold intolerance.
Drug of choice for hypothyroidism - ASNWER-Levothyroxine (Synthroid)
§ Signs and symptoms of hyperthyroidism - ASNWER-Hair loss, bulging eyes,
goiter, rapid heartbeat, weight loss, diarrhea, menstrual periods loss often or
longer.
Drug of choice for hyperthyroidism - ASNWER-Methimazole (Tapazole)
Treatment of thyroid storm - ASNWER-high doses of potassium iodide or strong
iodine solution are given to suppress thyroid hormone release. Methimazole is
given to suppress thyroid hormone synthesis. Beta blocker given to reduce HR.
additional measures include sedation, cooling, and giving glucocorticoids and IV
fluids.
,Result of not treating hypothyroidism during pregnancy: - ASNWER-Permanent
neuro-psychological deficits in the child. Decrease IQ/neuropsychological
function. First trimester.
Medication to treat symptoms of hyperthyroidism (notice this is treating
symptoms and not the hyperthyroidism itself): - ASNWER-Beta blockers
(tachycardia) - propranolol/atenolol most popular.Non-radioactive iodine.
ADJUNCTIVE THERAPY.
Drug/Food/Supplement interactions with levothyroxine: - ASNWER-Do not take
antacids, Calcium or Iron, how to take it (morning 30-60 min b4 eat.
How to confirm a diagnosis of DM prior to beginning treatment: - ASNWER-Fasting
plasma glucose above 126. A random plasma glucose of over 200 plus symptoms
of diabetes, an oral glucose tolerance test of two hours, plasma glucose of over
200, or a A1C higher than 6.5.
At least two times a year if meeting goals and quarterly if meds have changed or
not meeting goals.
Action of Insulin - ASNWER-Anabolic, energy conservation, promotes cellular
growth and division.
Pioglitazone contraindications: - ASNWER-Heart failure (severe = no, mild =
caution) and bladder cancer. Causes fluid retention.
GLP-1 (abbreviation and examples) - ASNWER-Glucagonlike Peptide -
Subcutaneous injections - Dulaglutide (Trulicity), Semaglutide (Ozempic),
Liraglutide (Victoza).
, SGLT2i (abbreviation and examples) - ASNWER-Sodium Glucose Cotransporter 2
Inhibitors - Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin
(Jardiance).
DPP4-I (abbreviation and examples) - ASNWER-Dipeptidyl Peptidase-4 Inhibitors -
Sitagliptin, Saxagliptin, Linagliptin, Alogliptin.
Who is at risk for toxicity and why? - ASNWER-smokers require higher doses.
Heart disease liver disease require lower doses. INITIAL doses are based on age
and weight. P.569 low therapeutic range. Smoking causes increased clearance so if
stop smoking levels will rise to toxic levels.
Step 1 therapy for asthma and COPD - ASNWER-Manage with a SABA (albuterol)
as needed.
Symptoms associated with intermittent asthma frequency - ASNWER-2 days/week
or less
TZD (abbreviation and examples) - ASNWER-Thiazolidinediones - Rosiglitazone &
Pioglitazone
Which drug class should be considered for diabetes prior to insulin? - ASNWER-It
is recommended that a GLP-1 be considered before starting insulin. Metformin
first always unless contraindicated.
Ratio of basal insulin to rapid-acting insulin in total daily dose (TDD) of insulin -
ASNWER-Basal and bolus insulin replacement encompasses approximately 50% of
the total daily insulin dose (TDD)
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