NUR 504 - Exam 1 Practice Questions and Correct Answers
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Course
NUR 504
Institution
NUR 504
1. What labs will you test before initiating antithyroid medication? Baseline CBC and LFTs
(Dunphy Chapter 57) this is to make sure that someone is healthy before starting medication. Rare but serious side effects of antithyroid medications include agranulocytosis and liver damage.
What diet woul...
NUR 504 - Exam 1 Practice Questions
and Correct Answers
1. What labs will you test before initiating antithyroid medication? ✅Baseline CBC and
LFTs
(Dunphy Chapter 57) this is to make sure that someone is healthy before starting
medication. Rare but serious side effects of antithyroid medications include
agranulocytosis and liver damage.
What diet would you recommend to a patient who has been diagnosed with
hyperthyroidism? ✅Patients who have experienced significant weight loss would
benefit from
a high-carbohydrate, high calorie diet.
Once treatment is initiated and the patient is euthyroid, caloric needs decrease but the
patient may still have an increased appetite, a sensible diet low in fat and sugar with
adequate protein may avoid significant unwanted weight gain during this timeframe.
(Dunphy chapter 57)
What is the goal of thyroid hormone replacement therapy? What could happen with over
treatment? ✅The goal is to normalize, not suppress TSH.
Treat with Levothyroxine (L4) to TSH target of 0.5-3.5 or 4 mIU/L.
Suppressed TSH, particularly in post-menopausal women or individuals with
levothyroxine over-replacement, causes decreased bone mineral density after several
years, leading to osteoporosis (Dunphy chapter 57)
What are the hallmark features of hypothyroidism? ✅Fatigue, weight gain, hoarseness,
hyperlipidemia, constipation, bradycardia. (Brucker and King Pharm book page 532)
What should you educate your patient about regarding Levothyroxine (LT4)
administration? ✅Take this medication in the morning on an empty stomach, and do
not eat anything for 30-60 minutes after taking the medication as this can decrease
absorption of Levothyroxine.
Also important to consistently take the same brand or generic formulation, do not switch
these (pharm book)
What is the diagnostic criteria for diabetes? ✅a. HbA1C 6.5 or higher
, b. Symptoms of diabetes (polyuria, polydipsia, weight loss) AND a random BG level of
200 mg/dl or higher
c. Fasting (at least 8hr since last meal) BG of 126 mg/dl or higher
d. 2 hour BG of 200 mg/dl or higher during oral glucose tolerance test with 75g glucose
load
e. Any ONE of the previous are diagnostic criteria type 1
f. Any TWO are criteria for type 2
(Dunphy Chapter 58)
How should you counsel a patient who has Type 1 DM and wishes to exercise more but
is scared about how it will influence their diabetes? ✅a. People with DM1 can perform
all levels of exercise as long as glycemic control is achieved and there are no other
risks for complications
b. Guidelines:
i. Check BG before, q30-60 minutes during, and after exercise
ii. Avoid exercise if fasting glucose is >250 mg/dL and ketosis is present OR BG
>300mg/dL
iii. Consume additional carbs is BG <100mg/dL to avoid hypoglycemia
iv. Identify when changes in insulin dose or food intake are necessary.
c. This is also true for a Type 2 diabetic, incorporating exercise is an important part of
the treatment plan however education about their medications should be provided to
prevent the risk of hypoglycemia.
Additionally, before starting an exercise program the patient should be screened for
presence of macrovascular and microvascular complications that can be worsened with
exercise (CAD, PVD, retinopathy, nephropathy, and peripheral or autonomic
neuropathy)
(Chapter 58 Dunphy)
What are the risk factors for Diabetes Mellitus Type 2 ✅a. Family history (first degree
relative)
b. BMI >25 (lower for Asian Americans)
c. Age >45
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