NURS 623 EXAM 2 | ALL QUESTIONS AND
CORRECT ANSWERS | ALREADY GRADED
A+ | VERIFIED ANSWERS | LATEST
VERSION (JUST RELEASED) | MARYVILLE
UNIVERSITY
What is the classification of the recommended first choice of oral
antihyperglycemic medication in Type 2 DM? ------CORRECT ANSWER----
-----------BIGUANIDE - METFORMIN
What periodic testing should you order if a patient has been on the first
choice oral antihyperglycemic medicine long term and complains of
neuropathy? Why? (hint: hematological) ------CORRECT ANSWER-----------
----●Vitamin B12 annually (CAN CAUSE B12 DEF)
What is the goal of treatment for DM2? ------CORRECT ANSWER-------------
--A1C <7%; PREVENT FURTHER ORGAN DAMAGE
What subsequent laboratory tests are needed to evaluate the general
health of patients with DM2 (consider co-morbidities)? ------CORRECT
ANSWER---------------CMP (liver, kidney, glucose), Lipids, serum creatinine,
and urine albumin
What is the treatment for acute hypoglycemia in an alert patient? ------
CORRECT ANSWER---------------6 to 12 ounces of orange juice or another
fruit juice without additional sugar. One cup (8 oz) of milk can be
substituted if juice is not available. Glucose tablets, If available
,What is the primary cause of mortality in DM patients? ------CORRECT
ANSWER---------------ISCHEMIC HEART FAILURE
You are Seeing a patient in the office and you determine they need to start
insulin for DM2, what type of insulin would you select and how would you
initiate their dosing regimen? ------CORRECT ANSWER---------------A1C
<8% BASAL (LONG ACTING) 0.1-0.2 U/KG
A1C >8% BASAL (LONG ACTING) 0.2-0.3 U/KG
TITRATE EVERY 2-3 DAYS DEPENDING ON FINGER STICK GLUCOSE
Middle-aged man presents with a painful, hot, red, swollen MTP joint of
great toe. Precipitated by weekend of binge drinking. What is the likely
diagnosis? ------CORRECT ANSWER---------------GOUT
What are the PRIMARY risk factors for gout? ------CORRECT ANSWER----
-----------PRIMARY: ENZYME DEFECT & DECREASED RENAL
CLEARANCE OF URIC ACID
What are the SECONDARY risk factors for gout? ------CORRECT
ANSWER---------------EXCESSIVE PURINE
OBESITY
STARVATION
ALCOHOL ABUSE
MEDS: THIAZIDES, NIACIN
What diagnostic results would be seen with gout? ------CORRECT
ANSWER---------------elevated serum uric acid levels, ESR and WBCs;
,What is the initial management for an acute attack of gout? ------CORRECT
ANSWER---------------COLCHICINE 1.2mg PO X 1 then 0.6mg in 1 hour
(within 36 hrs of onset up to 0.6 mg) NSAIDs, AND CORTICOSTEROIDS;
rest, elevation, immobilization
What is the subsequent pharmacological management used to prevent
further attacks of prophylaxis? ------CORRECT ANSWER---------------
ALLOPURINOL (wait 4-6 week to after acute attack to start)
What educational information should you discuss with a patient diagnosed
with gout? ------CORRECT ANSWER---------------AVOID FOODS HIGH IN
PURINE (MEAT & SEAFOOD, YEAST, BEER/ALCOHOL, BEANS, PEAS,
LENTILS, OATS, SPINACH, ASPARAGUS, CAULIFLOWER,
MUSHROOMS
How is obesity classified? ------CORRECT ANSWER---------------BMI >30,
WAIST >40" MEN & >35" WOMEN
What are the consequences of obesity? ------CORRECT ANSWER-----------
----CAD, CHF, HTN, HYPERLIPIDS, TYPE II DM, SLEEP APNEA,
RESTRICTIVE LUNGS, GOUT, VENOUS INSUFF, GERD,
GALLBLADDER, BLOOD CLOTS
The cluster of factors for metabolic syndrome include? ------CORRECT
ANSWER---------------HTN, HYPERLIPIDEMIA, INSULIN RESISTANCE
, Patients with metabolic syndrome are twice at risk for developing _____
over 5 yrs and have a 5-fold risk of ____? ------CORRECT ANSWER---------
------CVD; DM II
Brittle, coarse hair might be a sign of what thyroid disorder ------CORRECT
ANSWER---------------hypothyroidism
A thyroid bruit, gynomastia, fine hair, warm, smoot, moist skin are all
associated with what thyroid disorder ------CORRECT ANSWER---------------
hyperthyroidism
Hirsutism, Purple striae over the abdomen is seen with what condition and
hyperpigmentation are seen with what disease? ------CORRECT ANSWER-
--------------Cushings syndrome
ACE inhibitors are given to patients who have diabetes with persistent? -----
-CORRECT ANSWER---------------proteinuria
Addison crisis can be precipitated by? ------CORRECT ANSWER--------------
-abruptly stopping glucocorticoid medications
Signs and symptoms of DKA ------CORRECT ANSWER---------------
Kussmaul respirations (very deep), hypergylcemia, glucosuria, polyuria,
polydipsia, anorexia and headache, keytonuria, decreased blood pH
