NURS 6531 FINAL EXAM REVISION HANDBOOK
2026 MEDICATION CLASSES AND EVIDENCE
BASED PRESCRIBING
◉ A patient has new-onset hypertension with a systolic blood
pressure of 180 mm Hg. Which test will the provider order to
diagnose this patient?
a. ACTH suppression testing
b. Adrenal antibody tests
c. Cortisol excretion studies
d. Fractionated metanephrine levels.
Answer: ANS: D
Patients with pheochromocytoma may present with new-onset
hypertension with systolicpressure >170 mm Hg. Fractionated
metanephrine will be elevated when the diagnosis is confirmed.
ACTH suppression testing and cortisol excretion studies are
performed to diagnose Cushing's syndrome. Adrenal antibody tests
are performed as part of the evaluation for Addison's disease.
◉ A patient has rapid weight gain, amenorrhea without pregnancy,
and mild hypertension. Once confirmatory tests are performed, what
is a possible treatment for this patient?
a. Antihypertensive therapy
,b. Mineralocorticoid replacement
c. Oral hydrocortisone
d. Pituitary tumor resection.
Answer: ANS: D
This patient has symptoms of Cushing's syndrome. When indicated,
pituitary tumor resection is performed as the first choice.
Antihypertensive therapy is initiated in patients with
pheochromocytoma. Mineralocorticoids and glucocorticoids are
given to patients with Addison's disease.
◉ A patient has unexplained weight loss and the provider notes
increased skin pigmentation on light-exposed skin folds along with
darkened palmar creases. Which laboratory tests will the provider
order? (Select all that apply.)
a. Serum ACTH
b. Serum cortisol
c. Serum electrolytes
d. TB skin testing
e. Urine cortisol.
Answer: ANS: A, C, D
This patient has symptoms of Addison's disease. Serum ACTH will be
elevated in patients with Addison's disease. Hyponatremia and
hyperkalemia may occur and are sometimes the initial finding. TB
skin testing is done to exclude tuberculosis. Serum and urine cortisol
levels are evaluated with Cushing's syndrome is suspected.
,◉ An obese patient has recurrent urinary tract infections and
reports feeling tired most of the time. What initial diagnostic test
will the provider order in the clinic at this visit?
a. C-peptide level
b. Hemoglobin A1C
c. Random serum glucose
d. Thyroid studies.
Answer: ANS: B
HbA1C, along with fasting plasma glucose or a 2-hour plasma
glucose during an oral glucose tolerance test (OGTT), is diagnostic of
diabetes. This patient is probably not fasting, so a glucose level will
not be helpful. C-peptide levels help to distinguish type 1 from type
2 diabetes and may be performed after a diagnosis of diabetes is
made and if there is uncertainty about the cause. Thyroid studies are
helpful in evaluating comorbidity.
◉ A patient diagnosed with type 2 diabetes mellitus becomes insulin
dependent after a year of therapy with oral diabetes medications.
When explaining this change in therapy, the provider will tell the
patient
a. it is necessary because the patient cannot comply with the
previous regimen.
b. that strict diet and exercise measures may be relaxed with insulin
therapy.
, c. the use of insulin therapy may be temporary.
d. this is because of the natural progression of the disease..
Answer: ANS: D
Even after several years of therapy for type 2 DM well controlled
with oral diabetic medications, diet, and exercise, the natural
progression of the disease may require patients to become insulin
dependent. Patients must understand that this does not represent
failure on
their part. Adding insulin may cause weight gain, so continuing
lifestyle measures is essential. The addition of insulin is not
temporary.
◉ A patient diagnosed with diabetes has a blood pressure of 140/90
mm Hg and albuminuria. Which initial action by the primary care
provider is indicated for management of this patient?
a. Consulting with a nephrologist
b. Limiting protein intake
c. Prescribing an antihypertensive medication
d. Referring to an ophthalmologist.
Answer: ANS: A
Patients with diabetes who have elevated blood pressure and
reduced renal function should be referred to a nephrologist.
Limiting protein intake and giving an antihypertensive medication
may be recommended, but evaluation by a nephrologist is essential.
2026 MEDICATION CLASSES AND EVIDENCE
BASED PRESCRIBING
◉ A patient has new-onset hypertension with a systolic blood
pressure of 180 mm Hg. Which test will the provider order to
diagnose this patient?
a. ACTH suppression testing
b. Adrenal antibody tests
c. Cortisol excretion studies
d. Fractionated metanephrine levels.
Answer: ANS: D
Patients with pheochromocytoma may present with new-onset
hypertension with systolicpressure >170 mm Hg. Fractionated
metanephrine will be elevated when the diagnosis is confirmed.
ACTH suppression testing and cortisol excretion studies are
performed to diagnose Cushing's syndrome. Adrenal antibody tests
are performed as part of the evaluation for Addison's disease.
◉ A patient has rapid weight gain, amenorrhea without pregnancy,
and mild hypertension. Once confirmatory tests are performed, what
is a possible treatment for this patient?
a. Antihypertensive therapy
,b. Mineralocorticoid replacement
c. Oral hydrocortisone
d. Pituitary tumor resection.
Answer: ANS: D
This patient has symptoms of Cushing's syndrome. When indicated,
pituitary tumor resection is performed as the first choice.
Antihypertensive therapy is initiated in patients with
pheochromocytoma. Mineralocorticoids and glucocorticoids are
given to patients with Addison's disease.
◉ A patient has unexplained weight loss and the provider notes
increased skin pigmentation on light-exposed skin folds along with
darkened palmar creases. Which laboratory tests will the provider
order? (Select all that apply.)
a. Serum ACTH
b. Serum cortisol
c. Serum electrolytes
d. TB skin testing
e. Urine cortisol.
Answer: ANS: A, C, D
This patient has symptoms of Addison's disease. Serum ACTH will be
elevated in patients with Addison's disease. Hyponatremia and
hyperkalemia may occur and are sometimes the initial finding. TB
skin testing is done to exclude tuberculosis. Serum and urine cortisol
levels are evaluated with Cushing's syndrome is suspected.
,◉ An obese patient has recurrent urinary tract infections and
reports feeling tired most of the time. What initial diagnostic test
will the provider order in the clinic at this visit?
a. C-peptide level
b. Hemoglobin A1C
c. Random serum glucose
d. Thyroid studies.
Answer: ANS: B
HbA1C, along with fasting plasma glucose or a 2-hour plasma
glucose during an oral glucose tolerance test (OGTT), is diagnostic of
diabetes. This patient is probably not fasting, so a glucose level will
not be helpful. C-peptide levels help to distinguish type 1 from type
2 diabetes and may be performed after a diagnosis of diabetes is
made and if there is uncertainty about the cause. Thyroid studies are
helpful in evaluating comorbidity.
◉ A patient diagnosed with type 2 diabetes mellitus becomes insulin
dependent after a year of therapy with oral diabetes medications.
When explaining this change in therapy, the provider will tell the
patient
a. it is necessary because the patient cannot comply with the
previous regimen.
b. that strict diet and exercise measures may be relaxed with insulin
therapy.
, c. the use of insulin therapy may be temporary.
d. this is because of the natural progression of the disease..
Answer: ANS: D
Even after several years of therapy for type 2 DM well controlled
with oral diabetic medications, diet, and exercise, the natural
progression of the disease may require patients to become insulin
dependent. Patients must understand that this does not represent
failure on
their part. Adding insulin may cause weight gain, so continuing
lifestyle measures is essential. The addition of insulin is not
temporary.
◉ A patient diagnosed with diabetes has a blood pressure of 140/90
mm Hg and albuminuria. Which initial action by the primary care
provider is indicated for management of this patient?
a. Consulting with a nephrologist
b. Limiting protein intake
c. Prescribing an antihypertensive medication
d. Referring to an ophthalmologist.
Answer: ANS: A
Patients with diabetes who have elevated blood pressure and
reduced renal function should be referred to a nephrologist.
Limiting protein intake and giving an antihypertensive medication
may be recommended, but evaluation by a nephrologist is essential.
