Which of the following conditions is a common pathological cause of hirsutism?
ANSWERS-Polycystic ovary syndrome.
Joan has severe asthma and has been on high doses of oral corticosteroids for 2 years.
She has been reading some home remedy books and stops all of her medications.
What condition may she develop?ANSWERS-Addisonian crisis.
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 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?ANSWERS-"Drink four ounces of fruit juice."
The most common cause of hyperthyroidism is:ANSWERS-Graves disease.
Marie, age 50, has type 1 diabetes and checks her blood glucose level several times
every day. Her blood glucose level ranges from 250 to 280 mg/dL in the morning and is
usually about 140 at lunch, about 120 at dinner, and about 100 at bedtime. In the
morning, she takes 30 units of 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?ANSWERS-Have her check her blood glucose level between 2 am and
4 am for the next several days.
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:ANSWERS-Obtain a 24-hour urine test for
catecholamines.
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:ANSWERS-Refer the client for immediate evaluation by an
ophthalmologist.
What is the medication of choice for an initial acute attack of gout?ANSWERS-A non
steroidal anti-inflammatory drug (NSAID)
, Morris has had type 1 diabetes for 10 years. Several recent urinalysis reports have
shown microalbuminuria. Your next step would be to:ANSWERS-Start him on an
angiotensin-converting enzyme (ACE) inhibitor.
What is the primary pathological irregularity associated with diabetes mellitus type 1?
ANSWERS-Nonfunctioning beta cells.
A patient presents to your primary care office with abnormal lab results. On physical
exam, you tap the patient's facial nerve around the zygomatic arch, just anterior to the
earlobe. This describes which of the following tests and is associated with which of the
following lab abnormalities?ANSWERS-Chvostek sign, hypocalcemia
Martin, age 62, has acute nontransient abdominal pain that grows steadily worse in the
epigastric 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?ANSWERS-Acute pancreatitis.
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?ANSWERS-"Let's try it. Your
glycohemoglobin will be lowered and you may lose weight."
Which class of antihypertensive agents may be problematic for clients with diabetes?
ANSWERS-Beta blockers.
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:ANSWERS-Have an increased blood sugar level.
Sadie, age 40, has just been given a diagnosis of Graves disease. She has recently lost
25 lb, has palpitations, is very irritable, feels very warm, and has a noticeable bulge on
her neck. The most likely cause of her increased thyroid function is:ANSWERS-An
autoimmune response.
Mr. Reynolds is on the antithyroid drug (ATD) methimazole (Tapazole), so you make it a
point to check his:ANSWERS-Complete blood count (CBC) and liver transaminases.
Jeffrey, age 17, has gynecomastia. You should also assess him for:ANSWERS-
Testicular cancer
When teaching Marcy how to use her new insulin pump, you tell her that she needs to
monitor her blood glucose level:ANSWERS-At least 4 times a day.
A client with diabetes on a sulfonylurea and metformin with a glycated hemoglobin
(HbA1c) of 6.5% is complaining of episodes of low blood sugar. Which of the following