MN 568 Midterm Exam Questions and Answers Latest Update 2023/2024 | 100% Correct

MN 568 Midterm Exam Questions and Answers Latest Update 2023/2024 | 100% Correct. Complete study guide to pass your exam. A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment? a. No treatment at this time b. Diet and exercise for 6-week trial c. Diet, exercise, and oral medication d. Diet, exercise, and exogenous insulin ____ 2. The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit? a. High sensitivity thyroid-stimulating hormone (TSH) and free T4 b. Free T4 and serum calcium c. Free T3 and T4 d. TSH and thyroxin antibodies ____ 3. A patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer her, the clinician must understand that exercise has what effect on the patient with type 2 diabetes? a. Reduces postprandial blood glucose b. Reduces triglycerides and increases high-density lipoprotein (HDL) c. Reduces total cholesterol d. All of the above ____ 4. A patient with type 1 diabetes comes to the clinic complaining of feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first? a. Check his blood sugar. b. Have him drink 4 ounces of juice. c. Call 911. d. Ask him about his usual eating habits. ____ 5. A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin? a. Ketoacidosis b. Cirrhosis c. Hypoglycemic episodes d. All of the above ____ 6. A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next? a. Serum calcium b. TSH c. Electrolytes d. Urine specific gravity ____ 7. The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been effective? a. “As long as I don’t need glasses, I don’t have to worry about going blind.” b. “I know I need to have my eyes checked every year.” c. “My optometrist checks my eyes.” d. “I will see my eye doctor when my vision gets blurry.” ____ 8. A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment? a. Tricyclic antidepressants b. Capsaicin cream c. Vitamin B12 injections d. Insulin ____ 9. After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient? a. Suggest she use a heating pad to improve circulation. b. Refer to a podiatrist for a foot care treatment plan. c. Send her for acupuncture treatments. d. All of the above ____ 10. Joyce is seen in the clinic complaining of vague symptoms of nervousness and irritability. She says that her hair will not hold a permanent wave anymore. On physical examination, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis should include which of the following conditions? a. Myxedema b. Thyrotoxicosis c. Cushing’s syndrome d. Pan-hypopituitarism ____ 11. The patient is prescribed radioactive iodine (RAI) and asks the clinician how this drug works. The clinician’s response should include which of the following data? a. RAI prevents the peripheral conversion of T4 to T3. b. RAI binds free T4. c. RAI destroys thyroid tissue. d. RAI reduces freely circulating iodine. ____ 12. A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expect as a manifestation of the disease? a. Sinus bradycardia b. Atrial fibrillation c. Supraventricular tachycardia d. U waves ____ 13. After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? a. Elevated TSH b. Normal TSH c. Low TSH d. Undetectable TSH ____ 14. Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease? a. Elevated TSH b. Elevated T4 c. Elevated thyrotropin-releasing hormone (TRH) d. All of the above ____ 15. The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective? a. “I’ll take my pill at least 30 minutes before breakfast.” b. “I’ll take my Glucotrol before bedtime.” c. “It is important to take my medication right after I eat.” d. “Since I only like to eat two meals a day, I can take the pill between my meals.” ____ 16. A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate? a. “Control of glucose will help postpone or delay complications.” b. “Regularly checking blood sugar will help establish a routine.” c. “Monitoring glucose will promote a sense of control.” d. All of the above ____ 17. How often should the clinician examine the feet of a person with diabetes? a. Once a year b. Every 6 months c. Every 3 months d. Every visit ____ 18. The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient? a. Overweight b. Mild obesity c. Moderate obesity d. Morbid obesity ____ 19. Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this patient? a. Elevated uric acid level b. Elevated blood urea nitrogen c. Decreased urine pH d. Decreased C-reactive protein ____ 20. Mr. W, 53 years old, is seen in the clinic with concerns about his left foot. He has a 40-year history of type 1 diabetes with “fairly good” control on twice-daily insulin. He denies injury but states that he tripped a few months ago and that his foot is sore when he walks. Physical examination reveals an edematous, erythremic, and warm foot. There is a superficial ulcer on the plantar surface. Which of the following is the most likely diagnosis? a. Fallen arch b. Arthritis c. Charcot joint d. Sprained ankle ____ 21. Which of the following tests should you order to confirm Mr. W’s diagnosis? a. Bone scan b. Computed tomography (CT) scan c. X-ray of the foot d. Culture of the ulcer ____ 22. A vegetarian patient with gout asks the clinician about food he should avoid. The clinician should advise the patient to avoid which of the following foods? a. Rice b. Carrots c. Spinach d. Potatoes ____ 23. The clinician should question the patient with suspected gout about use of which of these medications? a. Low-dose aspirin b. Thiazide diuretics c. Ethambutol d. All of the above ____ 24. The clinician finds numerous nodules on the thyroid of a 65-year-old woman. The clinician suspects thyroid cancer. Which of the following data would be most significant for this patient? a. A history of tonsillectomy in the 1940s b. Recent exposure to mumps c. Vegetarian diet d. Allergy to iodine ____ 25. Which of the following is essential for diagnosing thyroid cancer? a. Fine needle aspiration b. Thyroid ultrasound c. CT scan d. Magnetic resonance imaging ____ 26. Which of the following are common signs of type 2 DM? a. Anorexia b. Recurrent yeast infection c. Weight gain d. Elevated HDL cholesterol ____ 27. Which of the following medications can cause hyperglycemia? a. Prednisone b. Metformin c. Synthroid d. Cephalexin ____ 28. Which of the following is diagnostic for diabetes mellitus? a. A1C 7.0 on one occasion b. Fasting blood sugar (FBS) of 100 mg/dL on two occasions c. Random glucose of 200 mg/dL on two occasions d. Two-hour post-load plasma glucose of 300 mg/dL on one occasion ____ 29. Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy? a. Insulin b. Metformin c. Glucotrol d. Precose ____ 30. A 35-year-old woman presents with symptoms of hypoglycemia. There is no history of diabetes mellitus. Which of the following should be included in the differential diagnosis? a. Anxiety disorder b. Pheochromocytoma c. Psychosis d. All of the above True/False Indicate whether the statement is true or false. _T___ 1. Metformin is the first line of pharmacologic treatment for type 2 DM. __F__ 2. Fruit juice with added sugar is the treatment of choice for anyone experiencing hypoglycemia. __T__ 3. Lifestyle modification is the treatment of choice for metabolic syndrome. __F__ 4. A BMI of 29 kg/m2 is considered obesity. __T__ 5. Urine-free cortisol is one of four diagnostic tests recommended for Cushing’s syndrome. 1.Why would a patient with hyperthyroidism be prescribed the drug methimazole (Tapa-zole)? a. To limit the effect of the pituitary on the thyroid b. To destroy part of the hyperactive thyroid tissue c. To stimulate the pineal gland d. To block the production of thyroid hormones 2.To which diet should a patient with Cushing syndrome adhere? a. Less sodium b. More calories c. Less potassium d. More carbohydrates 3.A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of the potentially lethal complication of: a. severe nausea and vomiting. b. bradycardia. c. delirium with restlessness. d. congestive heart failure. 4.The purpose of the use of radioactive iodine in the treatment of hyperthyroidism is to: a. stimulate the thyroid gland. b. depress the pituitary. c. destroy some of the thyroid tissue. d. alter the stimulus from the pituitary. 5.Which precaution(s) should the nurse take when caring for a patient who is being treated with radioactive iodine 131 (RAIU)? a. Initiate radioactive safety precautions b. Avoid assigning any young woman to the patient c. Wait three days after dose before assigning a pregnant nurse to care for this patient d. Advise visitors to sit at least 10 feet away from the patient d. To block the production of thyroid hormones 7.What is the postoperative position for a person who has had a thyroidectomy? a. Prone b. Semi-Fowler c. Side-lying d. Supine 8.What extra equipment should the nurse provide at the bedside of a new postoperative thyroidectomy patient? a. Large bandage scissors b. Tracheotomy tray c. Ventilator d. Water-sealed drainage system 9.As the nurse is shaving a patient who is 2 days postoperative from a thyroidectomy, the patient has a spasm of the facial muscles. What should the nurse recognize this as? a. Chvostek sign b. Montgomery sign c. Trousseau sign d. Homans sign 10.A patient has undergone tests that indicate a deficiency of the parathyroid hormone secretion. She should be informed of which potential complication? a. Osteoporosis b. Lethargy c. Laryngeal spasms d. Kidney stones 11.A 27-year-old patient with hypothyroidism is referred to the dietitian for dietary consultation. What should nutritional interventions include? a. Frequent small meals high in carbohydrates b. Calorie-restricted meals c. Caffeine-rich beverages d. Fluid restrictions 12.What instructions should be included in the discharge instructions for a 47-year-old patient with hypothyroidism? a. Taking medication whenever symptoms cause discomfort b. Decreasing fluid and fiber intake c. Consuming foods rich in iron d. Seeing the physician regularly for follow-up care 13.How should the nurse administer insulin to prevent lipohypertrophy? a. At room temperature b. At body temperature c. Straight from the refrigerator d. After rolling bottle between hands to warm 14.A patient with a history of Graves disease is admitted to the unit with shortness of breath. The nurse notes the patients vital signs: T 103 F, P 160, R 24, BP 160/80. The nurse also notes distended neck veins. What does the patient most likely have? a. Pulmonary embolism b. Hypertensive crisis c. Thyroid storm d. Cushing crisis 15.What is the master gland of the endocrine system? a. Thyroid b. Parathyroid c. Pancreas d. Pituitary 16.What information should be obtained from the patient before an iodine-131 test? a. Presence of metal in the body b. Allergy to sulfa drugs c. Status of possible pregnancy d. Use of prescription drugs for hypertension 17.The patient being treated for hypothyroidism should be instructed to eat well-balanced meals including intake of iodine. Which of the following foods contains iodine? a. Eggs b. Pork c. White bread d. Skinless chicken 18.The nurse is caring for a patient who is receiving calcium gluconate for treatment of hypoparathyroid tetany. Which assessment would indicate an adverse reaction to the drug? a. Increase in heart rate b. Flushing of face and neck c. Drop in blood pressure d. Urticaria 19.The adrenal cortex secretes glucocorticoids. The most important is cortisol. What is it involved in? (Select all that apply.) a. Glucose metabolism b. Releasing androgens and estrogens c. Providing extra reserve energy during stress d. Decreasing the level of potassium in the blood stream e. Increasing retention of sodium in the blood stream 1.Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks? a. Fasting blood sugar (FBS) b. Oral glucose tolerance test (OGT) c. Glycosylated hemoglobin (HbA1c) d. Postprandial glucose test (PPBG) 2.Which test will furnish immediate feedback for a newly diagnosed diabetic who is not yet under control? a. Fasting blood sugar (FBS) b. Glycosylated hemoglobin (HgbA1c) c. Oral glucose tolerance test (OGTT) d. Clinitest 3.The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of an exercise regimen. The patient plans to enroll in a swimming class. Which adjustment should be made based on this information? a. Time the morning insulin injection so that the peak action will occur during swimming class. b. Delete normal walks on swimming class days. c. Delay the meal before the swimming class until the session is over. d.Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin. 4.What is a long-term complication of diabetes mellitus? a. Diverticulitis b. Renal failure c. Hypothyroidism d. Hyperglycemia 5.In diabetes insipidus, a deficiency of which hormone causes clinical manifestations? a. antidiuretic hormone (ADH) b. follicle-stimulating hormone (FSH) c. thyroid-stimulating hormone (TSH) d. adrenocorticotropic hormone (ACTH) 6.What should the nurse caution a type I diabetic about excessive exercise? a. It can increase the need for insulin and may result in hyperglycemia. b. It can decrease the need for insulin and may result in hypoglycemia. c. It can increase muscle bulk and may result in malabsorption of insulin. d. It can decrease metabolic demand and may result in metabolic acidosis. 7.The nurse caring for a 75-year-old man who has developed diabetes insipidus following a head injury will include in the plan of care provisions for: a. limiting fluids to 1500 mL a day. b. encouraging physical exercise. c. protecting patient from injury. d. discouraging daytime naps. 8.The physician orders an 1800-calorie diabetic diet and 40 units of (Humulin N) insulin U-100 subcutaneously daily for a patient with diabetes mellitus. Why would a mid-afternoon snack of milk and crackers be given? a. To improve nutrition b. To improve carbohydrate metabolism c. To prevent an insulin reaction d. To prevent diabetic coma 9.The nurse teaching a patient with type 1 diabetes mellitus (IDDM) about early signs of insulin reaction would include information about: a. abdominal pain and nausea. b. dyspnea and pallor. c. flushing of the skin and headache. d. hunger and a trembling sensation. 10.The nurse discovers the type 1 diabetic (IDDM) patient drowsy and tremulous, the skin is cool and moist, and the respirations are 32 and shallow. These are signs of: a. hypoglycemic reaction; give 6 oz of orange juice. b. hyperglycemic reaction; give ordered regular insulin. c. hyperglycemic hyperosmolar nonketotic reaction; squeeze glucagon gel in buccal cavity. d. hypoglycemic reaction; give ordered insulin. 11.What instructions should a nurse give to a diabetic patient to prevent injury to the feet? a. Soak feet in warm water every day. b. Avoid going barefoot and always wear shoes with soles. c. Use of commercial keratolytic agents to remove corns and calluses are preferred to cutting off corns and calluses. d. Use a heating pad to warm feet when they feel cool to the touch. 12.The physician prescribes glyburide (Micronase, DiaBeta, Glynase) for a patient, age 57, when diet and exercise have not been able to control type 2 diabetes. What should the nurse include in the teaching plan about this medication? a. It is a substitute for insulin and acts by directly stimulating glucose uptake into the cell. b. It does not cause the hypoglycemic reactions that may occur with insulin use. c. It is thought to stimulate insulin production and increase sensitivity to insulin at receptor sites. d. It lowers blood sugar by inhibiting glucagon release from the liver, preventing gluconeogenesis. 13.The nurse is administering long-acting insulin once a day, which provides insulin coverage for 24 hours. This insulin is _________________. Lantus 14.Another term for hyperglycemic reaction is ____________ ______________. ANS: diabetic ketoacidosis (DKA) 15.Only ________insulin can be administered intravenously. ANS: regular 1. What kind of control mechanism is indicated when increased blood glucose levels stimulate increased secretion of insulin? a. Control by releasing hormones b. Control by tropic hormones c. Negative feedback control d. Hypothalamus/hypophysis coordination 2. What is the most common cause of endocrine disorders? a. Malignant neoplasm b. Infection c. Congenital defect d. Benign tumor 3. Choose the statement that applies to type 1 diabetes mellitus. a. Onset often occurs during childhood. b. Relative insufficiency of insulin or insulin resistance develops. c. It can be treated by diet, weight control and exercise, or oral hypoglycemics. d. Complications rarely occur. 4. Why does polyuria develop with diabetes mellitus? a. Increased thirst and hypoglycemia b. Ketoacidosis c. Osmotic pressure due to glucose d. Diabetic nephropathy 5. What is the cause of diabetic ketoacidosis? a. Excess insulin in the body b. Loss of glucose in the urine c. Failure of the kidney to excrete sufficient acids d. Increased catabolism of fats and proteins 6. What is a precipitating factor for diabetic ketoacidosis? a. Skipping a meal b. Anorexia c. Serious infection d. Insulin overdose 7. Which of the following may cause insulin shock to develop? a. Strenuous exercise b. Missing an insulin dose c. Eating excessively large meals d. Sedentary lifestyle 8. Which of the following indicates hypoglycemia in a diabetic? a. Deep, rapid respirations b. Flushed dry skin and mucosa c. Thirst and oliguria d. Staggering gait, disorientation, and confusion 9. Which of the following are signs of diabetic ketoacidosis in an unconscious person? a. Pale moist skin b. Thirst and poor skin turgor c. Deep rapid respirations and fruity breath odor d. Tremors and strong rapid pulse