NRNP 6645 MIDTERM AND FINAL YEAR 2024/2025 /
ACCURATE CURRENTLY TESTING EXAM VERSIONS WITH
ACTUAL QUESTIONS AND DETAILED ANSWERS WITH A
STUDY GUIDE / EXPERT VERIFIED FOR GURANTEED PASS/
LATEST UPDATE.
Which laboratory values representing parathyroid hormone (PTH) and serum calcium are
consistent with a diagnosis of primary hyperparathyroidism?
Appropriately increased PTH and low or normal serum calcium
Inappropriate secretion of PTH along with hypercalcemia
Appropriately high PTH along with hypocalcemia
Prolonged inappropriate secretion of PTH with subsequent hypercalcemia - CORRECT
ANSWER Inappropriate secretion of PTH along with hypercalcemia
A patient who is obese 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?
Hemoglobin A1C
Random serum glucose
C-peptide level
Thyroid studies - CORRECT ANSWER Hemoglobin A1C
Which thyroid stimulating hormone (TSH) level indicates hyperthyroidism? (normal TSH is 0.3-
4)
0.2 uIU/L
4.2 uIU/L
0.4 uIU/L
2.4 uIU/L - CORRECT ANSWER 0.2 uIU/L
,A 20-year-old female patient with tachycardia and weight loss but no optic symptoms has the
following laboratory values: decreased TSH, increased T3, and increased T4 and free T4. A
pregnancy test is negative. What is the initial treatment for this patient?
Radioiodine therapy
Surgical resection of the thyroid gland
Beta blocker medications
Thionamide therapy - CORRECT ANSWER Beta blocker medications
A 40-year-old patient with primary hyperparathyroidism has increased serum calcium 0.5 mg/dL
above normal without signs of nephrolithiasis. What is the recommended treatment for this
patient?
Avoidance of weight bearing exercises
Annual monitoring of calcium, creatinine, and bone density
Decreasing calcium and Vitamin D intake until values normal
Parathyroidectomy - CORRECT ANSWER Annual monitoring of calcium, creatinine, and bone
density
A patient has thyroid nodules and the provider suspects thyroid cancer. To evaluate thyroid
nodules for potential malignancy, which test is performed?
Serum calcitonin
Radionucleotide imaging
Serum TSH level
Thyroid ultrasound - CORRECT ANSWER Thyroid ultrasound
Which laboratory values representing parathyroid hormone (PTH) and serum calcium are
consistent with a diagnosis of primary hyperparathyroidism?
Prolonged inappropriate secretion of PTH with subsequent hypercalcemia
Inappropriate secretion of PTH along with hypercalcemia
Appropriately high PTH along with hypocalcemia
Appropriately increased PTH and low or normal serum calcium - CORRECT ANSWER
Inappropriate secretion of PTH along with hypercalcemia
,What is important about increased PAI-1 levels in patients with metabolic syndrome?
They cause increased insulin resistance.
They predispose patients to dyslipidemia.
They lower the risk of hypertension.
They increase the risk of arterial thrombosis. - CORRECT ANSWER They increase the risk of
arterial thrombosis.
A patient who has 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?
Consulting with a nephrologist
Prescribing an antihypertensive medication
Referring to an ophthalmologist
Limiting protein intake - CORRECT ANSWER Consulting with a nephrologist
A postpartum woman develops fatigue, weight gain, and constipation. Laboratory values reveal
elevated TSH and decreased T3 and T4 levels. What will the provider tell this patient?
She will need lifelong medication.
A thyroidectomy will be necessary.
This condition may be transient.
She should be referred to an endocrinologist. - CORRECT ANSWER This condition may be
transient.
Which findings are symptoms of hyperparathyroidism? (Select all that apply.)
Cognitive impairment
Left ventricular hypertrophy
Renal calculi
Perioral paresthesias
Chvostek's sign - CORRECT ANSWER Cognitive impairment
Left ventricular hypertrophy
, Renal calculi
Which medication given for patients with metabolic syndrome helps to lower PAI-1 levels?
Aspirin
Niacin
Atorvastatin
Metformin - CORRECT ANSWER Metformin
A patient recently diagnosed with type 1 diabetes mellitus is in clinic for a follow-up evaluation.
The provider notes that the patient appears confused and irritable and is sweating and shaking.
What intervention will the provider expect to perform once the point of care blood glucose level
is known?
Giving a rapid-acting carbohydrate
Performing a hemoglobin A1C
Dipstick urinalysis for ketones
Injection of rapid-acting insulin - CORRECT ANSWER Giving a rapid-acting carbohydrate
A patient 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:
that strict diet and exercise measures may be relaxed with insulin therapy.
it is necessary because the patient cannot comply with the previous regimen.
this is because of the natural progression of the disease.
the use of insulin therapy may be temporary. - CORRECT ANSWER this is because of the
natural progression of the disease.
A patient develops a dry, non-productive cough and is diagnosed with bronchitis. Several days
later, the cough becomes productive with mucoid sputum. What may be prescribed to help with
symptoms?
Bronchodilator treatment
Mucokinetic agents
ACCURATE CURRENTLY TESTING EXAM VERSIONS WITH
ACTUAL QUESTIONS AND DETAILED ANSWERS WITH A
STUDY GUIDE / EXPERT VERIFIED FOR GURANTEED PASS/
LATEST UPDATE.
Which laboratory values representing parathyroid hormone (PTH) and serum calcium are
consistent with a diagnosis of primary hyperparathyroidism?
Appropriately increased PTH and low or normal serum calcium
Inappropriate secretion of PTH along with hypercalcemia
Appropriately high PTH along with hypocalcemia
Prolonged inappropriate secretion of PTH with subsequent hypercalcemia - CORRECT
ANSWER Inappropriate secretion of PTH along with hypercalcemia
A patient who is obese 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?
Hemoglobin A1C
Random serum glucose
C-peptide level
Thyroid studies - CORRECT ANSWER Hemoglobin A1C
Which thyroid stimulating hormone (TSH) level indicates hyperthyroidism? (normal TSH is 0.3-
4)
0.2 uIU/L
4.2 uIU/L
0.4 uIU/L
2.4 uIU/L - CORRECT ANSWER 0.2 uIU/L
,A 20-year-old female patient with tachycardia and weight loss but no optic symptoms has the
following laboratory values: decreased TSH, increased T3, and increased T4 and free T4. A
pregnancy test is negative. What is the initial treatment for this patient?
Radioiodine therapy
Surgical resection of the thyroid gland
Beta blocker medications
Thionamide therapy - CORRECT ANSWER Beta blocker medications
A 40-year-old patient with primary hyperparathyroidism has increased serum calcium 0.5 mg/dL
above normal without signs of nephrolithiasis. What is the recommended treatment for this
patient?
Avoidance of weight bearing exercises
Annual monitoring of calcium, creatinine, and bone density
Decreasing calcium and Vitamin D intake until values normal
Parathyroidectomy - CORRECT ANSWER Annual monitoring of calcium, creatinine, and bone
density
A patient has thyroid nodules and the provider suspects thyroid cancer. To evaluate thyroid
nodules for potential malignancy, which test is performed?
Serum calcitonin
Radionucleotide imaging
Serum TSH level
Thyroid ultrasound - CORRECT ANSWER Thyroid ultrasound
Which laboratory values representing parathyroid hormone (PTH) and serum calcium are
consistent with a diagnosis of primary hyperparathyroidism?
Prolonged inappropriate secretion of PTH with subsequent hypercalcemia
Inappropriate secretion of PTH along with hypercalcemia
Appropriately high PTH along with hypocalcemia
Appropriately increased PTH and low or normal serum calcium - CORRECT ANSWER
Inappropriate secretion of PTH along with hypercalcemia
,What is important about increased PAI-1 levels in patients with metabolic syndrome?
They cause increased insulin resistance.
They predispose patients to dyslipidemia.
They lower the risk of hypertension.
They increase the risk of arterial thrombosis. - CORRECT ANSWER They increase the risk of
arterial thrombosis.
A patient who has 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?
Consulting with a nephrologist
Prescribing an antihypertensive medication
Referring to an ophthalmologist
Limiting protein intake - CORRECT ANSWER Consulting with a nephrologist
A postpartum woman develops fatigue, weight gain, and constipation. Laboratory values reveal
elevated TSH and decreased T3 and T4 levels. What will the provider tell this patient?
She will need lifelong medication.
A thyroidectomy will be necessary.
This condition may be transient.
She should be referred to an endocrinologist. - CORRECT ANSWER This condition may be
transient.
Which findings are symptoms of hyperparathyroidism? (Select all that apply.)
Cognitive impairment
Left ventricular hypertrophy
Renal calculi
Perioral paresthesias
Chvostek's sign - CORRECT ANSWER Cognitive impairment
Left ventricular hypertrophy
, Renal calculi
Which medication given for patients with metabolic syndrome helps to lower PAI-1 levels?
Aspirin
Niacin
Atorvastatin
Metformin - CORRECT ANSWER Metformin
A patient recently diagnosed with type 1 diabetes mellitus is in clinic for a follow-up evaluation.
The provider notes that the patient appears confused and irritable and is sweating and shaking.
What intervention will the provider expect to perform once the point of care blood glucose level
is known?
Giving a rapid-acting carbohydrate
Performing a hemoglobin A1C
Dipstick urinalysis for ketones
Injection of rapid-acting insulin - CORRECT ANSWER Giving a rapid-acting carbohydrate
A patient 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:
that strict diet and exercise measures may be relaxed with insulin therapy.
it is necessary because the patient cannot comply with the previous regimen.
this is because of the natural progression of the disease.
the use of insulin therapy may be temporary. - CORRECT ANSWER this is because of the
natural progression of the disease.
A patient develops a dry, non-productive cough and is diagnosed with bronchitis. Several days
later, the cough becomes productive with mucoid sputum. What may be prescribed to help with
symptoms?
Bronchodilator treatment
Mucokinetic agents
