NR341/NR 341 COMPLEX ADULT HEALTH FINAL EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS |A+ GRADE
1. A condition in which the pituitary gland does not make enough ACTH.: -
Adrenal crisis )(*&^%$
2. What are the causes of adrenal crisis?: - Insufficient cortisol
- Untreated Addison's disease
- Suddenly stopping intake of glucocorticoids
3. What are the signs and symptoms of adrenal crisis?: - Weakness
- Chills
- Mental confusion
- Rash
- Dizziness
- Sweating
- NV
- Tachycardia
- Extreme HoTN
- Loss of consciousness
4. What are some diagnostic tests for adrenal crisis?: - Cosyntropin stimulation
test
- Cortisol level test
5. How is adrenal crisis treated?: Immediate injection of hydrocortisone
6. What are the risk factors for stress-induced hyperglycemia?: - Diabetes
- Advancing age
- Glucocorticoid therapy
- Enteral or parenteral nutrition therapy
,- Medications
- Obesity
- Pancreatitis
- Cirrhosis
7. What are the potential complications of stress-induced hyperglycemia?: -
Immune suppression
- Cerebral ischemia/stroke
- Dehydration/osmotic diuresis
- Endothelial dysfunction/thrombosis
- Impaired wound healing
- Decreased erythropoiesis
- Impaired gastric motility
8. How is stress-induced hyperglycemia managed?: Insulin protocol - target
glucose of 140-180 mg/dL
9. What are the causes of DKA?: - Infections
- Insufficient insulin relative to need
,- Severe stress (trauma, surgery, AMI)
- Pregnancy in type 1 DM
- Missed or reduced insulin
- Glucocorticoids
10. What are the clinical manifestations of DKA?: - Classic signs of dehydration
- Orthostatic HoTN
- Polyuria
- Polydipsia
- Polyphagia
- Kussmaul respirations
- Fruity breath odor
- Flushed/dry skin
- Lethargy/altered consciousness
- Abdominal pain
- NV
- Blood glucose >250 mg/dL
- Ketonuria
- Glucosuria
- Weight loss
- Metabolic acidosis
- Nitrogen losses
- Protein degradation
- Severe depletion of sodium, potassium, chloride, magnesium, and phosphate
, - Fever
11. Which of these patients has DKA?
a. Blood glucose 450; pH 7.48; HCO3 21
b. Blood glucose 300; pH 7.28; HCO3 16: b. Blood glucose 300; pH 7.28; HCO3
16
12. What is the therapeutic management of DKA?: - Correct fluid and electrolyte
imbalances
- Slowly decrease serum glucose
- Correct acidosis
- Prevent further complications
- Provide patient education
13. What are the clinical manifestations of hyperosmolar hyperglycemic state
(HHS)?: - Hyperglycemia
- Osmotic diuresis
- Profound dehydration
VERIFIED ANSWERS |A+ GRADE
1. A condition in which the pituitary gland does not make enough ACTH.: -
Adrenal crisis )(*&^%$
2. What are the causes of adrenal crisis?: - Insufficient cortisol
- Untreated Addison's disease
- Suddenly stopping intake of glucocorticoids
3. What are the signs and symptoms of adrenal crisis?: - Weakness
- Chills
- Mental confusion
- Rash
- Dizziness
- Sweating
- NV
- Tachycardia
- Extreme HoTN
- Loss of consciousness
4. What are some diagnostic tests for adrenal crisis?: - Cosyntropin stimulation
test
- Cortisol level test
5. How is adrenal crisis treated?: Immediate injection of hydrocortisone
6. What are the risk factors for stress-induced hyperglycemia?: - Diabetes
- Advancing age
- Glucocorticoid therapy
- Enteral or parenteral nutrition therapy
,- Medications
- Obesity
- Pancreatitis
- Cirrhosis
7. What are the potential complications of stress-induced hyperglycemia?: -
Immune suppression
- Cerebral ischemia/stroke
- Dehydration/osmotic diuresis
- Endothelial dysfunction/thrombosis
- Impaired wound healing
- Decreased erythropoiesis
- Impaired gastric motility
8. How is stress-induced hyperglycemia managed?: Insulin protocol - target
glucose of 140-180 mg/dL
9. What are the causes of DKA?: - Infections
- Insufficient insulin relative to need
,- Severe stress (trauma, surgery, AMI)
- Pregnancy in type 1 DM
- Missed or reduced insulin
- Glucocorticoids
10. What are the clinical manifestations of DKA?: - Classic signs of dehydration
- Orthostatic HoTN
- Polyuria
- Polydipsia
- Polyphagia
- Kussmaul respirations
- Fruity breath odor
- Flushed/dry skin
- Lethargy/altered consciousness
- Abdominal pain
- NV
- Blood glucose >250 mg/dL
- Ketonuria
- Glucosuria
- Weight loss
- Metabolic acidosis
- Nitrogen losses
- Protein degradation
- Severe depletion of sodium, potassium, chloride, magnesium, and phosphate
, - Fever
11. Which of these patients has DKA?
a. Blood glucose 450; pH 7.48; HCO3 21
b. Blood glucose 300; pH 7.28; HCO3 16: b. Blood glucose 300; pH 7.28; HCO3
16
12. What is the therapeutic management of DKA?: - Correct fluid and electrolyte
imbalances
- Slowly decrease serum glucose
- Correct acidosis
- Prevent further complications
- Provide patient education
13. What are the clinical manifestations of hyperosmolar hyperglycemic state
(HHS)?: - Hyperglycemia
- Osmotic diuresis
- Profound dehydration
