1. An adult patient presents with tachycardia lower the dose to 50 mcg daily.
and nervousness. The patient is Rationale: The patient is presenting with
currently taking levothyroxine symptoms of hyperthyroidism, and since
(Synthroid), 75 mcg daily. The nurse they are being supplemented with
practitioner orders a thy- levothyroxine
roid-stimulating hormone (TSH) and antic- for hypothyroidism, it's suggestive that
they
ipates having to: are overdosing and their dose should be de-
creased. The only option that is appropriate
is to lower the dose to 50 mcg daily, and
although adding a 50 mg daily dose of pro-
pranolol may be helpful to manage
symptoms for a hyperthyroid patient, this
hyperthyroid presentation is related to
overmedication. To evaluate this more
directly, the patient should have a TSH and
T3/T4 level drawn and it is likely we would
find the TSH is low, T3 and T4 are elevated.
2. Which of the following is produced Glucagon
in the pancreas and counteracts Rationale: Glucagon is made in the pan-
hypoglycemia? creas and stimulates glycogen release from
the liver's glycogen stores which increases
blood sugar in contrast to insulin which
low- ers blood sugar by increasing
permeability of the cell membrane to
glucose thereby in- creasing intracellular
levels of glucose.
Begin to increase the patient's diabetes med-
3. An adult male who has managed
type 2
diabetes mellitus well for many years pre- ications incrementally
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9
, CEA Prep Questions: Endocrine Latest Update.
sents for a 6-month follow up. His Hgb A1c Rationale: A common side ettect of
initia- has risen from 7% to 9% over the interval. tion of onanzapine (Zyprexa) is
increased ap- All other laboratory values are normal and petite and it is
evidenced by this by the pa- his BMI is still 25. His psychiatrist recently tient
having their A1c increase from 7 to 9%.
2/
9