NR 508 Week 5 Quiz 2025| Chamberlain University|
Actual Exam Questions and Answers
A 67-year-old male with type 2 diabetes on glipizide and metformin presents with confusion,
sluggishness, and extreme thirst. His wife reports non-compliance with meal plan and exercise,
and he hasn’t checked his blood glucose for 1 week. A random glucose is 500 mg/dL. A likely
preliminary diagnosis is:
A) Diabetic ketoacidosis (DKA)
B) Hyperglycemic hyperosmolar syndrome (HHS)
C) Hypoglycemia
D) Stroke
Correct Answer: B) Hyperglycemic hyperosmolar syndrome (HHS)
Explanation: Confusion, sluggishness, extreme thirst, and a random glucose of 500 mg/dL in a
type 2 diabetic suggest HHS, characterized by severe hyperglycemia, dehydration, and altered
mental status, often due to non-compliance. DKA is less likely in type 2 diabetes without
acidosis symptoms.
After starting a patient with Grave’s disease on methimazole, patient monitoring includes TSH
and free T4 every:
A) 1–2 weeks
B) 4–6 weeks
C) 3 months
D) 6 months
Correct Answer: B) 4–6 weeks
Explanation: Methimazole takes weeks to normalize thyroid function in Grave’s disease.
Monitoring TSH and free T4 every 4–6 weeks ensures efficacy and detects side effects (e.g.,
agranulocytosis), per ATA guidelines.
Goals when treating hypothyroidism with thyroid replacement include:
A) Normalizing TSH and relieving symptoms
B) Increasing T3 to supraphysiologic levels
C) Suppressing TSH below normal range
D) Maintaining elevated free T4 levels
Correct Answer: A) Normalizing TSH and relieving symptoms
Explanation: The goal of thyroid replacement (e.g., levothyroxine) is to normalize TSH
, (typically 0.4–4.0 mIU/L) and alleviate symptoms like fatigue and dry skin, restoring euthyroid
state, per ATA guidelines.
The action of “gliptins” is different from other antidiabetic agents because they:
A) Stimulate insulin release from beta cells
B) Inhibit DPP-4 to increase incretin levels
C) Reduce hepatic glucose production
D) Enhance insulin sensitivity in peripheral tissues
Correct Answer: B) Inhibit DPP-4 to increase incretin levels
Explanation: Gliptins (e.g., sitagliptin) are DPP-4 inhibitors that increase incretin (e.g., GLP-1)
levels, enhancing glucose-dependent insulin secretion and suppressing glucagon, unlike other
agents like sulfonylureas or metformin.
Which of the following is not an indication that growth hormone supplements should be used?
A) Growth hormone deficiency in children
B) Turner syndrome
C) Routine use in healthy adults to improve vitality
D) Prader-Willi syndrome
Correct Answer: C) Routine use in healthy adults to improve vitality
Explanation: Growth hormone is indicated for specific conditions like growth hormone
deficiency, Turner syndrome, or Prader-Willi syndrome. Routine use in healthy adults lacks
evidence and carries risks (e.g., diabetes, edema).
A patient with type 1 diabetes who plays tennis for his university exhibits a knowledge deficit
about insulin and his diagnosis. He should be taught that:
A) Insulin doses are fixed and never adjusted
B) Exercise increases insulin requirements
C) Insulin needs may decrease with exercise
D) He should avoid carbohydrates completely
Correct Answer: C) Insulin needs may decrease with exercise
Explanation: Exercise increases insulin sensitivity and glucose uptake, often requiring reduced
insulin doses to prevent hypoglycemia. Education should include monitoring blood glucose and
adjusting insulin accordingly.
When methimazole is started for hyperthyroidism, it may take ________ to see a total reversal of
hyperthyroid symptoms:
Actual Exam Questions and Answers
A 67-year-old male with type 2 diabetes on glipizide and metformin presents with confusion,
sluggishness, and extreme thirst. His wife reports non-compliance with meal plan and exercise,
and he hasn’t checked his blood glucose for 1 week. A random glucose is 500 mg/dL. A likely
preliminary diagnosis is:
A) Diabetic ketoacidosis (DKA)
B) Hyperglycemic hyperosmolar syndrome (HHS)
C) Hypoglycemia
D) Stroke
Correct Answer: B) Hyperglycemic hyperosmolar syndrome (HHS)
Explanation: Confusion, sluggishness, extreme thirst, and a random glucose of 500 mg/dL in a
type 2 diabetic suggest HHS, characterized by severe hyperglycemia, dehydration, and altered
mental status, often due to non-compliance. DKA is less likely in type 2 diabetes without
acidosis symptoms.
After starting a patient with Grave’s disease on methimazole, patient monitoring includes TSH
and free T4 every:
A) 1–2 weeks
B) 4–6 weeks
C) 3 months
D) 6 months
Correct Answer: B) 4–6 weeks
Explanation: Methimazole takes weeks to normalize thyroid function in Grave’s disease.
Monitoring TSH and free T4 every 4–6 weeks ensures efficacy and detects side effects (e.g.,
agranulocytosis), per ATA guidelines.
Goals when treating hypothyroidism with thyroid replacement include:
A) Normalizing TSH and relieving symptoms
B) Increasing T3 to supraphysiologic levels
C) Suppressing TSH below normal range
D) Maintaining elevated free T4 levels
Correct Answer: A) Normalizing TSH and relieving symptoms
Explanation: The goal of thyroid replacement (e.g., levothyroxine) is to normalize TSH
, (typically 0.4–4.0 mIU/L) and alleviate symptoms like fatigue and dry skin, restoring euthyroid
state, per ATA guidelines.
The action of “gliptins” is different from other antidiabetic agents because they:
A) Stimulate insulin release from beta cells
B) Inhibit DPP-4 to increase incretin levels
C) Reduce hepatic glucose production
D) Enhance insulin sensitivity in peripheral tissues
Correct Answer: B) Inhibit DPP-4 to increase incretin levels
Explanation: Gliptins (e.g., sitagliptin) are DPP-4 inhibitors that increase incretin (e.g., GLP-1)
levels, enhancing glucose-dependent insulin secretion and suppressing glucagon, unlike other
agents like sulfonylureas or metformin.
Which of the following is not an indication that growth hormone supplements should be used?
A) Growth hormone deficiency in children
B) Turner syndrome
C) Routine use in healthy adults to improve vitality
D) Prader-Willi syndrome
Correct Answer: C) Routine use in healthy adults to improve vitality
Explanation: Growth hormone is indicated for specific conditions like growth hormone
deficiency, Turner syndrome, or Prader-Willi syndrome. Routine use in healthy adults lacks
evidence and carries risks (e.g., diabetes, edema).
A patient with type 1 diabetes who plays tennis for his university exhibits a knowledge deficit
about insulin and his diagnosis. He should be taught that:
A) Insulin doses are fixed and never adjusted
B) Exercise increases insulin requirements
C) Insulin needs may decrease with exercise
D) He should avoid carbohydrates completely
Correct Answer: C) Insulin needs may decrease with exercise
Explanation: Exercise increases insulin sensitivity and glucose uptake, often requiring reduced
insulin doses to prevent hypoglycemia. Education should include monitoring blood glucose and
adjusting insulin accordingly.
When methimazole is started for hyperthyroidism, it may take ________ to see a total reversal of
hyperthyroid symptoms:
