Herzing NU636 Quiz 4 Graded Quiz

One of your obese female patients is coming to review her recent lab results. Her HgbA1C is 12.1. She reports she just cannot seem to commit herself to an appropriate nutritional lifestyle. There were no other abnormalities noted with her lab results. With your understanding of the current ADA standards of care which of the following medications will you include in the plan for this patient? Rosiglitazone (Avandia) , Not Selected Glipizide (Glucotrol) , Not Selected Incorrect answer: Acarbose (Precose) Correct Answer: Metformin (Glucophage) Metformin (Glucophage) , Not Selected Feedback General Feedback Rationale: Ch 46 – initiating therapy; Biguanides; used as first-line monotherapy for treatment of type 2 diabetes; Metformin inhibits hepatic glucose production and improves peripheral sensitivity to insulin; ADA Standards of Medical Care in Diabetes directs use of Metformin as first-line monotherapy Results for item 2. 2 0 / 2 points A 52-year-old male patient with a family history of cardiac disease reports to the clinic with a complaint of intermittent chest pain. A review of his medical record reveals that he was started on 112.5mcg of synthetic T4 (Synthroid) three weeks ago for a TSH level of 7.2. While he reports improved energy and mental clarity since starting on Synthroid he is concerned about the chest pain. You take his vital signs and find he has a BP of 142/86 and a regular pulse at 128. Which of the following represents your best treatment plan for this patient? Make no changes in the Synthroid dose, order a TSH and an EKG , Not Selected Decrease the Synthroid dose, order a TSH and an EKG , Not Selected Incorrect answer: Order a stress test because of his family history Correct Answer: Decrease the Synthroid dose, order a TSH and an EKG Discontinue Synthroid as chest pain is an adverse event , Not Selected Feedback General Feedback Rationale: Ch 47 – initiating therapy; thyroid hormone and symptoms and signs of hyperthyroidism – excess thyroid hormone can cause palpitations and arrhythmias; thyroid hormone replacement therapy is a life long intervention therefore it is not appropriate to outright discontinue it Results for item 3. 3 2 / 2 points Your 73-year-old patient reports a history thyroid hormone replacement therapy since 19 years of age secondary to having a partial thyroidectomy. The patient is on Synthroid. As an astute advanced practice nurse you understand that chronic treatment with a thyroid hormone can result in the development of which of the following? Correct answer: Osteoporosis Tachycardia , Not Selected Insomnia , Not Selected Sweating , Not Selected