NUR 667 – FINAL EXAM QUESTIONS &
ELABORATED COMPLETE SOLUTIONS
PASSED 100%
A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her
physical examination is remarkable for left lower quadrant tenderness. At this time, which of
the following should be considered in the differential diagnosis?
A. Endometriosis
B. Yersinia enterocolitica infection
C. Appendicitis
D. GERD
A. Endometriosis
A 21-year-old student presents with complaints of fatigue, headache, anorexia, and a runny
nose, all of which began about 2 weeks ago. She started taking vitamins and over-the-counter
cold preparations but feels worse. The smell of food makes her nauseated. Her boyfriend had
mononucleosis about 1 month ago, and she wonders if she might have it also. Examination
reveals cervical adenopathy and an enlarged liver and spleen. Which of the following labs would
be most helpful in the differential diagnosis at this point?
A. Stool culture
B. Liver enzymes
C. Antihepatitis D virusD
Thyroid-stimulating hormone test
C. Antihepatitis D virus
A pt is seen with c/o diarrhea. Which of the following should be included in the pt's
differentials?
a. Gastroenteritis
b. Inflammatory bowel disease
c. Lactase deficiency
d. All of the above
d. All of the above
,One of the three P's of diabetes is:
A. paresthesias
B. polydipsia
C. polycythemia
D. proteinuria
b. polydipsia
B. polydipsia
A client is experiencing sudden tachycardia, systolic hypertension, and a high fever after a
thyroid assessment by the provider. What medication should be administered? Select all that
apply.
A. Antithyroid medications
B. Thyroid supplements
C. Vitamin D
D. Iodine preparations
E. Glucocorticoids
A. Antithyroid medications
D. Iodine preparations
E. Glucocorticoids
Rationale: Thyroid storm or thyrotoxicosis may develop with poorly managed hyperthyroidism.
Clinical manifestations include tachycardia, fever, systolic hypertension, abdominal pain,
tremors, and changes in level of consciousness. Airway management and fluid resuscitation are
priorities. Antithyroid medications may be administered along with iodine preparations. For
management of tachycardia, beta-adrenergic blockers may be administered. Glucocorticoids
may also be administered because in high doses these medications decrease the conversion of
T4 to the more active T3, as well as decreasing the release of TSH from the anterior pituitary
gland.
Joyce is seen in the clinic complaining of vague symptoms of nervousness and irritability. She
says that her hair will not hold a permanent wave anymore. On physical examination, the
clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis should include
which of the following conditions?
A. Myxedema
B. Thyrotoxicosis
,C. Cushing's syndrome
D. Pan-hypopituitarism
B. Thyrotoxicosis
The nurse is caring for a client with exophthalmos. What is the anticipated cause?
A. Hypothyroidism
B. Hyperthyroidism
C. Thyrotoxicosis
D. Hypoparathyroidism
B. Hyperthyroidism
The patient experiencing thyroid storm (thyrotoxicosis) is ordered to receive beta-adrenergic
agents. The nurse monitors which therapeutic effect of these medications?
A. Increased respiratory rate
B. Increased appetite
C. Decreased heart rate
D. Decreased bowel sounds
C. Decreased heart rate
A 45yo pt presents with a CC of generalized abd pain. Her physical exam is remarkable for LLQ
tenderness. At this time, which of the following should be considered in the differential dx?
a. Endometriosis
b. Colon cancer
c. Diverticulitis
d. All of the above
d. All of the above
What is the mainstay of management for infectious mononucleosis?
A. Antivirals
B. Symptom control
C. Corticosteroids
D. Isolation
B. Symptom control
, How long would the clinician inform the patient to rest after onset of infectious mononucleosis?
A. 4 days
B. 10 days
C. 2 weeks
D. 4 weeks
D. 4 weeks
Mandy, age 18, has infectious mononucleosis. What might you expect her blood work to
reflect?
A. Thrombocytopenia and elevated transaminase
B. Elevated WBCs
C. Decreased WBCs
D. Decreased serum globulins
A. Thrombocytopenia and elevated transaminase
The clinician suspects that a patient seen in the office has hyperthyroidism. Which test should
the clinician order on the initial visit?
A. Sensitive thyroid-stimulating hormone (TSH) assay and T4
B. Free T4 and serum calcium
C. Nuclear scintigraphy with radiolabeled iodine (123I)
D. Magnetic resonance imaging
A. Sensitive thyroid-stimulating hormone (TSH) assay and T4
Which of the following laboratory findings should the clinician expect in a patient with
untreated Graves' disease? Select all that apply
A. Low TSH
B. Elevated T4
C. Elevated thyrotropin-releasing hormone (TRH)
D. All of the above
D. All of the above
Graves Disease, a form or HYPERTHYROIDISM.
ELABORATED COMPLETE SOLUTIONS
PASSED 100%
A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her
physical examination is remarkable for left lower quadrant tenderness. At this time, which of
the following should be considered in the differential diagnosis?
A. Endometriosis
B. Yersinia enterocolitica infection
C. Appendicitis
D. GERD
A. Endometriosis
A 21-year-old student presents with complaints of fatigue, headache, anorexia, and a runny
nose, all of which began about 2 weeks ago. She started taking vitamins and over-the-counter
cold preparations but feels worse. The smell of food makes her nauseated. Her boyfriend had
mononucleosis about 1 month ago, and she wonders if she might have it also. Examination
reveals cervical adenopathy and an enlarged liver and spleen. Which of the following labs would
be most helpful in the differential diagnosis at this point?
A. Stool culture
B. Liver enzymes
C. Antihepatitis D virusD
Thyroid-stimulating hormone test
C. Antihepatitis D virus
A pt is seen with c/o diarrhea. Which of the following should be included in the pt's
differentials?
a. Gastroenteritis
b. Inflammatory bowel disease
c. Lactase deficiency
d. All of the above
d. All of the above
,One of the three P's of diabetes is:
A. paresthesias
B. polydipsia
C. polycythemia
D. proteinuria
b. polydipsia
B. polydipsia
A client is experiencing sudden tachycardia, systolic hypertension, and a high fever after a
thyroid assessment by the provider. What medication should be administered? Select all that
apply.
A. Antithyroid medications
B. Thyroid supplements
C. Vitamin D
D. Iodine preparations
E. Glucocorticoids
A. Antithyroid medications
D. Iodine preparations
E. Glucocorticoids
Rationale: Thyroid storm or thyrotoxicosis may develop with poorly managed hyperthyroidism.
Clinical manifestations include tachycardia, fever, systolic hypertension, abdominal pain,
tremors, and changes in level of consciousness. Airway management and fluid resuscitation are
priorities. Antithyroid medications may be administered along with iodine preparations. For
management of tachycardia, beta-adrenergic blockers may be administered. Glucocorticoids
may also be administered because in high doses these medications decrease the conversion of
T4 to the more active T3, as well as decreasing the release of TSH from the anterior pituitary
gland.
Joyce is seen in the clinic complaining of vague symptoms of nervousness and irritability. She
says that her hair will not hold a permanent wave anymore. On physical examination, the
clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis should include
which of the following conditions?
A. Myxedema
B. Thyrotoxicosis
,C. Cushing's syndrome
D. Pan-hypopituitarism
B. Thyrotoxicosis
The nurse is caring for a client with exophthalmos. What is the anticipated cause?
A. Hypothyroidism
B. Hyperthyroidism
C. Thyrotoxicosis
D. Hypoparathyroidism
B. Hyperthyroidism
The patient experiencing thyroid storm (thyrotoxicosis) is ordered to receive beta-adrenergic
agents. The nurse monitors which therapeutic effect of these medications?
A. Increased respiratory rate
B. Increased appetite
C. Decreased heart rate
D. Decreased bowel sounds
C. Decreased heart rate
A 45yo pt presents with a CC of generalized abd pain. Her physical exam is remarkable for LLQ
tenderness. At this time, which of the following should be considered in the differential dx?
a. Endometriosis
b. Colon cancer
c. Diverticulitis
d. All of the above
d. All of the above
What is the mainstay of management for infectious mononucleosis?
A. Antivirals
B. Symptom control
C. Corticosteroids
D. Isolation
B. Symptom control
, How long would the clinician inform the patient to rest after onset of infectious mononucleosis?
A. 4 days
B. 10 days
C. 2 weeks
D. 4 weeks
D. 4 weeks
Mandy, age 18, has infectious mononucleosis. What might you expect her blood work to
reflect?
A. Thrombocytopenia and elevated transaminase
B. Elevated WBCs
C. Decreased WBCs
D. Decreased serum globulins
A. Thrombocytopenia and elevated transaminase
The clinician suspects that a patient seen in the office has hyperthyroidism. Which test should
the clinician order on the initial visit?
A. Sensitive thyroid-stimulating hormone (TSH) assay and T4
B. Free T4 and serum calcium
C. Nuclear scintigraphy with radiolabeled iodine (123I)
D. Magnetic resonance imaging
A. Sensitive thyroid-stimulating hormone (TSH) assay and T4
Which of the following laboratory findings should the clinician expect in a patient with
untreated Graves' disease? Select all that apply
A. Low TSH
B. Elevated T4
C. Elevated thyrotropin-releasing hormone (TRH)
D. All of the above
D. All of the above
Graves Disease, a form or HYPERTHYROIDISM.
