NUR 654 Midterm – 200+ Verified Q&A |
Endocrine, Cancer, Pain Management,
Reproductive, Neuro – 2025/2026 |
Grand Canyon University
1. A patient presents with rapid weight gain, amenorrhea without
pregnancy, and mild hypertension. Once confirmatory tests are
performed, what is a possible treatment for this patient?
• A) Thyroid hormone replacement
• B) Oral contraceptives
• C) Pituitary tumor resection
• D) Metformin
Rationale: These symptoms are classic for Cushing's syndrome, often
caused by an ACTH-secreting pituitary adenoma (Cushing's disease).
First-line treatment is transsphenoidal resection of the pituitary tumor.
2. A patient has unexplained weight loss and the provider notes
increased skin pigmentation on light-exposed skin folds along with
darkened palmar creases. Which laboratory tests will the provider
order vs NOT order?
• A) ORDER: Serum ACTH, Serum electrolytes, TB skin testing;
NOT: Serum cortisol
• B) ORDER: Serum cortisol, Serum ACTH; NOT: Serum electrolytes
, • C) ORDER: Serum electrolytes, Serum cortisol; NOT: TB skin
testing
• D) ORDER: TB skin testing, Serum cortisol; NOT: Serum ACTH
Rationale: These findings suggest Addison's disease (primary adrenal
insufficiency), characterized by hyperpigmentation due to elevated
ACTH. Diagnosis requires serum ACTH (elevated), electrolytes
(hyponatremia, hyperkalemia), and TB testing (to rule out infectious
cause). Serum cortisol would be low, not ordered as a confirmatory first
step.
3. Addison's Disease may cause which of the following lab
abnormalities?
• A) Hypokalemia
• B) Hypernatremia
• C) Elevated cortisol
• D) Elevated ACTH
Rationale: In primary adrenal insufficiency, the adrenal cortex fails to
produce cortisol, leading to loss of negative feedback on the pituitary and
subsequent elevation of ACTH.
4. Symptoms of Cushing's Syndrome include:
• A) Weight loss
• B) Hyperpigmentation
• C) Amenorrhea
, • D) Hypotension
Rationale: Cushing's syndrome (glucocorticoid excess) causes central
obesity, moon facies, hypertension, glucose intolerance, and menstrual
irregularities including amenorrhea.
5. True or False: Pituitary tumor resection may be first-line treatment
for Cushing's Syndrome if indicated.
• A) True
• B) False
Rationale: When Cushing's syndrome is caused by a pituitary adenoma
(Cushing's disease), transsphenoidal resection of the tumor is the
treatment of choice.
6. An elevated serum alkaline phosphatase (SAP) may include all of
the following EXCEPT:
• A) Hyperglycemia
• B) Diabetes
• C) Acromegaly
• D) Hypothyroidism
Rationale: Elevated SAP is seen in conditions with increased bone
turnover (Paget's disease, metastases), liver disease, and growth
hormone excess (acromegaly). Hypothyroidism is not associated with
elevated SAP.
, 7. A patient has unexplained weight loss, increased skin
pigmentation, and darkened palmar creases. What condition should
the provider suspect?
• A) Cushing's syndrome
• B) Addison's disease
• C) Hyperthyroidism
• D) Pheochromocytoma
Rationale: These are classic signs of primary adrenal insufficiency
(Addison's disease). Hyperpigmentation results from elevated ACTH and
melanocyte-stimulating hormone.
8. A positive Trousseau's sign occurs with which serum abnormality?
• A) Hypercalcemia
• B) Hypocalcemia
• C) Hyperkalemia
• D) Hyponatremia
Rationale: Trousseau's sign (carpal spasm induced by inflating a blood
pressure cuff) indicates latent tetany from hypocalcemia.
9. Which of the following is an FDA-approved treatment for
osteoporosis?
Endocrine, Cancer, Pain Management,
Reproductive, Neuro – 2025/2026 |
Grand Canyon University
1. A patient presents with rapid weight gain, amenorrhea without
pregnancy, and mild hypertension. Once confirmatory tests are
performed, what is a possible treatment for this patient?
• A) Thyroid hormone replacement
• B) Oral contraceptives
• C) Pituitary tumor resection
• D) Metformin
Rationale: These symptoms are classic for Cushing's syndrome, often
caused by an ACTH-secreting pituitary adenoma (Cushing's disease).
First-line treatment is transsphenoidal resection of the pituitary tumor.
2. A patient has unexplained weight loss and the provider notes
increased skin pigmentation on light-exposed skin folds along with
darkened palmar creases. Which laboratory tests will the provider
order vs NOT order?
• A) ORDER: Serum ACTH, Serum electrolytes, TB skin testing;
NOT: Serum cortisol
• B) ORDER: Serum cortisol, Serum ACTH; NOT: Serum electrolytes
, • C) ORDER: Serum electrolytes, Serum cortisol; NOT: TB skin
testing
• D) ORDER: TB skin testing, Serum cortisol; NOT: Serum ACTH
Rationale: These findings suggest Addison's disease (primary adrenal
insufficiency), characterized by hyperpigmentation due to elevated
ACTH. Diagnosis requires serum ACTH (elevated), electrolytes
(hyponatremia, hyperkalemia), and TB testing (to rule out infectious
cause). Serum cortisol would be low, not ordered as a confirmatory first
step.
3. Addison's Disease may cause which of the following lab
abnormalities?
• A) Hypokalemia
• B) Hypernatremia
• C) Elevated cortisol
• D) Elevated ACTH
Rationale: In primary adrenal insufficiency, the adrenal cortex fails to
produce cortisol, leading to loss of negative feedback on the pituitary and
subsequent elevation of ACTH.
4. Symptoms of Cushing's Syndrome include:
• A) Weight loss
• B) Hyperpigmentation
• C) Amenorrhea
, • D) Hypotension
Rationale: Cushing's syndrome (glucocorticoid excess) causes central
obesity, moon facies, hypertension, glucose intolerance, and menstrual
irregularities including amenorrhea.
5. True or False: Pituitary tumor resection may be first-line treatment
for Cushing's Syndrome if indicated.
• A) True
• B) False
Rationale: When Cushing's syndrome is caused by a pituitary adenoma
(Cushing's disease), transsphenoidal resection of the tumor is the
treatment of choice.
6. An elevated serum alkaline phosphatase (SAP) may include all of
the following EXCEPT:
• A) Hyperglycemia
• B) Diabetes
• C) Acromegaly
• D) Hypothyroidism
Rationale: Elevated SAP is seen in conditions with increased bone
turnover (Paget's disease, metastases), liver disease, and growth
hormone excess (acromegaly). Hypothyroidism is not associated with
elevated SAP.
, 7. A patient has unexplained weight loss, increased skin
pigmentation, and darkened palmar creases. What condition should
the provider suspect?
• A) Cushing's syndrome
• B) Addison's disease
• C) Hyperthyroidism
• D) Pheochromocytoma
Rationale: These are classic signs of primary adrenal insufficiency
(Addison's disease). Hyperpigmentation results from elevated ACTH and
melanocyte-stimulating hormone.
8. A positive Trousseau's sign occurs with which serum abnormality?
• A) Hypercalcemia
• B) Hypocalcemia
• C) Hyperkalemia
• D) Hyponatremia
Rationale: Trousseau's sign (carpal spasm induced by inflating a blood
pressure cuff) indicates latent tetany from hypocalcemia.
9. Which of the following is an FDA-approved treatment for
osteoporosis?
