NURS 6531 EXAMINATION PREPARATION
STUDY GUIDE 2026 EVIDENCE BASED
PRACTICE AND ADVANCED DIAGNOSTIC
REASONING
◉ Which medication given for patients with metabolic syndrome is
most likely to lower PAI-1 levels?
a. Aspirin
b. Atorvastatin
c. Metformin
d. Niacinc
Answer: ANS: C
Metformin is given not only to reduce hyperinsulinemia and lower
insulin resistance, but also
to lower plasma PAI-1 levels. Aspirin is given to reduce MI risk.
Atorvastatin helps with dyslipidemia. Niacin may be given to lower
triglycerides.
◉ Which findings are part of the diagnostic criteria for metabolic
syndrome? (Select all that apply.)
a. Decreased plasminogen activator inhibitor 1 levels
b. Elevated waist circumference
,c. Fasting plasma glucose > 100 mg/dL
d. HDL cholesterol > 45 mg/dL
e. Triglycerides > 150 mg/dL
Answer: ANS: B, C, E
The current criteria for diagnosing metabolic syndrome include
increased waist circumference, elevated fasting plasma glucose, and
elevated triglycerides. According to these criteria, patients will have
HDL levels <40 mg/dL. The old criteria included elevated
plasminogen activator inhibitor 1 levels.
◉ Which laboratory values representing parathyroid hormone
(PTH) and serum calcium are consistent with a diagnosis of primary
hyperparathyroidism?
a. Appropriately high PTH along with hypocalcemia
b. Appropriately increased PTH and low or normal serum calcium
c. Inappropriate secretion of PTH along with hypercalcemia
d. Prolonged inappropriate secretion of PTH with subsequent
hypercalcemia
Answer: ANS: C
Primary hyperparathyroidism is characterized by the inappropriate
secretion of PTH in the setting of hypercalcemia. Appropriately high
PTH with hypocalcemia characterizes hypoparathyroidism. An
appropriately increased secretion of PTH with low or normal serum
calcium is characteristic of secondary hyperparathyroidism.
,Prolonged inappropriate secretion of PTH in which hypercalcemia
develops is tertiary hyperparathyroidism.
◉ A 40-year-old patient with primary hyperparathyroidism has
increased serum calcium 0.5 mg/dL above normal without signs of
nephrolithiasis. What is the recommended treatment for
this patient?
a. Annual monitoring of calcium, creatinine, and bone density
b. Avoidance of weight-bearing exercises
c. Decreasing calcium and vitamin D intake until values normal
d. Parathyroidectomy
Answer: ANS: A
Medical management of primary hyperparathyroidism involves
close monitoring of serum calcium and creatinine and bone density
screenings. Weight-bearing exercises should be encouraged, and
vitamin D and calcium intake should be adequate, not decreased.
This patient does not meet criteria for parathyroidectomy because
of age less than 50 years and serum calcium less than 1 mg/dL
above the upper limit of normal.
◉ Which findings are symptoms of hyperparathyroidism? (Select all
that apply.)
a. Chvostek's sign
b. Cognitive impairment
, c. Left ventricular hypertrophy
d. Perioral paresthesias
e. Renal calculi
Answer: ANS: B, C, E
Cognitive impairment, left ventricular hypertrophy, and renal calculi
all occur with hyperparathyroidism. Chvostek's sign and perioral
paresthesias occur with
hypoparathyroidism.
◉ Which thyroid-stimulating hormone (TSH) level indicates
hyperthyroidism?
a. 0.2 uIU/L
b. 0.4 uIU/L
c. 2.4 uIU/L
d. 4.2 uIU/L
Answer: ANS: A
A TSH less than 0.3 uIU/L indicates hyperthyroid; greater than 4.0
uIU/L indicates hypothyroid, and between 0.3 and 4.0 uIU/L
indicates euthyroid.
◉ A patient has thyroid nodules and the provider suspects thyroid
cancer. To evaluate thyroid nodules for potential malignancy, which
test is performed?
a. Radionucleotide imaging
STUDY GUIDE 2026 EVIDENCE BASED
PRACTICE AND ADVANCED DIAGNOSTIC
REASONING
◉ Which medication given for patients with metabolic syndrome is
most likely to lower PAI-1 levels?
a. Aspirin
b. Atorvastatin
c. Metformin
d. Niacinc
Answer: ANS: C
Metformin is given not only to reduce hyperinsulinemia and lower
insulin resistance, but also
to lower plasma PAI-1 levels. Aspirin is given to reduce MI risk.
Atorvastatin helps with dyslipidemia. Niacin may be given to lower
triglycerides.
◉ Which findings are part of the diagnostic criteria for metabolic
syndrome? (Select all that apply.)
a. Decreased plasminogen activator inhibitor 1 levels
b. Elevated waist circumference
,c. Fasting plasma glucose > 100 mg/dL
d. HDL cholesterol > 45 mg/dL
e. Triglycerides > 150 mg/dL
Answer: ANS: B, C, E
The current criteria for diagnosing metabolic syndrome include
increased waist circumference, elevated fasting plasma glucose, and
elevated triglycerides. According to these criteria, patients will have
HDL levels <40 mg/dL. The old criteria included elevated
plasminogen activator inhibitor 1 levels.
◉ Which laboratory values representing parathyroid hormone
(PTH) and serum calcium are consistent with a diagnosis of primary
hyperparathyroidism?
a. Appropriately high PTH along with hypocalcemia
b. Appropriately increased PTH and low or normal serum calcium
c. Inappropriate secretion of PTH along with hypercalcemia
d. Prolonged inappropriate secretion of PTH with subsequent
hypercalcemia
Answer: ANS: C
Primary hyperparathyroidism is characterized by the inappropriate
secretion of PTH in the setting of hypercalcemia. Appropriately high
PTH with hypocalcemia characterizes hypoparathyroidism. An
appropriately increased secretion of PTH with low or normal serum
calcium is characteristic of secondary hyperparathyroidism.
,Prolonged inappropriate secretion of PTH in which hypercalcemia
develops is tertiary hyperparathyroidism.
◉ A 40-year-old patient with primary hyperparathyroidism has
increased serum calcium 0.5 mg/dL above normal without signs of
nephrolithiasis. What is the recommended treatment for
this patient?
a. Annual monitoring of calcium, creatinine, and bone density
b. Avoidance of weight-bearing exercises
c. Decreasing calcium and vitamin D intake until values normal
d. Parathyroidectomy
Answer: ANS: A
Medical management of primary hyperparathyroidism involves
close monitoring of serum calcium and creatinine and bone density
screenings. Weight-bearing exercises should be encouraged, and
vitamin D and calcium intake should be adequate, not decreased.
This patient does not meet criteria for parathyroidectomy because
of age less than 50 years and serum calcium less than 1 mg/dL
above the upper limit of normal.
◉ Which findings are symptoms of hyperparathyroidism? (Select all
that apply.)
a. Chvostek's sign
b. Cognitive impairment
, c. Left ventricular hypertrophy
d. Perioral paresthesias
e. Renal calculi
Answer: ANS: B, C, E
Cognitive impairment, left ventricular hypertrophy, and renal calculi
all occur with hyperparathyroidism. Chvostek's sign and perioral
paresthesias occur with
hypoparathyroidism.
◉ Which thyroid-stimulating hormone (TSH) level indicates
hyperthyroidism?
a. 0.2 uIU/L
b. 0.4 uIU/L
c. 2.4 uIU/L
d. 4.2 uIU/L
Answer: ANS: A
A TSH less than 0.3 uIU/L indicates hyperthyroid; greater than 4.0
uIU/L indicates hypothyroid, and between 0.3 and 4.0 uIU/L
indicates euthyroid.
◉ A patient has thyroid nodules and the provider suspects thyroid
cancer. To evaluate thyroid nodules for potential malignancy, which
test is performed?
a. Radionucleotide imaging
