NP Endocrine questions & answers
A 51-year-old overweight Caucasian male is diagnosed today with Type 2 diabetes. What
medications should be initiated today?
Metformin, ASA, and pravastatin
Metformin, niacin, Monopril
Glimepiride, ASA, fosinopril
Metformin, atorvastatin, ramipril, ASA ✔️✔️Metformin, atorvastatin, ramipril, ASA This
patient needs several medications started today. American Diabetes Association recommends
starting treatment with metformin. This should be initiated today. The drug class of choice for
treatment of his LDL cholesterol is a statin. Dietary modifications are usually attempted for 3
months prior to initiation of a statin. However, considering this patient's LDLs of 210 mg/dL and
his diagnosis of diabetes, strong consideration should be given to initiating therapy today with a
statin. An ACE inhibitor is a good antihypertensive medication to treat blood pressure elevations
in a 51-year-old overweight Caucasian male who has diabetes. An aspirin should be initiated if
there are no contraindications. ADA recommends (Level C) ASA therapy (low dose) as primary
prevention in patients who have Type 2 diabetes that are at increased cardiovascular risk. ASA
use as secondary prevention in patients who have diabetes and a history of a cardiovascular event
is Level A.
A patient who has been treated for hypothyroidism presents for her annual exam. She complains
of weight gain and fatigue. How should the NP proceed? TSH is 14.1
Ask what time of day she is taking her medication
, Ask if she is taking her medication Correct
Increase her dose of thyroid supplement
Repeat the TSH in 2-3 months ✔️✔️Ask if she is taking her medication Her TSH is elevated.
This is usually caused by insufficient supplementation in a patient with hypothyroidism. If the
TSH was within normal range following her last annual exam, something has changed. The first
point that must be established is whether the patient is still taking her medication. If she is still
taking her medication, determining when she is taking it is important. It should be taken on an
empty stomach for absorption. These two important facts must be established BEFORE
increasing her current dose. The TSH is usually repeated when an abnormal value is measured,
but this patient has symptoms of an abnormal TSH.
What is the AM fasting glucose goal for a 75-year-old patient who has diabetes?
80-100 mg/dL
100-120 mg/dL
80-130 mg/dL Correct
120-140 mg/dL ✔️✔️80-130 Considering this patient's age and the risk of hypoglycemia, a
reasonable goal is 80-130 mg/dL preprandial. A value less than 130 mg/dL is desirable, but not
less than 80 mg/dL. The goal peak postprandial capillary plasma glucose should be less than 180
mg/dL. Hypoglycemia during sleep can result in stroke or seizures in this age group.
Next
A female patient has the following characteristics. Which one represents the greatest risk factor
for development of Type 2 diabetes?
A 51-year-old overweight Caucasian male is diagnosed today with Type 2 diabetes. What
medications should be initiated today?
Metformin, ASA, and pravastatin
Metformin, niacin, Monopril
Glimepiride, ASA, fosinopril
Metformin, atorvastatin, ramipril, ASA ✔️✔️Metformin, atorvastatin, ramipril, ASA This
patient needs several medications started today. American Diabetes Association recommends
starting treatment with metformin. This should be initiated today. The drug class of choice for
treatment of his LDL cholesterol is a statin. Dietary modifications are usually attempted for 3
months prior to initiation of a statin. However, considering this patient's LDLs of 210 mg/dL and
his diagnosis of diabetes, strong consideration should be given to initiating therapy today with a
statin. An ACE inhibitor is a good antihypertensive medication to treat blood pressure elevations
in a 51-year-old overweight Caucasian male who has diabetes. An aspirin should be initiated if
there are no contraindications. ADA recommends (Level C) ASA therapy (low dose) as primary
prevention in patients who have Type 2 diabetes that are at increased cardiovascular risk. ASA
use as secondary prevention in patients who have diabetes and a history of a cardiovascular event
is Level A.
A patient who has been treated for hypothyroidism presents for her annual exam. She complains
of weight gain and fatigue. How should the NP proceed? TSH is 14.1
Ask what time of day she is taking her medication
, Ask if she is taking her medication Correct
Increase her dose of thyroid supplement
Repeat the TSH in 2-3 months ✔️✔️Ask if she is taking her medication Her TSH is elevated.
This is usually caused by insufficient supplementation in a patient with hypothyroidism. If the
TSH was within normal range following her last annual exam, something has changed. The first
point that must be established is whether the patient is still taking her medication. If she is still
taking her medication, determining when she is taking it is important. It should be taken on an
empty stomach for absorption. These two important facts must be established BEFORE
increasing her current dose. The TSH is usually repeated when an abnormal value is measured,
but this patient has symptoms of an abnormal TSH.
What is the AM fasting glucose goal for a 75-year-old patient who has diabetes?
80-100 mg/dL
100-120 mg/dL
80-130 mg/dL Correct
120-140 mg/dL ✔️✔️80-130 Considering this patient's age and the risk of hypoglycemia, a
reasonable goal is 80-130 mg/dL preprandial. A value less than 130 mg/dL is desirable, but not
less than 80 mg/dL. The goal peak postprandial capillary plasma glucose should be less than 180
mg/dL. Hypoglycemia during sleep can result in stroke or seizures in this age group.
Next
A female patient has the following characteristics. Which one represents the greatest risk factor
for development of Type 2 diabetes?
