NR601/NR 601 Final Exam Questions with Verified Answers
(Correct Update)
Question 1: ____ 1. An elderly client presents with a new onset of feeling her heart race and fatigue.
An EKG reveals atrial fibrillation with rate >110. The patient also has a new fine tremor of both
hands. Which of the following would the nurse practitioner suspect?
A. Hypothyroidism
B. Hyperthyroidism
C. Congestive heart failure
D. Type 2 diabetes mellitus
Answer: B. Hyperthyroidism
Question 2: ____ 2. A 62-year-old female complains of fatigue and lack of energy. Constipation has
increased and the patient has gained ten pounds in the past 3 months. Depression is denied although
the patient reports a lack of interest in usual hobbies. Vital signs are within normal limits and the
patient's skin is dry and cool. Which of the following must be included in the differential?
A. Hyperthyroidism
B. Hypothyroidism
C. Hyperparathyroidism
D. Grave's disease
Answer: B. Hypothyroidism
Question 3: ____ 3. Mrs. Black, an 87-year-old patient, has been taking 100 mcg of Synthroid for 10
years. She comes to your office for a routine follow-up, feeling well. Her heart rate is 90. Your first
response is to:
A. Increase the Synthroid
B. Order TSH
C. Start a beta-blocker
D. Order thyroid scan
Answer: B. Order TSH
Question 4: ____ 4. Which patient is most likely to have osteoporosis?
A. An 80-year-old underweight male who smokes and has been on steroids for psoriasis
B. A 90-year-old female with no family history of osteoporosis who is on hormone replacement
therapy
C. A 68-year-old overweight female who drinks 1-2 drinks alcohol/day
D. An 82-year-old female with a normal BMI takes calcium and performs weightbearing exercise daily
Answer: A. An 80-year-old underweight male who smokes and has been on steroids for psoriasis
Page 1
,Question 5: ____ 5. When evaluating the expected outcome for a hypothyroid elderly patient placed
on levothyroxine, the nurse practitioner will:
A. Assess a weekly TSH
B. Assess the TSH in 4-6 weeks
C. Ask the patient if the symptoms have subsided and adjust dosage accordingly
D. Decrease the dosage should a cardiac event occur
Answer: B. Assess the TSH in 4-6 weeks
Question 6: ____ 6. A postmenopausal woman with osteoporosis is taking a bisphosphonate daily by
mouth. What action information statement would indicate the patient understood the nurse
practitioner's instructions regarding this medication?
A. Takes medication at bedtime with a full glass of water
B. Takes medication with a full glass of water when up in a.m. 30 minutes prior to other food and
medications
C. Takes medication when up in a.m. with a glass of orange juice to increase absorption
D. Takes medication sitting up and with a meal to avoid gastrointestinal distress
Answer: B. Takes medication with a full glass of water when up in a.m. 30 minutes prior to other
food and medications
Question 7: ____ 7. The primary reason levothyroxine sodium is initiated at a low dose in an elderly
patient with hypothyroidism is to prevent which of the following untoward effects?
A. Angina and arrhythmia
B. Nausea and diarrhea
C. Confusion and delirium
D. Osteoporosis and muscle weakness
Answer: A. Angina and arrhythmia
Question 8: ____ 8. Six months ago an elderly patient was diagnosed with subclinical
hypothyroidism. Today the patient returns and has a TSH of 11.0 and complains of fatigue. He has
taken Synthroid 25 mcg daily as prescribed. What is the best course of action for the nurse
practitioner?
A. Assess further for a cause of fatigue
B. Double the dose of Synthroid
C. Discontinue the Synthroid
D. Prescribe Liotrix (T3 & T4 combination)
Answer: B. Double the dose of Synthroid
Page 2
, Question 9: ____ 9. A fluoroquinolone (Ciprofloxin) is prescribed for a male patient with a UTI.
What should the nurse practitioner teach the patient regarding taking this medication?
A. It must be taken on an empty stomach
B. Its effectiveness is decreased by antacids, iron, or caffeine ingestion
C. It may cause a metallic aftertaste
D. Its effectiveness is not a concern and it can be taken with any medications
Answer: B. Its effectiveness is decreased by antacids, iron, or caffeine ingestion
Question 10: ____ 10. A patient has been prescribed metformin (Glucophage). One week later he
returns with lowered blood sugars but complains of some loose stools during the week. How should
the nurse practitioner respond?
A. Discontinue the medication immediately
B. Reassure the patient that this is an anticipated side effect
C. Double the dosage of medication and have patient return in 1 week
D. Order a chem. 7 to check for lactic acidosis
Answer: B. Reassure the patient that this is an anticipated side effect
Question 11: ____ 11. Which of the following signs of hyperthyroidism commonly manifest in
younger populations, but is notably lacking in the elderly?
A. Weight gain
B. Constipation
C. Bradycardia
D. Exophthalmos
Answer: D. Exophthalmos
Question 12: ____ 12. A 60-year-old obese male client has type 2 diabetes mellitus and a lipid panel
of TC = 250, HDL = 32, LDL = 165. The nurse practitioner teaches the patient about his modifiable
cardiac risk factors, which include:
A. Advancing age, diabetes, hyperlipidemia, and male gender
B. Diabetes, obesity, and hyperlipidemia
C. Hyperlipidemia, smoking, and family history of heart disease
D. Male with age > 45, diabetes mellitus, and hyperlipidemia
Answer: B. Diabetes, obesity, and hyperlipidemia
Question 13: ____ 13. A diabetic patient presents with the complaint of right foot pain but denies any
recent known injury. He states it has gotten progressively worse over the past few months. On exam,
vibratory sense, as well as sensation tested with a monofilament, was abnormal. The patient's foot is
warm, edematous, and misshapen. The nurse practitioner suspects Charcot foot. What intervention
is indicated?
Answer: C
Page 3
(Correct Update)
Question 1: ____ 1. An elderly client presents with a new onset of feeling her heart race and fatigue.
An EKG reveals atrial fibrillation with rate >110. The patient also has a new fine tremor of both
hands. Which of the following would the nurse practitioner suspect?
A. Hypothyroidism
B. Hyperthyroidism
C. Congestive heart failure
D. Type 2 diabetes mellitus
Answer: B. Hyperthyroidism
Question 2: ____ 2. A 62-year-old female complains of fatigue and lack of energy. Constipation has
increased and the patient has gained ten pounds in the past 3 months. Depression is denied although
the patient reports a lack of interest in usual hobbies. Vital signs are within normal limits and the
patient's skin is dry and cool. Which of the following must be included in the differential?
A. Hyperthyroidism
B. Hypothyroidism
C. Hyperparathyroidism
D. Grave's disease
Answer: B. Hypothyroidism
Question 3: ____ 3. Mrs. Black, an 87-year-old patient, has been taking 100 mcg of Synthroid for 10
years. She comes to your office for a routine follow-up, feeling well. Her heart rate is 90. Your first
response is to:
A. Increase the Synthroid
B. Order TSH
C. Start a beta-blocker
D. Order thyroid scan
Answer: B. Order TSH
Question 4: ____ 4. Which patient is most likely to have osteoporosis?
A. An 80-year-old underweight male who smokes and has been on steroids for psoriasis
B. A 90-year-old female with no family history of osteoporosis who is on hormone replacement
therapy
C. A 68-year-old overweight female who drinks 1-2 drinks alcohol/day
D. An 82-year-old female with a normal BMI takes calcium and performs weightbearing exercise daily
Answer: A. An 80-year-old underweight male who smokes and has been on steroids for psoriasis
Page 1
,Question 5: ____ 5. When evaluating the expected outcome for a hypothyroid elderly patient placed
on levothyroxine, the nurse practitioner will:
A. Assess a weekly TSH
B. Assess the TSH in 4-6 weeks
C. Ask the patient if the symptoms have subsided and adjust dosage accordingly
D. Decrease the dosage should a cardiac event occur
Answer: B. Assess the TSH in 4-6 weeks
Question 6: ____ 6. A postmenopausal woman with osteoporosis is taking a bisphosphonate daily by
mouth. What action information statement would indicate the patient understood the nurse
practitioner's instructions regarding this medication?
A. Takes medication at bedtime with a full glass of water
B. Takes medication with a full glass of water when up in a.m. 30 minutes prior to other food and
medications
C. Takes medication when up in a.m. with a glass of orange juice to increase absorption
D. Takes medication sitting up and with a meal to avoid gastrointestinal distress
Answer: B. Takes medication with a full glass of water when up in a.m. 30 minutes prior to other
food and medications
Question 7: ____ 7. The primary reason levothyroxine sodium is initiated at a low dose in an elderly
patient with hypothyroidism is to prevent which of the following untoward effects?
A. Angina and arrhythmia
B. Nausea and diarrhea
C. Confusion and delirium
D. Osteoporosis and muscle weakness
Answer: A. Angina and arrhythmia
Question 8: ____ 8. Six months ago an elderly patient was diagnosed with subclinical
hypothyroidism. Today the patient returns and has a TSH of 11.0 and complains of fatigue. He has
taken Synthroid 25 mcg daily as prescribed. What is the best course of action for the nurse
practitioner?
A. Assess further for a cause of fatigue
B. Double the dose of Synthroid
C. Discontinue the Synthroid
D. Prescribe Liotrix (T3 & T4 combination)
Answer: B. Double the dose of Synthroid
Page 2
, Question 9: ____ 9. A fluoroquinolone (Ciprofloxin) is prescribed for a male patient with a UTI.
What should the nurse practitioner teach the patient regarding taking this medication?
A. It must be taken on an empty stomach
B. Its effectiveness is decreased by antacids, iron, or caffeine ingestion
C. It may cause a metallic aftertaste
D. Its effectiveness is not a concern and it can be taken with any medications
Answer: B. Its effectiveness is decreased by antacids, iron, or caffeine ingestion
Question 10: ____ 10. A patient has been prescribed metformin (Glucophage). One week later he
returns with lowered blood sugars but complains of some loose stools during the week. How should
the nurse practitioner respond?
A. Discontinue the medication immediately
B. Reassure the patient that this is an anticipated side effect
C. Double the dosage of medication and have patient return in 1 week
D. Order a chem. 7 to check for lactic acidosis
Answer: B. Reassure the patient that this is an anticipated side effect
Question 11: ____ 11. Which of the following signs of hyperthyroidism commonly manifest in
younger populations, but is notably lacking in the elderly?
A. Weight gain
B. Constipation
C. Bradycardia
D. Exophthalmos
Answer: D. Exophthalmos
Question 12: ____ 12. A 60-year-old obese male client has type 2 diabetes mellitus and a lipid panel
of TC = 250, HDL = 32, LDL = 165. The nurse practitioner teaches the patient about his modifiable
cardiac risk factors, which include:
A. Advancing age, diabetes, hyperlipidemia, and male gender
B. Diabetes, obesity, and hyperlipidemia
C. Hyperlipidemia, smoking, and family history of heart disease
D. Male with age > 45, diabetes mellitus, and hyperlipidemia
Answer: B. Diabetes, obesity, and hyperlipidemia
Question 13: ____ 13. A diabetic patient presents with the complaint of right foot pain but denies any
recent known injury. He states it has gotten progressively worse over the past few months. On exam,
vibratory sense, as well as sensation tested with a monofilament, was abnormal. The patient's foot is
warm, edematous, and misshapen. The nurse practitioner suspects Charcot foot. What intervention
is indicated?
Answer: C
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