NURS 487 FINAL EXAM ACTUAL QUESTIONS AND ANSWERS
What sort of subjective history do you need for endocrine? - CORRECT ANSWER✅✅Signs and
Symptoms
Past health history
Family history
Previous surgeries
Endocrine physical assessment - CORRECT ANSWER✅✅Vital signs
Head to toe
Abnormalities
Endocrine blood tests - CORRECT ANSWER✅✅TSH, T4, T3, Free T4
High TSH and Low FT4= hypothyroid
Low TSH and High FT4= hyperthyroidism
PTH; total calcium vs ionized calcium; serum phosphate
Cortisol/Aldosterone/ACTH: blood levels
Glucose
Urinalysis for endocrine - CORRECT ANSWER✅✅Dipstick can tell a lot about patient
Not used in isolation to diagnose
Tells us if there is ketones in urine
Diagnostic imaging for endocrine - CORRECT ANSWER✅✅CT
MRI
Ultrasound
Risk factors for acute pancreatitis - CORRECT ANSWER✅✅Obstructive biliary tract disease (particularly
cholelithiasis
Alcoholism
,Obesity
Peptic ulcers
Trauma
Hyperlipidemia
Hypercalcemia
Smoking
Certain drugs
Genetic factors
Pathophysiology of acute pancreatitis - CORRECT ANSWER✅✅Usually mild but can lead to necrotizing
or hemorrhagic
Develops due to an obstruction of the outflow of pancreatic digestive enzymes caused by bile and
pancreatic duct obstruction
Leads to autodigestion of pancreatic cells resulting in vascular damage, coagulation necrosis, fat necrosis
and edema
Alcohol:
Acinar cell metabolizes ethanol with toxic metabolites which in turn injure pancreatic acinar cells,
causing a release of activated enzymes
Chronic alcohol use causes formation of protein plugs in pancreatic ducts and spasm of the sphincter of
Oddi, resulting in obstruction and release of activated enzymes, inflammation and pancreatitis
Severe acute pancreatitis, proinflammatory cytokines activate leukocytes, cause injury to vessel walls
and abnormal coagulation in the lungs. Paralytic ileus and GI bleed can occur. Bacteria in bloodstream
may cause peritonitis or sepsis. Vasoactive peptides cause vasodilation, hypotension, and shock. ARDS,
renal failure and Systemic Inflammatory Response syndrome may occur. These are medical
emergencies.
Patient presentation of acute pancreatitis - CORRECT ANSWER✅✅Fever
Pain
N&V
Increased RR
,Increased HR
Low BP
Changes in lab values: high lipase and amylase, alterations in WBCs, leukocytes, Na, K+, Creatinine, GFR
Clinical manifestations of acute pancreatitis - CORRECT ANSWER✅✅Mid-epigastric or LUQ pain, N & V,
jaundice, fever and leukocytosis, abdominal distention, hypovolemia, hypotension, tachycardia,
myocardial insufficiency and shock
Severe:
Tachypnea and hypoxemia due to pulmonary edema, atelectasis or pleural effusions, hypovolemia, AKI,
transient hyperglycemia, multisystem organ failure
Nursing assessment for patients with acute pancreatitis - CORRECT ANSWER✅✅Inspect, auscultate,
palpate, percuss
GI assessment: bowel sounds, distention, N&V, guarding
Resp
Cardio
Renal
Hyperlipidemia, hyperglycemia, hypocalcemia
Lab values:
Lipase and amylase, WBC, bilirubin, Na, K+, Creatinine, BUN, Lipids (TC, TG, HDL, LDL), Ca, Troponin,
ABGs
What are the two most common types of diabetes? - CORRECT ANSWER✅✅Type I and Type II
What are the three other type of diabetes? - CORRECT ANSWER✅✅Gestational
Prediabetes
Secondary diabetes
Type 1 Diabetes - CORRECT ANSWER✅✅Pancreas does not produce insulin
, Complete loss of beta cell function
Unknown etiology but may be autoimmune or idiopathic
Requires exogenous insulin
Occurs in 10% of population
Type II Diabetes - CORRECT ANSWER✅✅Pancreas does not produce enough insulin or insulin resistance
Usually diagnosed as adults, but more children being diagnosed
Progressive loss of beta cells function as patient get older
Occurs in 90% of population
Other specific types of diabetes - CORRECT ANSWER✅✅Genetic defects of beta-cell function
Genetic defects in insulin action
Endocrinopathies
Drug-or-chemical induced beta cell dysfunction
Infections
Uncommon forms of immune-mediated DM
Other genetic symptoms associated with DM
Gestational diabetes - CORRECT ANSWER✅✅Insulin resistance combined with inadequate insulin
secretion in relation to hyperglycemia
Women who are obese, older than 25, family history of DM, history of GDM, or of certain ethnic groups
(Hispanic, Indigenous, Asian, or African American) have an increased risk of developing GDM
Metabolic stress of pregnancy may uncover tendency for T2DM
Clinical manifestations of Type I DM - CORRECT ANSWER✅✅Polyuria
Polydipsia
Polyphagia
Fruity odor to breath
Kussmaul respiration
What sort of subjective history do you need for endocrine? - CORRECT ANSWER✅✅Signs and
Symptoms
Past health history
Family history
Previous surgeries
Endocrine physical assessment - CORRECT ANSWER✅✅Vital signs
Head to toe
Abnormalities
Endocrine blood tests - CORRECT ANSWER✅✅TSH, T4, T3, Free T4
High TSH and Low FT4= hypothyroid
Low TSH and High FT4= hyperthyroidism
PTH; total calcium vs ionized calcium; serum phosphate
Cortisol/Aldosterone/ACTH: blood levels
Glucose
Urinalysis for endocrine - CORRECT ANSWER✅✅Dipstick can tell a lot about patient
Not used in isolation to diagnose
Tells us if there is ketones in urine
Diagnostic imaging for endocrine - CORRECT ANSWER✅✅CT
MRI
Ultrasound
Risk factors for acute pancreatitis - CORRECT ANSWER✅✅Obstructive biliary tract disease (particularly
cholelithiasis
Alcoholism
,Obesity
Peptic ulcers
Trauma
Hyperlipidemia
Hypercalcemia
Smoking
Certain drugs
Genetic factors
Pathophysiology of acute pancreatitis - CORRECT ANSWER✅✅Usually mild but can lead to necrotizing
or hemorrhagic
Develops due to an obstruction of the outflow of pancreatic digestive enzymes caused by bile and
pancreatic duct obstruction
Leads to autodigestion of pancreatic cells resulting in vascular damage, coagulation necrosis, fat necrosis
and edema
Alcohol:
Acinar cell metabolizes ethanol with toxic metabolites which in turn injure pancreatic acinar cells,
causing a release of activated enzymes
Chronic alcohol use causes formation of protein plugs in pancreatic ducts and spasm of the sphincter of
Oddi, resulting in obstruction and release of activated enzymes, inflammation and pancreatitis
Severe acute pancreatitis, proinflammatory cytokines activate leukocytes, cause injury to vessel walls
and abnormal coagulation in the lungs. Paralytic ileus and GI bleed can occur. Bacteria in bloodstream
may cause peritonitis or sepsis. Vasoactive peptides cause vasodilation, hypotension, and shock. ARDS,
renal failure and Systemic Inflammatory Response syndrome may occur. These are medical
emergencies.
Patient presentation of acute pancreatitis - CORRECT ANSWER✅✅Fever
Pain
N&V
Increased RR
,Increased HR
Low BP
Changes in lab values: high lipase and amylase, alterations in WBCs, leukocytes, Na, K+, Creatinine, GFR
Clinical manifestations of acute pancreatitis - CORRECT ANSWER✅✅Mid-epigastric or LUQ pain, N & V,
jaundice, fever and leukocytosis, abdominal distention, hypovolemia, hypotension, tachycardia,
myocardial insufficiency and shock
Severe:
Tachypnea and hypoxemia due to pulmonary edema, atelectasis or pleural effusions, hypovolemia, AKI,
transient hyperglycemia, multisystem organ failure
Nursing assessment for patients with acute pancreatitis - CORRECT ANSWER✅✅Inspect, auscultate,
palpate, percuss
GI assessment: bowel sounds, distention, N&V, guarding
Resp
Cardio
Renal
Hyperlipidemia, hyperglycemia, hypocalcemia
Lab values:
Lipase and amylase, WBC, bilirubin, Na, K+, Creatinine, BUN, Lipids (TC, TG, HDL, LDL), Ca, Troponin,
ABGs
What are the two most common types of diabetes? - CORRECT ANSWER✅✅Type I and Type II
What are the three other type of diabetes? - CORRECT ANSWER✅✅Gestational
Prediabetes
Secondary diabetes
Type 1 Diabetes - CORRECT ANSWER✅✅Pancreas does not produce insulin
, Complete loss of beta cell function
Unknown etiology but may be autoimmune or idiopathic
Requires exogenous insulin
Occurs in 10% of population
Type II Diabetes - CORRECT ANSWER✅✅Pancreas does not produce enough insulin or insulin resistance
Usually diagnosed as adults, but more children being diagnosed
Progressive loss of beta cells function as patient get older
Occurs in 90% of population
Other specific types of diabetes - CORRECT ANSWER✅✅Genetic defects of beta-cell function
Genetic defects in insulin action
Endocrinopathies
Drug-or-chemical induced beta cell dysfunction
Infections
Uncommon forms of immune-mediated DM
Other genetic symptoms associated with DM
Gestational diabetes - CORRECT ANSWER✅✅Insulin resistance combined with inadequate insulin
secretion in relation to hyperglycemia
Women who are obese, older than 25, family history of DM, history of GDM, or of certain ethnic groups
(Hispanic, Indigenous, Asian, or African American) have an increased risk of developing GDM
Metabolic stress of pregnancy may uncover tendency for T2DM
Clinical manifestations of Type I DM - CORRECT ANSWER✅✅Polyuria
Polydipsia
Polyphagia
Fruity odor to breath
Kussmaul respiration
