NR511 WEEK 6 CLINICAL CASE STUDY PART
ONE DISCUSSION 56 YEAR OLD CAUCASIAN
FEMALE FATIGUE COMPREHENSIVE EXAM
SCRIPT FULL ANSWERS VERIFIED 2026
◉ Marsha, age 24, is preparing for radioactive iodine therapy for her
Graves disease. Which test must she undergo first?
a. Beta-human chorionic gonadotropin
b. Basal metabolism rate
c. Lithium level
d. Serum calcium Answer: beta HCG
◉ When teaching Marcy how to use her new insulin pump, you tell her
that she needs to monitor her blood glucose level:
At least once a day.
Only occasionally because glycemic levels are maintained very steadily.
At least 4 times a day.
On an as needed basis when she feels she needs to give herself an extra
dose of insulin. Answer: at least 4 times per day
,◉ joan has severe asthma and has been on high dose oral corticosteroids
for 2 years. She has been reading some home remedy books and stops all
of her medications. What condition may she develop?
Myxedema crisis.
Diabetes insipidus.
Hypoparathyroidism.
Addisonian crisis. Answer: addisonian crisis
◉ The process of aging results in:
An increase in liver weight and mass.
A decreased absorption of fat-soluble vitamins.
An increase in enzyme activity.
Constricted pancreatic ducts Answer: decreased absorption of fat soluble
vitamins
◉ Sigrid, age 48, appears with a 3-month history of heat intolerance,
increased sweating, palpitations, tachycardia, nervousness, irritability,
fatigue, and muscle weakness. Which test would you order first?
A blood chemistry panel.
Thyroid-stimulating hormone (TSH) level.
,Liver function studies.
Electrocardiogram. Answer: TSH
◉ A client with newly diagnosed diabetes who has a glycated
hemoglobin (HbA1c) of 7.5 is started on therapeutic lifestyle changes
(TLCs) and medical nutrition therapy (MNT). Which oral antidiabetic
agent is recommended as monotherapy?
Glipizide (Glucotrol).
Sitagliptin (Januvia).
Exenatide (Byetta).
Metformin (Glucophage). Answer: METFORMIN
◉ Mr. Reynolds is on the antithyroid drug (ATD) methimazole
(Tapazole), so you make it a point to check his:
Glycated hemoglobin (HbA1c).
Complete blood count (CBC) and liver transaminases.
Uric acid level.
Total thyroxine (T4) Answer: CBC and liver enzymes
◉ Steve, age 42, has never been hypertensive but appears today in the
office with a blood pressure of 162/100 mm Hg. He also complains of
"attacks" of headaches, perspiration, and palpitations, with frequent
, bouts of nausea, pain, weakness, dyspnea, and visual disturbances. He
ahs lost 10lb over the past 2 months and seems very anxious today. Your
next action would be to:
Start him on an antianxiety agent.
Obtain a 24-hour urine test for catecholamines.
Start him on a diuretic or beta blocker
Recheck his blood pressure in 1 week. Answer: Obtain a 24-hour urine
test for catecholamines.
◉ Marie, age 50, has type 1 diabetes and checks her blood glucose level
several times every day. Her blood glucose levels range from 250 to 280
mg/dL in the morning and is usually about 140 at lunch, about 120 at
dinner, and about 100 at bedtime. In the morning, she takes 20 units of
neutral protamine Hagedorn (NPH) insulin and 4 units of regular insulin,
and before dinner she takes 18 units of NPH insulin and 4 units of
regular insulin. Although she has had her insulin dose adjusted several
times in the past month m it has had no effect on her high morning blood
glucose level. What is your next course of action?
Increase the evening NPH insulin dose by 2 more units.
Have her check blood glucose level between 2 am and 4 am for the next
several days.
Increase the morning regular insulin dose by 2 units.
Order a fasting blood sugar test. Answer: Have her check blood glucose
level between 2 am and 4 am for the next several days.
ONE DISCUSSION 56 YEAR OLD CAUCASIAN
FEMALE FATIGUE COMPREHENSIVE EXAM
SCRIPT FULL ANSWERS VERIFIED 2026
◉ Marsha, age 24, is preparing for radioactive iodine therapy for her
Graves disease. Which test must she undergo first?
a. Beta-human chorionic gonadotropin
b. Basal metabolism rate
c. Lithium level
d. Serum calcium Answer: beta HCG
◉ When teaching Marcy how to use her new insulin pump, you tell her
that she needs to monitor her blood glucose level:
At least once a day.
Only occasionally because glycemic levels are maintained very steadily.
At least 4 times a day.
On an as needed basis when she feels she needs to give herself an extra
dose of insulin. Answer: at least 4 times per day
,◉ joan has severe asthma and has been on high dose oral corticosteroids
for 2 years. She has been reading some home remedy books and stops all
of her medications. What condition may she develop?
Myxedema crisis.
Diabetes insipidus.
Hypoparathyroidism.
Addisonian crisis. Answer: addisonian crisis
◉ The process of aging results in:
An increase in liver weight and mass.
A decreased absorption of fat-soluble vitamins.
An increase in enzyme activity.
Constricted pancreatic ducts Answer: decreased absorption of fat soluble
vitamins
◉ Sigrid, age 48, appears with a 3-month history of heat intolerance,
increased sweating, palpitations, tachycardia, nervousness, irritability,
fatigue, and muscle weakness. Which test would you order first?
A blood chemistry panel.
Thyroid-stimulating hormone (TSH) level.
,Liver function studies.
Electrocardiogram. Answer: TSH
◉ A client with newly diagnosed diabetes who has a glycated
hemoglobin (HbA1c) of 7.5 is started on therapeutic lifestyle changes
(TLCs) and medical nutrition therapy (MNT). Which oral antidiabetic
agent is recommended as monotherapy?
Glipizide (Glucotrol).
Sitagliptin (Januvia).
Exenatide (Byetta).
Metformin (Glucophage). Answer: METFORMIN
◉ Mr. Reynolds is on the antithyroid drug (ATD) methimazole
(Tapazole), so you make it a point to check his:
Glycated hemoglobin (HbA1c).
Complete blood count (CBC) and liver transaminases.
Uric acid level.
Total thyroxine (T4) Answer: CBC and liver enzymes
◉ Steve, age 42, has never been hypertensive but appears today in the
office with a blood pressure of 162/100 mm Hg. He also complains of
"attacks" of headaches, perspiration, and palpitations, with frequent
, bouts of nausea, pain, weakness, dyspnea, and visual disturbances. He
ahs lost 10lb over the past 2 months and seems very anxious today. Your
next action would be to:
Start him on an antianxiety agent.
Obtain a 24-hour urine test for catecholamines.
Start him on a diuretic or beta blocker
Recheck his blood pressure in 1 week. Answer: Obtain a 24-hour urine
test for catecholamines.
◉ Marie, age 50, has type 1 diabetes and checks her blood glucose level
several times every day. Her blood glucose levels range from 250 to 280
mg/dL in the morning and is usually about 140 at lunch, about 120 at
dinner, and about 100 at bedtime. In the morning, she takes 20 units of
neutral protamine Hagedorn (NPH) insulin and 4 units of regular insulin,
and before dinner she takes 18 units of NPH insulin and 4 units of
regular insulin. Although she has had her insulin dose adjusted several
times in the past month m it has had no effect on her high morning blood
glucose level. What is your next course of action?
Increase the evening NPH insulin dose by 2 more units.
Have her check blood glucose level between 2 am and 4 am for the next
several days.
Increase the morning regular insulin dose by 2 units.
Order a fasting blood sugar test. Answer: Have her check blood glucose
level between 2 am and 4 am for the next several days.
