NM703 Exam Questions with Revised Answers|
Verified 100% Correct
What education would the APRN start with type 2 diabetes? - ✔✔Educate regarding
side effects of metformin which are nausea and diarrhea - mild and temporary;
education on diet and exercise, achievement and maintenance of desirable body
weight; educate how to monitor blood glucose - fasting 70-130 mg/dL and 2 hr post
prandial should be <180 mg/dL
Under what conditions would the APRN consult or refer to a physician with type 2
diabetes? - ✔✔End-organ complications (cardiac, kidney, thyroid, eyes, feet,
vascular), pregnancy
What is the follow-up plan most appropriate for a patient with type 2 diabetes? -
✔✔Follow-up every month until stable blood glucose with b/p wt, ht, BMI, eye/foot
exam, review glucometer readings, hbA1c Q3 months, lipid profile annually, serum
creatinine annually
What further history (pt reports "just not feeling well" 6 mo PP and being depressed,
Mother & sister have Hashimoto) would the APRN want to obtain? - ✔✔Dietary
history; Medical hx; Medications she takes
Describe the physical examination the APRN should conduct for a pt with
hypothyroidism. - ✔✔Assess for fatigue, increased sensitivity to cold, weight gain,
hoarseness, puffiness of the face and hands, heavy and irregular menstrual periods, dry
skin, dry/brittle nails, depression, paresthesias, muscles aches, constipation
List the laboratory tests that should be drawn for hypothyroidism. - ✔✔TSH - first
diagnostic test; if elevated then free T4
,What is the diagnostic criteria for Hashimoto thyroiditis? - ✔✔elevated TSH,
decreased Free T4, elevated antimicrosomal antibodies
Under what conditions would the APRN consult or refer to a physician with a pt with
hypothyroidism? - ✔✔Large obstructive goiter; solitary nodule or if difficultly
regulating medications
What is the follow-up plan most appropriate for a client with hypothyroidism? -
✔✔Follow up in 4-6 weeks
What further history (pt reports wt loss, heat intolerance, insomnia & nervousness, has
goiter and exopthalmia) would the APRN want to obtain from BH? - ✔✔Past medical
hx; Medication taking; Family hx
list the laboratory tests that should be drawn today for possible hyperthyroidism? -
✔✔TSH, T3, Free T4
Describe the physical examination the APRN should conduct for a pt with
hyperthyroidism. - ✔✔Assess for dry eyes, blurred vision, SOA, palpitation,
tachycardia, angina, hyperphagia, hyperdefecation, anorexia, amenorrhea, menstrual
irregularities, infertility, proximal muscle weakness, tremor, pruritus, hyperhidrosis,
warm, moist palms, onycholysis (brittle nails), osteoporosis, anxiety, irritability,
nervousness, diffuse goiter in pt with Graves disease
Under what conditions would the APRN consult or refer to a physician with
Hyperthyroidism? - ✔✔For Graves disease (other reasons are pregnancy, those
wanting to use radioiodine, if not familiar with thionamides)
What is the follow-up plan most appropriate for a client with hyperthyroidism? -
✔✔Follow up in 4-6 wks
, What if the diarrhea was foul smelling and she had a recent history of antibiotic use? -
✔✔If foul smell w/hx antibx use would CBC w/differential and CMP to assess for
infection and dehydration
When should a patient with diarrhea return to see you? - ✔✔1-2 weeks d/t relatively
negative exam and the fact that acute noninfectious diarrhea is usually self-limiting
What type of follow up should a patient with diarrhea receive? - ✔✔If diarrhea
continue then consider colitis, diverticulitis, IBD, panncreaitis, irritable bowel - perform
a CT of abd and KUB with possible referral for scheduling of possible endoscopy
procedure
What does an elevated alkaline phosphatase indicate? - ✔✔Cholestasis, primary
biliary cirrhosis, or infiltrative liver disease. In obstructive liver disease it may be more
than 3x the normal range.
What is the Pathophysiology of Type 1 diabetes? - ✔✔autoimmune destruction of
the beta cells within the islets of Langerhans in the pancreas
What is the Pathophysiology of Type 2 diabetes? - ✔✔"triumvirate" of decreased
glucose uptake (insulin resistance) increased hepatic glucose production, and impaired
insulin secretion
What is the screening criteria for diabetes? - ✔✔fasting plasma glucose 2hr 75 g
OGTT or hemoglobin A1C; begin testing at age 45 for all and 40-70 for those who are
overweight BMI >25 or Asian American BMI >23 and have one or more risk factor—
Physical inactivity; Family hx; High risk heritage (African American, Hispanic, Native
American, Asian American, pacific Islander); Hx of GDM or delivered a baby over 9 lb;
HTN; Dyslipidemia; Polycystic ovary syndrome; Presence of acanthosis nigrican; Hx of
Verified 100% Correct
What education would the APRN start with type 2 diabetes? - ✔✔Educate regarding
side effects of metformin which are nausea and diarrhea - mild and temporary;
education on diet and exercise, achievement and maintenance of desirable body
weight; educate how to monitor blood glucose - fasting 70-130 mg/dL and 2 hr post
prandial should be <180 mg/dL
Under what conditions would the APRN consult or refer to a physician with type 2
diabetes? - ✔✔End-organ complications (cardiac, kidney, thyroid, eyes, feet,
vascular), pregnancy
What is the follow-up plan most appropriate for a patient with type 2 diabetes? -
✔✔Follow-up every month until stable blood glucose with b/p wt, ht, BMI, eye/foot
exam, review glucometer readings, hbA1c Q3 months, lipid profile annually, serum
creatinine annually
What further history (pt reports "just not feeling well" 6 mo PP and being depressed,
Mother & sister have Hashimoto) would the APRN want to obtain? - ✔✔Dietary
history; Medical hx; Medications she takes
Describe the physical examination the APRN should conduct for a pt with
hypothyroidism. - ✔✔Assess for fatigue, increased sensitivity to cold, weight gain,
hoarseness, puffiness of the face and hands, heavy and irregular menstrual periods, dry
skin, dry/brittle nails, depression, paresthesias, muscles aches, constipation
List the laboratory tests that should be drawn for hypothyroidism. - ✔✔TSH - first
diagnostic test; if elevated then free T4
,What is the diagnostic criteria for Hashimoto thyroiditis? - ✔✔elevated TSH,
decreased Free T4, elevated antimicrosomal antibodies
Under what conditions would the APRN consult or refer to a physician with a pt with
hypothyroidism? - ✔✔Large obstructive goiter; solitary nodule or if difficultly
regulating medications
What is the follow-up plan most appropriate for a client with hypothyroidism? -
✔✔Follow up in 4-6 weeks
What further history (pt reports wt loss, heat intolerance, insomnia & nervousness, has
goiter and exopthalmia) would the APRN want to obtain from BH? - ✔✔Past medical
hx; Medication taking; Family hx
list the laboratory tests that should be drawn today for possible hyperthyroidism? -
✔✔TSH, T3, Free T4
Describe the physical examination the APRN should conduct for a pt with
hyperthyroidism. - ✔✔Assess for dry eyes, blurred vision, SOA, palpitation,
tachycardia, angina, hyperphagia, hyperdefecation, anorexia, amenorrhea, menstrual
irregularities, infertility, proximal muscle weakness, tremor, pruritus, hyperhidrosis,
warm, moist palms, onycholysis (brittle nails), osteoporosis, anxiety, irritability,
nervousness, diffuse goiter in pt with Graves disease
Under what conditions would the APRN consult or refer to a physician with
Hyperthyroidism? - ✔✔For Graves disease (other reasons are pregnancy, those
wanting to use radioiodine, if not familiar with thionamides)
What is the follow-up plan most appropriate for a client with hyperthyroidism? -
✔✔Follow up in 4-6 wks
, What if the diarrhea was foul smelling and she had a recent history of antibiotic use? -
✔✔If foul smell w/hx antibx use would CBC w/differential and CMP to assess for
infection and dehydration
When should a patient with diarrhea return to see you? - ✔✔1-2 weeks d/t relatively
negative exam and the fact that acute noninfectious diarrhea is usually self-limiting
What type of follow up should a patient with diarrhea receive? - ✔✔If diarrhea
continue then consider colitis, diverticulitis, IBD, panncreaitis, irritable bowel - perform
a CT of abd and KUB with possible referral for scheduling of possible endoscopy
procedure
What does an elevated alkaline phosphatase indicate? - ✔✔Cholestasis, primary
biliary cirrhosis, or infiltrative liver disease. In obstructive liver disease it may be more
than 3x the normal range.
What is the Pathophysiology of Type 1 diabetes? - ✔✔autoimmune destruction of
the beta cells within the islets of Langerhans in the pancreas
What is the Pathophysiology of Type 2 diabetes? - ✔✔"triumvirate" of decreased
glucose uptake (insulin resistance) increased hepatic glucose production, and impaired
insulin secretion
What is the screening criteria for diabetes? - ✔✔fasting plasma glucose 2hr 75 g
OGTT or hemoglobin A1C; begin testing at age 45 for all and 40-70 for those who are
overweight BMI >25 or Asian American BMI >23 and have one or more risk factor—
Physical inactivity; Family hx; High risk heritage (African American, Hispanic, Native
American, Asian American, pacific Islander); Hx of GDM or delivered a baby over 9 lb;
HTN; Dyslipidemia; Polycystic ovary syndrome; Presence of acanthosis nigrican; Hx of
