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NUR 221 Exam 3 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
|ALREADY
The nurse is providing patient education about glucocorticoid therapy to a patient preparing to be discharged home. Which statement made by the patient best demonstrates understanding of glucocorticoid therapy?
a. "I will take the entire dose early with breakfast."
b. "I will divide the dose in half and take half in the morning and half in the afternoon."
c. "I may take two-thirds of the dose in the morning and one-third in the evening."
d. "I will take a dose with each meal." - CORRECT ANSWERS c
The primary problem in Type 2 diabetes involves:
a. destruction of pancreatic alpha cells
b. insulin resistance by cells of the target organs
c. excessive glucagon in the liver
d. hypoglycemia - CORRECT ANSWERS b
A patient who has been newly diagnosed with adrenal hormone deficiency will begin taking hydrocortisone. The nurse provides teaching for this patient. Which statement by the patient indicates understanding of the teaching?
a. "I will need to take this medication until my symptoms completely clear, and then I may stop."
b. "When I am sick, I should take three times the normal dose for 3 days in a row."
c. "I may take all of my daily dose in the morning or divide it in half and take it twice daily."
d. "Side effects are common with hydrocortisone, even with therapeutic doses." - CORRECT ANSWERS b
Type 2 diabetes can be managed by lifestyle modification, particularly diet. Limiting which nutrient group is most effective in improving Type 2 diabetes
a. minerals
b. fats
c. carbohydrates
d. protein - CORRECT ANSWERS c
The primary cause of Type 1 diabetes is:
a. failure of insulin sensitivity in peripheral cells
b. destruction of pancreatic beta cells
c. absence of glucagon in the liver
d. destruction of alpha cells in the pancreas - CORRECT ANSWERS b
Which of the following symptoms would alert you to the possibility your patient is suffering from Benign Prostatic Hypertrophy (BPH)?
a. inability to completely empty bladder
b. blood in urine
c. sexual dysfunction
d. pain on urination - CORRECT ANSWERS a
Which of the following conditions can contribute to the development of sexual dysfunction?
a. smoking
b. hypertension
c. diabetes
d. delta - CORRECT ANSWERS a
Which pancreatic cells secrete insulin?
a. alpha
b. beta
c. gamma
d. delta - CORRECT ANSWERS b
What is the effect of glucagon? (select all that apply)
a. break down of glycogen into glucose
b. storage of glucose as glycogen
c. hyperglycemic effect
d. production of glucose from lactate and amino acids
e. hypoglycemic effect - CORRECT ANSWERS a,c,d
What is the effect of insulin? (select all that apply)
a. hyperglycemic effect
b. production of glucose from lactate and amino acids
c. promotes the entry of glucose into the cells
d. promotes the storage of glucose as glycogen
e. hypoglycemic effect - CORRECT ANSWERS c,d,e
What is the difference between type 1 and type 2 diabetes mellitus?
a. type 1 is caused by decreased sensitivity of insulin receptors in the tissues, whereas type 2 is caused by a metabolic disease where there is decreased insulin secretion
b. type 1 is caused by obesity, while type 2 is an autoimmune disorder
c. type 2 is caused by decreased sensitivity of insulin receptors in the tissues, whereas type 1 is caused by a metabolic disease where there is decreased insulin secretion
d. type 2 is caused by obesity, while type 1 is an autoimmune disorder - CORRECT ANSWERS c
Which of the following are risk factors for developing type 2 diabetes mellitus? (select all that apply)
a. sedentary lifestyle
b. stressful lifestyle
c. obesity
d. aging
e. poor diet - CORRECT ANSWERS a,b,c,d,e
How is type 1 diabetes mellitus, caused by autoimmune destruction of beta cells, treated?
a. diet and exercise changes
b. antidiabetic medications
c. antihypertensive medications
d. insulin - CORRECT ANSWERS d
A patient comes into the ER complaining of increased thirst, hunger, urination, and fatigue. As a nurse, what would you assess for in this patient?
a. hyperglycemia
b. glucosuria
c. weight loss
d. family history of diabetes mellitus - CORRECT ANSWERS a,b,c,d
What is the strongest diagnostic tool for assessing diabetes mellitus and why?
a. Hemoglobin A1C because it measures levels from last 4 months
a. diabetic ketoacidosis
b. hyperosmolar hyperglycemic state
c. hyperglycemia
d. hypoglycemia - CORRECT ANSWERS d
What is an acute complication of diabetes mellitus arising from an increase in blood sugar that triggers a diabetic coma?
a. diabetic ketoacidosis
b. hyperosmolar hyperglycemic state
c. hyperglycemia
d. hypoglycemia - CORRECT ANSWERS a
Which of the following has the correct blood sugar levels for hypoglycemia, diabetic ketoacidosis, and hyperosmolar hyperglycemic state?
a. <30, >200, >
b. <70, >250, >
c. <50, >300, >
d. <100, >500, >250 - CORRECT ANSWERS b
What differentiates hyperosmolar hyperglycemic state and diabetic ketoacidosis?
a. less insulin deficiency, with no change in Ketones and a higher blood sugar
b. less serious but can be fatal
c. occurs more often in patients with type 1 diabetes
d. causes patient's breath to have a fruity odor - CORRECT ANSWERS a
What is the key to treating type 1 diabetes?
a. be careful not administer too much insulin and cause hypoglycemia
b. remind patient not to skip or forget to take insulin
c. balance insulin with a proper diet and exercise
d. self monitor blood sugar daily - CORRECT ANSWERS c
Hypoglycemia
Hyperglycemia - CORRECT ANSWERS cold and clammy, need some candy
hot and dry, sugar high
What is the primary adverse effect of insulin?
a. hyperglycemia
b. hypoglycemia
c. diabetic ketoacidosis
d. GI effects - CORRECT ANSWERS b
Why do beta cells no longer respond to insulin in type 2 diabetes mellitus?
a. the beta cells are attacked by the autoimmune system
b. the beta cells grow exhausted by insulin and die
c. the receptors on the beta cells mutate
d. increased levels of glycogen cause beta cells to no longer need to respond - CORRECT ANSWERS b
Can type 2 diabetes be reversed?
a. yes, by a low carb diet
b. yes, with insulin therapy
c. no, it is an autoimmune disease
a. poor function of the thyroid gland
b. Hashimoto's thyroiditis
c. Grave's disease
d. pituitary tumor
e. surgical removal of the thyroid gland - CORRECT ANSWERS a,b,e
What are some main characteristics of hypothyroidism? (select all that apply)
a. weakness
b. dryness
c. bradycardia and low BP
d. intolerance of cold
e. weight gain - CORRECT ANSWERS a,b,c,d,e
A patient with hypothyroidism has been taking Levothyroxine for a few months, and states that they feel better and want to discontinue the medication. What patient education would you want to provide the patient?
a. it is important to wean off of this medication, as it can cause withdrawal symptoms
b. the half life of this drug is 6-7 days, so although you may feel better now, or even a week from now after continuing your medication, when there is no more of the drug left in your system in 2 weeks, you will begin to notice the effects
c. most patients begin to feel better after about 6 months of use, and it is important to discontinue the medication after the patient's hypothyroidism is cured
d. hypothyroidism is a chronic disease and discontinuing the medication would put the patient's health at risk - CORRECT ANSWERS b
Are levothyroxine preparations interchangeable?
a. levothyroxine cannot be interchanged with a generic preparation
b. there is only one levothyroxine preparation available on the U.S. market
c. levothyroxine can be interchanged with any preparation as long as TSHA levels are measured
d. levothyroxine is not used as commonly as many generic preparations - CORRECT ANSWERS a
What causes a goiter?
a. excess of iodine
b. lack of iodine
c. excess of salt
d. lack of salt - CORRECT ANSWERS b
Pregnant women have low levels of levels of T4, so if a pregnant women were on levothyroxine what might the provider change in her order?
a. the provider may want to decrease the dosage of levothyroxine because it is teratogenic
b. the provider should keep the dosage the same for all patients
c. the provider should increase the dosage to balance the low natural levels of T4 in pregnant females
d. the provider should decrease the dosage to prevent development of cretinism in the fetus - CORRECT ANSWERS c
Which of the following causes hyperthyroidism? (select all that apply)
a. Graves disease
b. pituitary tumor
c. Plummer's disease
d. Hashimoto's disease
e. iodine insufficiency - CORRECT ANSWERS a,b,c
What are signs of thyrotoxicosis? (select all that apply)
a. increased temperature
a. stimulates gluconeogenesis
b. promotes glucose storage
c. stores glucose for fasting and sleep
d. reduces peripheral glucose utilization - CORRECT ANSWERS c
What is the effect of aldosterone's regulation of plasma volume?
a. increases fluid retention
b. decreases fluid retention
c. hyperaldosteronism
d. increased plasma level - CORRECT ANSWERS a
What are androgens responsible for in the female body?
a. placenta production
b. sweat and odor
c. breast milk production
d. hair distribution and libido - CORRECT ANSWERS d
You believe a patient to have adrenocortical insufficiency. What might be causing this?
a. high blood glucose levels
b. lack of secretion from the adrenals
c. Hashimoto's disease
d. surgical removal of the adrenals - CORRECT ANSWERS b
What is a chronic autoimmune destruction of the adrenals that causes adrenal insufficiency?
a. Hashimoto's disease
b. Addison's disease
c. Grave's disease
d. Cushing's disease - CORRECT ANSWERS b
Why can corticosteroids not be used long term?
a. this can trick the anterior pituitary into stopping the adrenals from producing cortisol
b. this can trick the anterior pituitary into increasing the cortisol production from the adrenals
c. corticosteroids can cause osteoporosis
d. corticosteroids can be used long term - CORRECT ANSWERS a
What is the preferred drug for adrenocortical insufficiency?
a. ibuprofen
b. prednisone
c. fluticasone
d. potassium - CORRECT ANSWERS b
A patient taking prednisone for adrenocortical insufficiency is about to undergo surgery. Should the provider alter the dosage?
a. the provider should decrease the dosage to prevent systemic effects
b. the provider should tell the patient to stop taking prednisone two days prior to surgery and two days following
c. the provider should increase the dose during times of stress
d. the provider should keep the dose the same - CORRECT ANSWERS c
How can secondary acute adrenocortical insufficiency be avoided?
a. don't use a corticosteroid for more than 3 months
b. testosterone
c. the ovaries
d. the uterus - CORRECT ANSWERS c
What effect does estrogen have on bone remodeling?
a. limits the lifespan of osteoblasts
b. causes bones to brittle
c. limits the lifespan of osteoclasts
d. prevents bone remodeling - CORRECT ANSWERS c
What is the build up of endometrium that can cause endometrial cancer in menopausal women?
a. PMS
b. hysterotomy
c. hypoplasia
d. hyperplasia - CORRECT ANSWERS d
How do progesterone and estrogen work together?
a. progesterone limits the effects of estrogen
b. estrogen limits the effects of progesterone
c. progesterone and estrogen balance each other
d. estrogen enhances the effects of progesterone - CORRECT ANSWERS c
What causes PMS?
a. sensitivity to progesterone
b. mood swings
c. sensitivity to estrogen
d. genetics - CORRECT ANSWERS a
Which of the following is true about hormone replacement therapy?
a. if the patient has had a hysterectomy, use a combination of estrogen and progesterone
b. if the patient has a uterus, use a combination of estrogen and progesterone
c. progesterone is unnecessary if a patient has a uterus
d. if the patient has had a hysterectomy, use estrogen only - CORRECT ANSWERS d
True or false: Hormone replacement therapy cause heart attacks in older women?
a. true
b. false - CORRECT ANSWERS b
What are the benefits of hormone replacement therapy?
a. relieve of hot flashes
b. urogenital joy
c. reduced risk of breast cancer
d. living a long, happy life
e. cardiac protection - CORRECT ANSWERS a,b,d
True or false: Hormone replacement therapy cause dementia?
a. true
b. false - CORRECT ANSWERS b
What does male hypogonadism effect?
Erectile dysfunction can be caused by anything that alters:
a. mood
b. vasculature
c. testosterone production
d. mental health - CORRECT ANSWERS b
Erectile dysfunction in younger men is often caused by:
a. smoking and alcohol consumption
b. vasculature alterations
c. anabolic steroids
d. psychological causes - CORRECT ANSWERS d
True or false: Viagra can help all men achieve an erection, not just men with erectile dysfunction.
a. true
b. false - CORRECT ANSWERS b
Viagra is contradicted in patients taking what medication?
a. hypertensive agents
b. anticoagulants
c. testosterone
d. glucocorticoids - CORRECT ANSWERS a
Why might a 56 year old man not take his blood pressure medication?
a. it causes GI effects
b. it causes dizziness and vertigo
c. it cannot be taken in conjunction with erectile dysfunction medication
d. he doesn't feel like his medication does anything for him - CORRECT ANSWERS c
Which of the following are effects of Benign Prostatic Hyperplasia?
a. obstruction of the urethra
b. enlargement of the prostate
c. urinary frequency and leakage
d. UTI
e. severe pain - CORRECT ANSWERS a,b,c
How can BPH be treated? (select all that apply)
a. waiting for it to become a problem
b. there is no treatment
c. excision of tissue
d. alpha reductase inhibiters
e. alpha adrenergic antagonists - CORRECT ANSWERS a,c,d,e
What is the MOA of Finasteride, a alpha reductase inhibitor?
a. blocks the conversion of dihydrotestosterone to testosterone to prevent growth of prostate tissue
b. relaxes the bladder and constricts the urethral sphincter, releasing urine
c. constricts the bladder and relaxes the urethral sphincter, releasing urine
d. blocks the conversion of testosterone to dihydrotestosterone which shrinks the prostate - CORRECT ANSWERS d
Which drug can promote immediate urinary output in a patient with BPH?
a. Finasteride
