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Adult CCRN-Endocrine LATEST EXAM 2025 VERIFIED QUESTIONS AND CORRECT ANSWERS normal osmolality range - correct answer>> 275 - 295 mOsm/kg Hypo-osmolar - correct answer>><275mOmsm/Kg (low solutes in fluid) Hyperosmolar - correct answer>>>295 mOsm/kg Serum Osmolality definition. - correct answer>>Measure of concentration - number of solutes in comparison of fluid Antidiuretic hormone (ADH) is formed where? And produces where? - correct answer>>Formed in hypothalamus. Stored in posterior pituitary. What does ADH do? - correct answer>>ADH works on the ditsal convoluted tubules & collecting tubules of the kidneys to reabsorb water preventing diuresis,. ADH concentrates the urine. Specific Gravity range? - correct answer>>1.010-1. low specific gravity - correct answer>><1.005 dilute urine high specific gravity - correct answer>>>1.030 concentrated urine. SIADH basics? - correct answer>>Blood is dilute, urine is concentrated. What is SIADH mechanism of action? - correct answer>>Increased ADH-> kidneys retain urine->low urine output-> causing dilutional hyponatremia. What are you at high risk for with SIADH? - correct answer>>Seizures, cerebral edema, coma. ADH high SG high Urine Osmo high
Urine Na+ is high Serum Na+ low Serum Osmo low - correct answer>>SIADH What are the causes of SIADH? - correct answer>>thiazide diuretics, haloperidol, amiodarone, stroke, tumor. Treatment for SIADH? - correct answer>>Fluid restriction, hypertonics, loop diuretics or dilantin. What are patients at risk of with SIADH dx? - correct answer>>Seizures, increased ICP, coma. DI basics? - correct answer>>Blood is concentrated, urine is dilute. What is DI mechanism of action? - correct answer>>Decreased ADH-
kidneys lose water-> high U.O, causing hypernatremia ADH low SG low urine osmo low urine na+low serum na+ high serum osmo high - correct answer>>Diabetes Insipidus What causes DI to occur? - correct answer>>Trauma, tumor, craniotomy, phenytoin, ethanol, polycycstic kidneys. Treatment for DI? - correct answer>>DDAVP, electrolyte replacement. What are hypoglycemia initial s/s? - correct answer>>Shakiness, sweating, moodiness, inability to concentrate What are latent hypoglycemia s/s? - correct answer>>Confusion, abnormal behavior, difficult to arouse, slurred speech, seizures, LOC.
What are the 3 P's of Diabetes? - correct answer>>polyuria, polydipsia, polyphagia What is the treatment for DKA? - correct answer>>Give fluids (isotonic) BG<250 start D5 1/2 NS Slowly start insulin gtt Assess K, insulin drives k into the cell and D5 1/2 NS is hyptotonic. PH low Hco3 low Na low K high Phos low Ketones high Anion gap open/high > Urine glucose high - correct answer>>DKA normal anion gap range - correct answer>> 11 - 12mEq/L Normal ketone levels - correct answer>>0.6-1.5 ( >1.5 increased risk fo DKA) HHS causes - correct answer>>Infection (pneumonia, sepsis) Noncompliance of DM management Substance abuse Coexisting diseases S/S of HHS? - correct answer>>-extreme dehydration
- thirst
- lethargy/AMS
- mental confusion
- BG 1000 to 1500
- electrolyte imbalance
- coma
- death
What is the treatment for HHS? - correct answer>>Fluis replacment, BG is 250 - 300 add dextrose, 1/n NS for cellular hydration, insulin regular gtt slowly PH normal or mild acidosis Na+ high K low Mg low Phos low H/H high Urine glucose high - correct answer>>HHS What can cause Addison's disease? - correct answer>>abrupt withdrawl of steroids, sepsis, trauma. S/S of adrneal insufficency? - correct answer>>AMS, weakness, severe hypotension, N/V, fever. Labs in Addison's disease - correct answer>>hypoglycemia, hyponatremia, hyperkalemia, hyoercalcemia, low ACTH and cortisol levels Treatment for Addison's disease? - correct answer>>Lifelong glucocorticoid therapy Thyroid Storm labs? - correct answer>>TSH - suppressed Free T4 - elevated T3 - elevated Causes of thyroid storm? - correct answer>>Stress:
- Infection
- Diabetic ketoacidosis
- Physical or emotional trauma
- Manipulation of a hyperactive thyroid gland during thyroidectomy
