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- A patient is seen with com- plaints of diarrhea. Which of the following should be in- cluded in the patient's differ- ential diagnosis? A. Gastroenteritis B. Recent use of Imodium C. Lack of dietary fiber D. Decreased physical activity
- A 45-year-old patient pre- sents with a chief com- plaint of generalized abdom- inal pain. Her physical exam- ination is remarkable for left lower quadrant tenderness. At this time, which of the fol- lowing should be considered in the differential diagnosis? A. Endometriosis B. Yersinia enterocolitica in- fection C. Appendicitis D. GERD 3. A 21-year-old student pre- sents with complaints of fa- tigue, headache, anorexia, and a runny nose, all of which began about 2 weeks
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2 / A. Gastroenteritis A. Endometriosis C. Antihepatitis D virus
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4 / d. All of the above
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- One of the three P's of dia- betes is: A. paresthesias B. polydipsia C. polycythemia D. proteinuria b. polydipsia
- A client is experiencing sud- den tachycardia, systolic hy- pertension, and a high fever after a thyroid assessment by the provider. What medica- tion should be administered? Select all that apply. A. Antithyroid medications B. Thyroid supplements C. Vitamin D D. Iodine preparations E. Glucocorticoids B. polydipsia A. Antithyroid medications D. Iodine preparations E. Glucocorticoids Rationale: Thyroid storm or thyrotoxicosis may develop with poorly managed hyperthyroidism. Clinical manifestations in- clude tachycardia, fever, systolic hypertension, abdominal pain, tremors, and changes in level of consciousness. Airway man- agement and fluid resuscitation are priorities. Antithyroid med- ications may be administered along with iodine preparations. For management of tachycardia, beta- adrenergic blockers may be administered. Glucocorticoids may also be administered because in high doses these medications decrease the con- version of T4 to the more active T3, as well as decreasing the release of TSH from the anterior pituitary gland.
- Joyce is seen in the clinic com- B. Thyrotoxicosis plaining of vague symptoms of nervousness and irritabili- ty. She says that her hair will not hold
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7 / irregular heartbeat and brisk reflexes. The differential diag- nosis should include which of the following conditions? A. Myxedema B. Thyrotoxicosis C. Cushing's syndrome D. Pan-hypopituitarism
- The nurse is caring for a client B. Hyperthyroidism with exophthalmos. What is the anticipated cause? A. Hypothyroidism B. Hyperthyroidism C. Thyrotoxicosis D. Hypoparathyroidism
- The patient experiencing thyroid storm (thyrotoxico- sis) is ordered to receive beta- adrenergic agents. The nurse monitors which thera- peutic effect of these medica- tions? A. Increased respiratory rate B. Increased appetite C. Decreased heart rate D. Decreased bowel sounds
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8 / C. Decreased heart rate
- d. All of the above
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B. Symptom control D. 4 weeks
- A. Thrombocytopenia and elevated transaminase
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Mandy, age 18, has infectious mononucleosis. What might you expect her blood work to reflect? A.Thrombocytopenia and ele- vated transaminase B. Elevated WBCs C. Decreased WBCs D.Decreased serum globulins
- The clinician suspects that a patient seen in the office has hyperthyroidism. Which test should the clinician order on the initial visit? A. Sensitive thyroid- stimulat- ing hormone (TSH) assay and T B. Free T4 and serum calcium C. Nuclear scintigraphy with radiolabeled iodine (123I) D. Magnetic resonance imag- ing
- Which of the following lab- oratory findings should the clinician expect in a patient with untreated Graves' dis- ease? Select all that apply A. Low TSH
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B. Elevated T C. Elevated thyrotropin-re- leasing hormone (TRH) D. All of the above
- Polydipsia occurs in diabetes as a result of a high serum glucose level, which: A. interferes with the release of antidiuretic hormones B. has an osmotic effect on fluids and eventually trig- gers the thirst mechanism for compensation C. causes a dry mouth, in- creasing the client's thirst to the point of drinking compul- sively D. disrupts fluid and elec- trolyte imbalance, increasing the thirst mechanism to com- pensate for fluid gain or loss
- A patient is 66 inches in height, weighing 200 lbs, and newly diagnosed with type 2 diabetes mellitus (DM). The A1c is 7.1%. What is the best initial treatment? A. No treatment at this time
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B. has an osmotic ettect on fluids and eventually triggers the thirst mechanism for compensation C. Diet, exercise, and metformin
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D. drink 4 to 6 glasses of water per day C. Glipizide (Glucotrol) D. Renal disease
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ter reading about metformin in a magazine. Which condi- tion that the patient also has would be a contraindication to taking metformin? A. Ulcerative colitis B. Inflammatory bowel dis- ease C. Chronic obstructive pul- monary disease D. Renal disease
- A patient presents with symp- D. Heterophile antibody test toms of infectious mononu- cleosis. Which lab chemistry test should the clinician or- der? A. Viral load B. Hemoglobin A1c C. Western blot assay D. Heterophile antibody test
- Which cognitive behavioral finding would the nurse antic- ipate finding in a patient with cirrhosis who has hepatic en- cephalopathy? A. Intact short-term memory B. Intact long-term memory
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C. Personality changes D. Clear speech articulation
- In cirrhosis, alterations in blood and lymph flow can lead to what end organ effect of the liver? A.Increased perfusion as a re- sult of ascites B. Increased pressure leading to increased vascularity C. Cellular changes leading to malignancy D. Necrosis
- The nurse is caring for a patient with cirrhosis. What signs would the nurse moni- tor for worsening of the dis- ease? Select all that apply. A. Petechiae B. Increased appetite C. Laryngitis D. Pedal edema E. Jaundice
- Ron has cirrhosis and now presents with altered men- tal status after increasing protein intake because he was trying to increase muscle
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D. Necrosis A. Petechiae D. Pedal edema E. Jaundice B. Hepatic encephalopathy
