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Nurs 615 Exam IV questions and answers 2024/2025best exam for nursing
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Nurs 615 Exam IV questions andanswers 2024/2025best exam for nursing
How will you prescribe lipase, protease, and amylase components? - CORRECT
ANSWERS Patients with cystic fibrosis are often prescribed enzyme
replacement for pancreatic secretions each replacement drug has amylase, lipase
and protease components, however the drug is prescribed in units of lipase
What is the medication of choice for hypertensive crisis with pheochromocytoma? -
CORRECT ANSWERS Surgical resection of the tumor is the first treatment of
choice either my open laparotomy or laparoscopy either surgical option requires
prior treatment of nonspecific irreversible adrenergic adraonoreceptor blocker
phenoxybenzamine or a shorter acting alpha antagonists, prazosin, terazosin, and
doxazosin. Mainly use phenozibenamine in practice. Doing so promotes the surgery
to proceed while minimizing the likelihood of severe intraoperative hypertension
which is likely when the tumor is manipulated.
What is the onset of action, peak of action, and duration of action of each insulin
preparation? - CORRECT ANSWERS (Intermediate Acting) NPH
Onset-60-90 min after administration,
Peak 48 hrs
Duration 10-18 hrs.
(Short Acting) Regular Onset 30-60 min
Peak 2-4 hrs
Duration 6-10 hrs
(Long Acting) Aspart, Lispro, Glulisine
Onset less than 15 min
Peak 1-2 hrs
Duration 3-6 hrs
(Long Acting) Glargine, Detemir
Onset 1-2 hrs
Peak NO PEAK
Duration 24 hrs
,Nurs 615 Exam IV questions and
answers 2024/2025best exam for nursing
Identify the symptoms of hypoglycemia, hyperglycemia, and ketoacidosis. -
CORRECT ANSWERS Hypoglycemia- dizziness, confusion, diaphoresis,
tachycardia
Hyperglycemia- polyphagia, polydipsia, polyuria, blurred vision, and fatigue
Ketoacidosis- hallmark symptoms include acetone breath like nail polish remover or
fruity breath. Also abdominal pain, nausea, vomiting and sob.
When changing from NPH to glargine insulin, how will you adjust the patient's dose?
- CORRECT ANSWERS The initial dose of glargine is reduced by 20% to
prevent hypoglycemia.
How does metformin work? - CORRECT ANSWERS Decreases hyperglycemia
by decreasing hepatic glucose production called hepatic gluconeogenesis. The
average person with type 2 diabetes has three times the rate of gluconeogenesis,
metformin treatment reduces this by over 1/3rd. The molecular mechanism of
metformin isn't completely understood. In addition to suppressing hepatic glucose
production, metformin increases insulin sensitivity, enhances peripheral glucose
uptake by inducing the phosphorilization of glu4 enhancer factor, decreases insulin
induced suppression of fatty acid oxidation, and decreases absorption of glucose
from the GI tract. Also of note** Metformin helps reduce LDL cholesterol and
triglyceride levels and is not associated with weight gain, in some people it helps
promote weight loss**
What diagnostic testing is required before and throughout therapy with metformin? -
CORRECT ANSWERS Metformin is not metabolized, it is cleared from the
body by tubular secretion and is secreted unchanged in the urine. Metformin is
undetectable in blood plasma within 24 hrs of a single oral dose the average
elimination half-life in plasma is 6.2 hrs as it is secreted in the urine you should
check a serum crt to assess renal function.
What is the action of gliptin? - CORRECT ANSWERS The mechanism of DDP-
4 inhibitors is to increase incretin levels incretin are GLP1 and GIP which inhibit
glucagon release in which in turn increases insulin secretion, decreases gastric
emptying, and decreases blood glucose levels
, Nurs 615 Exam IV questions and
answers 2024/2025best exam for nursing
How do GLP agonists work? - CORRECT ANSWERS They bind directly to a
receptor in the pancreatic beta cell. These agents work in the same pathway as the
DPP-4 inhibitors as mentioned above but are generally considered more potent.
When should exenatide be administered? - CORRECT ANSWERS 60 minutes
prior to the morning and evening meal
How will you assess for granulocytopenia? - CORRECT ANSWERS Signs of a
Cold or flu including fever and sore throat
What are the adverse effects of propylthiouracil? - CORRECT ANSWERS
Agranulocytosis, thrombocytopenia, and fulminant liver failure as stated above, pt's
on PTU when they develop fever or sore throat, it would be important to check a
CBC preferably with a smear and a diff.
What are the adverse effects of levothyroxine? - CORRECT ANSWERS
Tachycardia and angina in the elderly
A patient develops a toxic goiter. What is the recommended treatment? - CORRECT
ANSWERS Methimazole for one month then radioactive iodine (p. 641)
What are the adverse effects of PTU and methimazole? - CORRECT ANSWERS
PTU- Fatal agranulocytopenia look for fever and sore throat and TEMPORARY
ALOPECIA
What is the action of biphosphonates? - CORRECT ANSWERS Bone
undergoes constant turnover and is kept in balance by osteoblasts creating bone
and osteoclasts destroying bone. Bisphosphonates inhibit the digestion of bone by
encouraging osteoclasts to undergo apoptosis or cell death there by slowing bone
loss. Oral bisphosphonates can cause upset stomach and inflammation as well as
erosion. Erosions of the esophagus which is the main problem of oral and containing
preparations. This can be prevented by sitting upright for 30-60 minutes after taking
the medication. If the patient does develop some type of gastric distress, give them
oral 30ml of Maalox 3 hrs after taking it. IV bisphosphonates can give fever and flu
like symptoms after the first infusion which is thought to occur because of their
potential to activate human T cells
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