NURS 623 EXAM 2 MARYVILLE UNIVERSITY
| QUESTIONS AND CORRECT ANSWERS |
GRADED A+ | VERIFIED ANSWERS | JUST
RELEASED
What drug is the treatment of choice in pregnant women with
hyperthyroidism? ------CORRECT ANSWER---------------PTU
(propylthiouracil) because they are less likely to cross the placenta
How long does it take antithyroid medications like PTU(prophylthiouracil)
and MMI (tapazole) to take effect? ------CORRECT ANSWER---------------2-
8 weeks
What symptoms should patients be told to report immedicatly if taking
antithyroid medications? ------CORRECT ANSWER---------------signs of
infection, fever, or sore throat, malaise or mouth sores (could be
agranulocytisis, aplastic anemia, or hepatitis)
What is the treatment choice for hyperthyroidism? ------CORRECT
ANSWER---------------radioactive iodine therapy
How long should women wait to get pregnant after receiving radioactive
iodine therapy? ------CORRECT ANSWER---------------4 months after
therapy
What is the most common cause of hypothroidism worldwide? and the
most common in the US? ------CORRECT ANSWER---------------worldwide:
iodine; US: autoimmune (hashimotos thyroiditis)
,What is the average age onset of hypothyroidism? ------CORRECT
ANSWER---------------30-60 years
In hypothyroidism what causes the goiter? ------CORRECT ANSWER--------
-------when T4 production is inadequate the thyroid gland enlarges due to
increasing levels of pituitary TSH; hypertrophy and hyperplasia of the
thyroid glad
Fatigue, weight gain, cold intolerance, hair loss or thinnig, constipation,
enlargement of neck and inability to exercise are all symptoms of ? ------
CORRECT ANSWER---------------Hypothyroidism
What are some specific findings for Hashimotos thyroiditis? ------CORRECT
ANSWER---------------painless thyroid enlargement, neck pain sore throat,
feeling of fullness in throat, low grade fever and exhaustion
What is the classification of the recommended first choice of oral
antihyperglycemic medication in Type 2 DM? ------CORRECT ANSWER----
-----------BIGUANIDE - METFORMIN
What periodic testing should you order if a patient has been on the first
choice oral antihyperglycemic medicine long term and complains of
neuropathy? Why? (hint: hematological) ------CORRECT ANSWER-----------
----●Vitamin B12 annually (CAN CAUSE B12 DEF)
,What is the goal of treatment for DM2? ------CORRECT ANSWER-------------
--A1C <7%; PREVENT FURTHER ORGAN DAMAGE
What subsequent laboratory tests are needed to evaluate the general
health of patients with DM2 (consider co-morbidities)? ------CORRECT
ANSWER---------------CMP (liver, kidney, glucose), Lipids, serum creatinine,
and urine albumin
What is the treatment for acute hypoglycemia in an alert patient? ------
CORRECT ANSWER---------------6 to 12 ounces of orange juice or another
fruit juice without additional sugar. One cup (8 oz) of milk can be
substituted if juice is not available. Glucose tablets, If available
What is the primary cause of mortality in DM patients? ------CORRECT
ANSWER---------------ISCHEMIC HEART FAILURE
You are Seeing a patient in the office and you determine they need to start
insulin for DM2, what type of insulin would you select and how would you
initiate their dosing regimen? ------CORRECT ANSWER---------------A1C
<8% BASAL (LONG ACTING) 0.1-0.2 U/KG
A1C >8% BASAL (LONG ACTING) 0.2-0.3 U/KG
TITRATE EVERY 2-3 DAYS DEPENDING ON FINGER STICK GLUCOSE
Middle-aged man presents with a painful, hot, red, swollen MTP joint of
great toe. Precipitated by weekend of binge drinking. What is the likely
diagnosis? ------CORRECT ANSWER---------------GOUT
, What are the PRIMARY risk factors for gout? ------CORRECT ANSWER----
-----------PRIMARY: ENZYME DEFECT & DECREASED RENAL
CLEARANCE OF URIC ACID
What are the SECONDARY risk factors for gout? ------CORRECT
ANSWER---------------EXCESSIVE PURINE
OBESITY
STARVATION
ALCOHOL ABUSE
MEDS: THIAZIDES, NIACIN
What diagnostic results would be seen with gout? ------CORRECT
ANSWER---------------elevated serum uric acid levels, ESR and WBCs;
What is the initial management for an acute attack of gout? ------CORRECT
ANSWER---------------COLCHICINE 1.2mg PO X 1 then 0.6mg in 1 hour
(within 36 hrs of onset up to 0.6 mg) NSAIDs, AND CORTICOSTEROIDS;
rest, elevation, immobilization
What is the subsequent pharmacological management used to prevent
further attacks of prophylaxis? ------CORRECT ANSWER---------------
ALLOPURINOL (wait 4-6 week to after acute attack to start)
What educational information should you discuss with a patient diagnosed
with gout? ------CORRECT ANSWER---------------AVOID FOODS HIGH IN
PURINE (MEAT & SEAFOOD, YEAST, BEER/ALCOHOL, BEANS, PEAS,
LENTILS, OATS, SPINACH, ASPARAGUS, CAULIFLOWER,
MUSHROOMS
