FINAL EXAM: NR511 / NR 511 DIFFERENTIAL DIAGNOSIS AND PRIMARY FINAL PRACTICE QUESTIONS AND VERIFIED ANSWERS | (2023/ 2024 UPDATE) CHAMBERLAIN

FINAL EXAM: NR511 / NR 511 DIFFERENTIAL DIAGNOSIS AND PRIMARY FINAL PRACTICE QUESTIONS AND VERIFIED ANSWERS | (2023/ 2024 UPDATE) CHAMBERLAIN 1. Mary, age 72, has been taking insulin for several years. She just called you because she realized that yesterday she put her short-acting insulin in the long-acting insulin box and vice versa. She just took 22 units of regular insulin when she was supposed to take only 5 units. She says that she tried to take a fingerstick to test her glucose level but was unable to obtain any blood. She states that she feels fine. What do you tell her to do first? a. "Keep trying to get a fingerstick and call me back with the results." b. "Call 911 before you collapse." c. "Drive immediately to the emergency room." d. "Drink 4 ounces of fruit juice." ~ Answer: "Drink 4 ounces of fruit juice." 2. A client with hyperthyroidism present s with a complaint of a "gritty" feeling in her eyes. Over the past week, her visual acuity has diminished, and her ability to see colors has changed. She also has a feeling of pressure behind her eyes. The next xtep for the nurse practitioner is to: a. Order a thyroid ultrasound. b. Refer the client for immediate evaluation by an ophthalmologist. c. Order a total thyroxine (T4). d. Prescribe a beta-adrenergic blocker. ~ Answer: Refer the client for immediate evaluation by an ophthalmologist. 3. You suspect that Sharon has hypoparathyroidism because, in addition tto her other signs and symptoms, she has: a. Elevated serum phosphate levels. b. Elevated serum calcium levels. c. Decreased neuromuscular activity. d. Increased bone resorption, as implied by her bone density test ~ Answer: elevated serum phosphate levels 4. A client with diabetes on a sulfonylurea and metformin with a glycated hemoglobin (HBA1C) Of 6.5% is complaining of episodes of low blood sugar. Which of the following changes would be most appropriate? a. Decreasing the dosage of the metformin b. Discontinuing the metformin c. Increasing carbohydrate intake d. Decreasing the dosage of the sulfonylurea ~ Answer: Decreasing the dosage of the sulfonylurea 5. Morton has type 2 diabetes. His treatment, which includes diet, exercise, in three oral antidiabetic agents at maximum dose, is insufficient to achieve acceptable glycemic control. Your next course of action is to: a. Give the patient a sliding scale with mealtime coverage with regular insulin. b. Add a dosage of long-acting insulin at bedtime to the regimen. c. Discontinue the oral anti diabetic agents and start insulin therapy with N and R d. Suggest treatment using an insulin pump. ~ Answer: Add a dosage of long-acting insulin at bedtime to the regimen 6. Lynne has Cushing syndrome. You would expect her to have or develop: a. Onychomycosis. b. Generalized increased pigmentation of the skin. c. Hair loss. d. Excitability and nervousness. ~ Answer: Onychomycosis 7. Joy has gout. In teaching her about her disease: which food do you tell her is allowed on the diet? a. Asparagus. b. Beans. c. Broccoli. d. Mushrooms. ~ Answer: Broccoli 8. Tamica, who has diabetes, states that she heard fiber is especially good to include in her diet. How do you respond? a. "Fiber is important in all diets." b. "Too much fiber interferes with insulin, so include only a moderate amount in your diet." c. "Fiber, especially soluble fiber, helps improve carbohydrate metabolism, so it is more important in the diet of persons with diabetes." d. "You get just the amount of fiber you need with a normal diet." ~ Answer: "Fiber, especially soluble fiber, helps improve carbohydrate metabolism, so it is more important in the diet of persons with diabetes." 9. Mark has type one diabetes and has mild hyperglycemia. What effect does physical activity (exercise) have on his blood glucose level? a. It may cause it to vary a little. b. It may decrease it. c. It may elevate it. d. It may fluctuate greatly either way ~ Answer: It may decrease it 10. Morris has had type one diabetes for 10 years. several recent urinalysis reports have shown Microalbuminuria. Your next step would be to: a. Order a 24 hour urinalysis. b. Start him on an angiotension-converting enzyme (ACE) inhibitor. c. Stress the importance of strict blood sugar control.