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NURS 621 QUIZ QUESTIONS AND ANSWERS RATED.
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NURS 621 QUIZ QUESTIONS AND ANSWERS RATED.
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NURS 621 QUIZ QUESTIONS AND ANSWERSRATED.
A 50yo with PMH of DM and CAD presents with fine tremors, anxiety,
restlessness, diarrhea, and tachycardia that has been ongoing for several
days. On exam you note an enlarged thyroid with hyperreflexia and afib.
Labs notable for elevated anti-TPO antibodies and ANA levels. Your
patient may have:
- Grave's disease
- Thyroid storm
- Myxedema coma
- Addison's disease
Verified Answer -Grave's disease
T/F: Steroids and selenium are used in the treatment of Graves disease.
Verified Answer -True
The best diagnostic test to assess a goiter or thyroid nodule for malignancy
is a:
Verified Answer -FNA biopsy
A patient presents with hyperpigmentation of the skin on the elbows and
oral mucosa, hypotension, fatigue, and nausea. Labs are notable for
hyponatremia, hyperkalemia, low cortisol levels, hypoglycemia, and
elevated ACTH levels. The patient has a diagnosis of:
- Cushings
Primary adrenal insufficiency due to Addisons
- Hypothyroidism
,- Adrenal Crisis
Verified Answer -Primary adrenal insufficiency due to Addisons disease
You suspect Addisons disease in your patient. In order to confirm, the next
appropriate step woud be to:
Verified Answer -Check cortisol level and 0800
A patient presents with hypotension, fatigue, hypothermia, tachycardia,
hypoglycemia, and hyperpigmentation of the face. Cortisol level is 3 and
ACTH level is elevated. Her BP is unresponsive to fluids and vasopressors.
The medication this patient needs urgently is:
- hydrocortisone 100mg now then 50 q6
- prednisone 60mg po now
- albumin
- levothyroxine
Verified Answer -Hydrocortisone
A 45yo male with PMH of obesity, DM, and HTN presents with a few
week history of easy bruising, moon face, edema of the extremities,
buffalo hump, hirsutism, fragile skin. Labs are notable for Na 160, glucose
240, elevated plasma cortisol level, and K of 2.5. His blood pressure is
180/72. You are concerned for which diagnosis?
- Addisons
- pheochromocytoma
- Cushings
- myxedema crisis
Verified Answer -Cushings
,What is the number one test for Cushings and what level would exclude
Cushings?
Verified Answer -Dexamethasone suppression test
Cortisol < 1.8 excludes Cushings
All of the following labs are consistent with Cushings Syndrome except:
- hypernatremia
- low morning cortisol
- hyperglycemia
- hyperkalemia
Verified Answer -Low morning cortisol
T/F: A transphenoidal selective resection is a recommended treatment
measure for Cushings caused by a pituitary adenoma.
Verified Answer -True
T/F: A person who is pregnant should avoid vaginal delivery if a
pheochromocytoma diagnosis is known or suspected.
Verified Answer -True
All of the following symptoms are concerning for pheochromocytoma
except:
- uncontrolled HTN
- diaphoresis
- tachycardia
- hypotension
Verified Answer -Hypotension
, A patient presents with a few week history of uncontrolled hypertension,
headaches and diaphoresis. You are concerned for a pheochromocytoma
and know that all of the following are important in the workup of the
disease to obtain a diagnosis except:
- plasma fractioned catecholamines and metanephrines
- urinary fractioned metanephrines
- Serum IgG level
- Serum CgA
Verified Answer -Serum IgG level
A patient is inquisitive about the best form of treatment for his
paraganglioma with metastatic disease. The best response would be:
Verified Answer -Surgery with debulking followed by chemotherapy
A patient with a history of COPD and lung cancer presents with polyuria
and hyponatremia. You are concerned with SIADH. All of the following
labs are seen in SIADH except:
- Na+ 125
- Normal TSH and FT4 levels
- Urine Na+ < 20
- Plasma osmol of < 280
Verified Answer -Urine Na+ < 20
All of the following can lead to SIADH except:
- benzodiazepines
- SSRIs
- Small cell lung cancer
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