ATI LPN
ATI Targeted Medical Surgical Endocrine Questions
Question 1 of 5
A 56-year-old woman is found on health screening to have a blood pressure of 168/109 mm Hg. No other physical examination findings are noted. Urinalysis shows a pH of 7.0; specific gravity, 1.020; 1+ proteinuria; and no blood, glucose, or ketones. The ANA and ANCA test results are negative. The serum urea nitrogen level is 51 mg/dL, and the creatinine level is 4.7 mg/dL. The hemoglobin A1c concentration is within the reference range. An abdominal ultrasound scan shows bilaterally and symmetrically small kidneys with no masses. What is her most likely diagnosis?
Correct Answer: C
Rationale: Chronic glomerulonephritis (GN) may follow specific forms of acute GN. In many cases, however, it develops insidiously with no known cause. With progressive glomerular injury and sclerosis, both kidneys become smaller, and their surfaces become granular. Hypertension often develops because of renal ischemia. Regardless of the initiating cause, these 'end-stage' kidneys appear morphologically identical. They have sclerotic glomeruli, thickened arteries, and chronic inflammation of interstitium. Because the patient's ANA and ANCA test results are negative, vasculitis is unlikely. Polycystic kidney disease and amyloidosis would cause the kidney size to increase, not decrease. The normal hemoglobin A1c concentration indicates that the patient does not have diabetes mellitus. Nodular glomerulosclerosis is typical of diabetes mellitus with an elevated hemoglobin A1c.
Question 2 of 5
A 43-year-old woman has had absent menstrual cycles along with increasing weakness and weight gain over the past 5 months. She notes low back pain for the past week. On physical examination, vital signs include blood pressure of 155/95 mm Hg. She has a prominent fat pad in the posterior neck and back. Facial plethora, hirsutism, and abdominal cutaneous striae are present. Laboratory findings include Na+, 139 mmol/L; K+, 4.1 mmol/L; Cl-, 96 mmol/L; CO2, 23 mmol/L; glucose, 163 mg/dL; creatinine, 1.3 mg/dL; calcium, 8.9 mg/dL; and phosphorus, 4.1 mg/dL. Her serum ACTH level is low. A radiograph of the spine shows decreased bone density with a compression fracture at T9. Which of the following radiographic findings is most likely to be present in this patient?
Correct Answer: A
Rationale: The clinical findings of Cushing syndrome with masculinization suggest an adrenal cortical carcinoma, which is more likely to have endocrine function in women. A low ACTH level helps to rule out the possibility of an ACTH-secreting pituitary adenoma in the sella turcica, or ectopic ACTH from a neoplasm such as lung carcinoma.
Question 3 of 5
Which of the following statements is false regarding the hypothalamus?
Correct Answer: C
Rationale: Hypothalamus produces ADH and oxytocin (stored in posterior pituitary), but ADH increases BP by reducing urine output; oxytocin aids labor.
Question 4 of 5
Since Adonis was unable lift the dumbbell, he decided to use the exercise bike for a cardiovascular workout. During maximum exertion on the exercise bike, Adonis began to breathe heavily and felt 'the burn' in his legs. The skeletal muscles of his legs were using primarily which form of respiration at maximum exertion?
Correct Answer: D
Rationale: At max exertion, glycolysis produces lactate (burn) due to limited O2, shifting from aerobic respiration.
Question 5 of 5
Which of the above will increase cardiac output?
Correct Answer: A
Rationale: Increased venous return boosts preload, raising CO; others decrease it (vagus, beta blocker) or resist flow.