ATI LPN
PN Learning System Medical Surgical Endocrine Practice Quiz Questions
Question 1 of 5
The nurse correlates a husky voice in the patient with hypothyroidism to which assessment finding?
Correct Answer: C
Rationale: Edema of the tongue and around the larynx causes changes in speech resulting in a husky tone, a common finding in hypothyroidism due to myxedema.
Question 2 of 5
What actions does the nurse implement for the patient experiencing thyroid storm? SelectONE that does not apply.
Correct Answer: C
Rationale: 1: Cooling blankets may be used to treat hyperthermia. 2: Fluid resuscitation is a priority in a thyroid storm. 4: Glucocorticoids, of which dexamethasone is one, may be administered to block the conversion of T4 to T3 and decrease the release of thyroid-stimulating hormone (TSH) from the anterior pituitary gland. 5: For management of tachycardia, beta-adrenergic blockers may be administered.
Question 3 of 5
You are caring for a patient who has unstable diabetes. As a nurse, it is important to recognise the early signs and symptoms of diabetic ketoacidosis These are:
Correct Answer: D
Rationale: Early DKA signs include the 3 P's (polydipsia, polyuria, polyphagia) due to hyperglycemia, before progressing to dehydration and fruity breath.
Question 4 of 5
A study of renal disease identifies patients with greater than 3.5 g of protein in a 24-hour urine collection, but no RBCs or WBCs. Dysfunction involving which of the following cells is most likely to be responsible for proteinuria?
Correct Answer: D
Rationale: The podocytes (visceral epithelial cells) of the glomerulus form a filtration barrier that depends upon both the anionic charge as well as slit diaphragms. Injuries that cause effacement, retraction, detachment, and vacuolization allow protein, principally albumin, to escape into Bowman space. Podocytes have limited capacity for regeneration and repair. The loss of 3.5 g/day of protein defines nephrotic syndrome. About a sixth of filtration occurs through the mesangium. The remaining listed options do not participate in this epithelial protein filtration barrier.
Question 5 of 5
A 15-year-old boy has been passing dark-colored urine for the past month. On physical examination, he has bilateral sensorineural hearing loss and corneal erosions. Urinalysis shows a pH of 6.5; specific gravity, 1.015; 1+ hematuria; 1+ proteinuria; and no ketones, glucose, or leukocytes. The serum creatinine level is 2.5 mg/dL, and the urea nitrogen level is 24 mg/dL. A renal biopsy specimen shows tubular epithelial foam cells by light microscopy. By electron microscopy, the glomerular basement membrane shows areas of attenuation, with splitting and lamination of lamina densa in other thickened areas. What is the most likely diagnosis?
Correct Answer: A
Rationale: Alport syndrome is a form of hereditary nephritis. Hematuria is the most common presenting feature, but proteinuria is often present and may be in the nephrotic range. Patients progress to chronic renal failure in adulthood. An X-linked pattern of inheritance is present in 85% of cases, but autosomal dominant and autosomal recessive pedigrees also exist. The foamy change in the tubular epithelial cells and ultrastructural alterations of the basement membrane are characteristic features. The genetic defect results from mutation in the gene for the a5 chain of type IV collagen. IgA nephropathy is a form of glomerulonephritis that does not produce tubular epithelial changes. TTP is often associated with inherited or acquired deficiencies of ADAMTS13, leading to thrombotic microangiopathy, similar to hemolytic uremic syndrome from Escherichia coli Shiga toxin damaging vascular endothelium. Nodular and diffuse glomerulosclerosis are typical changes in diabetic nephropathy that can occur following loss of pancreatic islet beta cells. Toxic injuries are most likely to damage tubular cells, leading to acute tubular necrosis.