ATI LPN
ATI Targeted Medical Surgical Endocrine Questions
Question 1 of 5
The nurse is evaluating care provided to a patient with hypothyroidism. Which finding indicates that additional care is needed?
Correct Answer: D
Rationale: Stable weight indicates thyroid health. A weight gain indicates a sluggish thyroid in this patient population, suggesting that hypothyroidism is not adequately controlled.
Question 2 of 5
When nursing a diabetic patient it is paramount that the nurse understands that glucagon
Correct Answer: B
Rationale: Glucagon opposes insulin by raising blood glucose levels, released during hypoglycemia, not hyperglycemia.
Question 3 of 5
A 7-year-old boy is recovering from impetigo. Physical examination shows five honey-colored crusts on his face. The crusts are removed, and a culture of the lesions grows Streptococcus pyogenes. He is treated with antibiotics. One week later, he develops malaise with nausea and a slight fever and passes dark brown urine. Laboratory studies show a serum anti-streptolysin O titer of 1:1024. Which of the following is the most likely outcome of his renal disease?
Correct Answer: B
Rationale: The strains of group A streptococci that cause poststreptococcal glomerulonephritis (GN) differ from the strains that cause rheumatic fever, and most elicit an immune response via streptococcal pyogenic exotoxin B (SpeB). Most children with poststreptococcal GN recover, although 1% develop a rapidly progressive GN characterized by crescent formation. Progression to chronic renal failure occurs in 40% of affected adults. A urinary tract infection is not likely to accompany poststreptococcal GN because the organisms that caused the immunologic reaction are no longer present when symptoms of GN appear.
Question 4 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 5 of 5
Blood relatives of individuals diagnosed with type 1 or type 2 diabetes mellitus are studied for 10 years. Laboratory testing for glucose and insulin levels and autoantibody formation is performed on a periodic basis. The HLA types of the subjects are determined. A cohort of the subjects who are 8 to 22 years old has no overt clinical illnesses and no hyperglycemia; however, autoantibodies to glutamic acid decarboxylase are present. Many subjects in this cohort have the HLA-DR3 and HLA-DR4 alleles. Which of the following pancreatic abnormalities is most likely to be found in this cohort of study subjects?
Correct Answer: D
Rationale: The presence of HLA-DR3 and HLA-DR4 alleles of the MHC class II region has the strongest linkage to type 1 diabetes mellitus. Autoantibodies to islet cell antigens such as glutamic acid decarboxylase are present years before overt clinical diabetes develops. An insulitis caused by T cell infiltration occurs before the onset of symptoms or very early in the course of type 1 diabetes mellitus.