ATI LPN
ATI Quiz Medical Surgical Endocrine Questions
Question 1 of 5
The nurse is preparing discharge instructions for a patient being treated medically for hyperthyroidism. What should the nurse emphasize to protect the patient's eyes?
Correct Answer: A
Rationale: Eye lubricant decreases possible eye dryness and potential for corneal irritation secondary to incomplete eyelid closure, a common issue in hyperthyroidism such as Graves' disease.
Question 2 of 5
You are to administer an Amlodipine to your patient. As a nurse you understand that the main effect of a calcium channel blocker is to
Correct Answer: D
Rationale: Amlodipine, a calcium channel blocker, dilates arteries, reducing systemic vascular resistance and lowering BP.
Question 3 of 5
A 46-year-old Hispanic man has had increasing malaise with headaches and easy fatigability for the past 3 months. Physical examination reveals his blood pressure is 200/100 mm Hg. There are no palpable abdominal masses and no costovertebral tenderness. Laboratory studies show hemoglobin, 9.5 g/dL; hematocrit, 28.3%; MCV, 92 μm3; creatinine, 4.5 mg/dL; and urea nitrogen, 42 mg/dL. Urinalysis reveals 3+ hematuria and 3+ proteinuria, but no glucose or leukocytes. A renal biopsy is done; light microscopic examination of the biopsy specimen shows that approximately 50% of the glomeruli appear normal, but the rest show that a portion of the capillary tuft is sclerotic. Immunofluorescence staining shows IgM and C3 deposition in these sclerotic areas. His history is significant for repeated episodes of passing dark brown urine, which failed to respond to corticosteroid therapy. Which of the following mechanisms is most likely responsible for his disease?
Correct Answer: D
Rationale: Corticosteroid-resistant hematuria and proteinuria leading to hypertension and renal failure is typical for focal segmental glomerulosclerosis (FSGS). FSGS is now the most common cause of nephrotic syndrome in adults in the United States. Specialized extracellular areas overlying the glomerular basement membrane between adjacent foot processes of podocytes are called slit diaphragms, and these exert control over glomerular permeability. Mutations in genes affecting several proteins, including nephrin and podocin, have been found in inherited cases of FSGS; podocyte dysfunction, possibly caused by cytokines or unknown toxic factors, may be responsible for acquired cases of FSGS. FSGS with collapsing glomerulopathy is seen in patients with HIV-associated nephropathy. Immune complexes containing microbial antigens cause postinfectious glomerulonephritis (GN). Antiglomerular basement membrane antibodies are responsible for Goodpasture syndrome. C3NeF is an autoantibody directed against C3 convertase, and it is seen in membranoproliferative GN. Inherited defects in basement membrane collagen cause Alport syndrome, also characterized by hematuria, but other congenital abnormalities, such as deafness, are often present, and nephrotic syndrome is uncommon.
Question 4 of 5
A 29-year-old woman has had a fever and sore throat for the past 3 days. On physical examination, her temperature is 38°C. The pharynx is erythematous, with yellowish tonsillar exudate. She is treated with ampicillin and recovers fully in 7 days. Two weeks later, she develops fever and a rash, and notices a slight decrease in urinary output. Her temperature is 37.7°C, and there is a diffuse erythematous rash on the trunk and extremities. Urinalysis shows a pH of 6; specific gravity, 1022; 1+ proteinuria; 1+ hematuria; and no glucose or ketones. Microscopic examination of the urine shows RBCs and WBCs, including eosinophils, but no casts or crystals. What is the most likely cause of her disease?
Correct Answer: D
Rationale: An acute drug-induced interstitial nephritis can be caused by ampicillin. This is an immunologic reaction, probably caused by a drug acting as a hapten. Pharyngitis with poststreptococcal glomerulonephritis with deposition of immune complexes is unlikely to be accompanied by a rash or by eosinophils in the urine. Anti-glomerular basement membrane antibodies occur in Goodpasture syndrome, with hemorrhages in lungs as well. Acute pyelonephritis is an ascending infection; it is uncommonly caused by hematogenous spread of bacteria from other sites.
Question 5 of 5
A 50-year-old man has had a nonhealing ulcer on the bottom of his foot for 2 months. On examination, the 2-cm ulcer overlies the right first metatarsal head. There is reduced sensation to pinprick in his feet. His visual acuity is reduced bilaterally. Laboratory studies show serum creatinine is 2.9 mg/dL. Which of the following laboratory test findings is he most likely to have?
Correct Answer: A
Rationale: Complications of diabetes mellitus are described in this man: vascular disease, neuropathy, nephropathy, and retinopathy. Hyperglycemia exceeds the capacity of renal tubular reabsorption, so glucose appears in the urine. The other listed findings involve organs that are not typically involved in diabetes mellitus: liver disease with decreased albumin synthesis, hyperaldosteronemia with hypokalemia, decreased marrow function with leukopenia, exocrine pancreatic disease with steatorrhea.