ATI LPN
ATI Medical Surgical Endocrine Quiz Questions
Question 1 of 5
The nurse monitors for which clinical manifestation in the patient diagnosed with hyperthyroidism?
Correct Answer: A
Rationale: Insomnia is a clinical manifestation the nurse anticipates when assessing the patient who is diagnosed with hyperthyroidism, due to the hypermetabolic state increasing alertness and energy.
Question 2 of 5
What is considered the most effective way to minimise vascular complications for both T1DM and T2 DM?
Correct Answer: B
Rationale: Optimal glycemic control reduces hyperglycemia-related vascular damage, the primary goal for both T1DM and T2DM.
Question 3 of 5
A 21-year-old previously healthy man has noticed blood in his urine for the past 2 days. He reports no dysuria, frequency, or hesitancy of urination. On physical examination, there are no abnormal findings. Laboratory findings show a serum urea nitrogen level of 39 mg/dL and creatinine level of 4.1 mg/dL. A renal biopsy specimen is obtained; the immunofluorescence pattern of staining with antibody against human IgG is shown in the figure. Which of the following serologic findings is most likely to be present in this patient?
Correct Answer: A
Rationale: The linear pattern of staining shown in the figure indicates the presence of anti-glomerular basement membrane antibodies (directed against the noncollagenous domain of the a3 chain of type IV collagen). Such antibodies are typically seen in Goodpasture syndrome, a form of rapidly progressive glomerulonephritis (GN) that has a bimodal pattern of occurrence in younger and older men. The anti-streptolysin O titer is increased in poststreptococcal GN, which typically has a granular pattern of immune complex deposition. The C3 nephritic factor can be a marker for dense deposit disease. Some cases of membranous nephropathy are associated with hepatitis B virus infection, but the immune complex deposition is granular, not linear. HIV infection can lead to a nephropathy that resembles FSGS, in which IgM and C3 are deposited in the mesangial areas of affected glomeruli.
Question 4 of 5
A 17-year-old boy is involved in a motor vehicle accident in which he sustains severe blunt trauma to the extremities and abdomen. Over the next 3 days, he develops oliguria and dark brown urine. The urine dipstick analysis is positive for myoglobin and for blood, but microscopic examination of the urine shows no RBCs. His serum urea nitrogen level increases to 38 mg/dL, and he undergoes hemodialysis for 3 weeks. His condition improves, but the urine output remains greater than 3 L/day for 1 week before the urea nitrogen returns to normal. Which of the following renal lesions was most likely present in this patient?
Correct Answer: B
Rationale: His severe muscle injury resulted in myoglobinemia and myoglobinuria. The large amount of excreted myoglobin produces a toxic form of acute tubular injury. With supportive care, the tubular epithelium can regenerate, and renal function can be restored. During the recovery phase of acute tubular injury, patients excrete large volumes of urine because the glomerular filtrate cannot be adequately reabsorbed by the damaged tubular epithelium. An infection with pyelonephritis is unlikely to be characterized by such a short course or such a marked loss of renal function. Trauma is not a cause of malignant hypertension. Glomerulonephritis does not occur as a result of trauma. A bilateral renal vein thrombosis is uncommon and not related to muscle trauma.
Question 5 of 5
A 13-year-old girl collapses while playing basketball. On arrival at the emergency department, she is obtunded. On physical examination, she is hypotensive and tachycardic with deep, rapid, labored respirations. Laboratory studies show serum Na+, 151 mmol/L; K+, 4.6 mmol/L; Cl-, 98 mmol/L; CO2, 7 mmol/L; and glucose, 521 mg/dL. Urinalysis shows 4+ glucosuria and 4+ ketonuria levels, but no protein, blood, or nitrite. Which pathologic abnormality is most likely to be present in her pancreas at the time of her collapse?
Correct Answer: A
Rationale: Type 1 diabetes mellitus does not become overt until the beta cells are markedly depleted, and insulin levels are greatly reduced. In this case, the girl has ketoacidosis. Amyloid replacement of islets is a feature of type 2 diabetes mellitus; ketoacidosis is not a feature of type 2 diabetes mellitus.