ATI LPN
Medical Surgical Endocrine Practice Quiz Questions
Question 1 of 5
What is the priority action by the nurse in providing care to a patient diagnosed with thyrotoxicosis?
Correct Answer: B
Rationale: Thyrotoxicosis is a medical emergency requiring definitive treatment to prevent respiratory compromise and cardiac collapse. The nurse follows the ABCs to prioritize patient care; therefore, the priority nursing action is to protect and manage the airway because intubation may be required.
Question 2 of 5
You are the nurse who is about to give Metformin to a patient with type 2 diabetes. As a nurse you know that the mechanism of action of Biguinides (metformin) is to
Correct Answer: C
Rationale: Metformin primarily reduces hepatic gluconeogenesis, lowering blood glucose without increasing insulin production.
Question 3 of 5
A 6-year-old girl has become increasingly lethargic over the past 2 weeks. On examination she has puffiness around the eyes. Her temperature is 36.9°C, and blood pressure is 100/60 mm Hg. Laboratory findings show serum creatinine, 0.7 mg/dL; urea nitrogen, 12 mg/dL; and cholesterol, 217 mg/dL. Urinalysis shows pH, 6.5; specific gravity, 1.011; 4+ proteinuria; lipiduria; and no blood or glucose. The 24-hour urine protein level is 3.8 g. The child's condition improves after glucocorticoid therapy. Which of the following findings by electron microscopy is most likely to characterize this disease process?
Correct Answer: B
Rationale: A child with nephrotic syndrome and no other clinical findings is most likely to have minimal change disease, a name that reflects the paucity of pathologic findings. There is fusion of podocyte foot processes, which can be seen only by electron microscopy. This fusion leads to selective proteinuria of low molecular weight proteins (albumin). Variability of basement membrane thickening may be seen in Alport syndrome. The mesangial matrix is expanded in some forms of glomerulonephritis (e.g. IgA nephropathy) and other diseases, such as diabetes mellitus, but not in minimal change disease. Reduplication of glomerular basement membrane may be seen with membranoproliferative GN. Subepithelial electron-dense humps represent immune complexes and are seen in postinfectious GN.
Question 4 of 5
A 51-year-old woman has had dysuria and urinary frequency for the past week. On physical examination, her temperature is 38°C, and she has pain on palpation over the left costovertebral angle. Laboratory findings show glucose, 177 mg/dL; hemoglobin A1c, 9.8%; hemoglobin, 13.1 g/dL; platelet count, 232,200/mm3; and WBC count, 11,320/mm3. Urinalysis shows a pH of 6.5; specific gravity, 1.016; 2+ glucosuria; and no blood, protein, or ketones. Microscopic examination of the urine shows numerous neutrophils, and a urine culture is positive for Escherichia coli. Which of the following complications is most likely to develop in this patient?
Correct Answer: D
Rationale: These laboratory findings are consistent with diabetes mellitus and clinical features of acute pyelonephritis caused by Escherichia coli infection. Necrotizing papillitis with papillary necrosis is a complication of acute pyelonephritis, and diabetic patients are particularly prone to this development. In the absence of diabetes mellitus, papillary necrosis develops when acute pyelonephritis occurs in combination with urinary tract obstruction. Papillary necrosis also can occur with long-term use of analgesics. Acute tubular necrosis typically occurs in acute renal failure caused by hypoxia (e.g., shock) or toxic injury (e.g., mercury). Crescentic glomerulonephritis causes rapidly progressive renal failure.
Question 5 of 5
A clinical study is conducted in patients diagnosed with either type 1 or type 2 diabetes mellitus. Persons with either type develop complications of accelerated and advanced atherosclerosis. All untreated patients have an elevated hemoglobin A1c. Which of the following features common to patients with either type 1 or type 2 diabetes mellitus is most likely to be found by this study?
Correct Answer: D
Rationale: Nonenzymatic glycosylation of proteins is a function of the level of blood glucose, rather than the cause of hyperglycemia. This is the basis for an elevated hemoglobin A1c. Type 1 and type 2 diabetes mellitus are characterized by hyperglycemia, but the underlying pathogenetic mechanisms are different.