ATI LPN
ATI Targeted Medical Surgical Endocrine Questions
Question 1 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 2 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 3 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.
Question 4 of 5
A 43-year-old woman has had absent menstrual cycles along with increasing weakness and weight gain over the past 5 months. She notes low back pain for the past week. On physical examination, vital signs include blood pressure of 155/95 mm Hg. She has a prominent fat pad in the posterior neck and back. Facial plethora, hirsutism, and abdominal cutaneous striae are present. Laboratory findings include Na+, 139 mmol/L; K+, 4.1 mmol/L; Cl-, 96 mmol/L; CO2, 23 mmol/L; glucose, 163 mg/dL; creatinine, 1.3 mg/dL; calcium, 8.9 mg/dL; and phosphorus, 4.1 mg/dL. Her serum ACTH level is low. A radiograph of the spine shows decreased bone density with a compression fracture at T9. Which of the following radiographic findings is most likely to be present in this patient?
Correct Answer: A
Rationale: The clinical findings of Cushing syndrome with masculinization suggest an adrenal cortical carcinoma, which is more likely to have endocrine function in women. A low ACTH level helps to rule out the possibility of an ACTH-secreting pituitary adenoma in the sella turcica, or ectopic ACTH from a neoplasm such as lung carcinoma.
Question 5 of 5
Which of the following statements is false regarding the hypothalamus?
Correct Answer: C
Rationale: Hypothalamus produces ADH and oxytocin (stored in posterior pituitary), but ADH increases BP by reducing urine output; oxytocin aids labor.