ATI LPN
ATI Targeted Medical Surgical Endocrine Questions
Question 1 of 5
Which should the nurse monitor a client for who has been on long-term steroid therapy?
Correct Answer: A
Rationale: Long-term steroids cause muscle wasting due to protein catabolism.
Question 2 of 5
A patient undergoes a total thyroidectomy, leaving one lobe of the parathyroid gland intact. Which laboratory value would provide the nurse the most accurate assessment of parathyroid function?
Correct Answer: B
Rationale: Ionized calcium is the free and active form of calcium, providing the most accurate assessment of parathyroid function, as it reflects the biologically active fraction unaffected by albumin levels.
Question 3 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 4 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 5 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.