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Case:
A 52-year-old female presents with complaints of fatigue, constipation, dry skin, and weight gain over the past 3 months. She also reports feeling cold all the time. Her lab results reveal elevated TSH and low T3 and T4 levels.
Question 1:
Which condition is most consistent with the patient’s clinical findings and lab results?
A. Graves’ disease
B. Hashimoto’s thyroiditis
C. Hyperthyroidism
D. Thyroid storm
B. Hashimoto’s thyroiditis
Case:
A 16-year-old female with Type 1 Diabetes is admitted for hyperglycemia. She admits to skipping insulin doses occasionally.
Question 2:
What insulin-related complication is this patient at greatest risk for?
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis (DKA)
C. Hypoglycemic coma
D. Myxedema coma
B. Diabetic ketoacidosis (DKA)
Case:
A 72-year-old woman with a history of hypothyroidism is found unresponsive. Vital signs show bradycardia, hypotension, and hypothermia.
Question 1:
Which condition does the nurse suspect?
A. DKA
B. Addisonian crisis
C. Myxedema coma
D. SIADH
C. Myxedema coma
A patient with Type 2 diabetes is prescribed metformin and glipizide (a sulfonylurea). Which of the following statements by the patient indicates a need for further education?
A. "Metformin helps lower my blood sugar by improving my body’s response to insulin."
B. "I will need to monitor my blood sugar closely when I start taking glipizide."
C. "I can take metformin with any meal to prevent stomach upset."
D. "I can stop glipizide if I start feeling better and my blood sugar drops."
D."I can stop glipizide if I start feeling better and my blood sugar drops."
A 50-year-old male presents with painful urination, lower abdominal pain, and fever. He is diagnosed with acute prostatitis. Which of the following is the most likely cause of his condition?
A. Sexually transmitted infections (STIs)
B. Urinary tract infection (UTI)
C. Chronic alcohol use
D. Benign prostatic hyperplasia
B. Urinary tract infection (UTI)
Case:
A 52-year-old female presents with complaints of fatigue, constipation, dry skin, and weight gain over the past 3 months. She also reports feeling cold all the time. Her lab results reveal elevated TSH and low T3 and T4 levels.
Question 2:
Which feedback mechanism is failing in this patient?
A. The pituitary gland is not responding to low T3 and T4
B. The thyroid gland is failing to respond to elevated TSH
C. The hypothalamus is producing too much TRH
D. The negative feedback loop is working too strongly
B. The thyroid gland is failing to respond to elevated TSH
Case:
A 65-year-old male with Type 2 Diabetes presents with diaphoresis, confusion, and shakiness. His capillary glucose reads 52 mg/dL.
Question 1:
What is the nurse’s priority action?
A. Administer IV insulin
B. Check HgbA1c level
C. Provide 15g of fast-acting carbohydrates
D. Notify the provider immediately
C. Provide 15g of fast-acting carbohydrates
Case:
A 72-year-old woman with a history of hypothyroidism is found unresponsive. Vital signs show bradycardia, hypotension, and hypothermia.
Question 2:
What is the priority nursing intervention?
A. Rapid IV infusion of glucose
B. Administer IV levothyroxine and support airway
C. Give hydrocortisone and monitor potassium
D. Restrict fluids and monitor sodium
B. Administer IV levothyroxine and support airway
An older adult with hypothyroidism is started on levothyroxine. What is the nurse’s priority consideration when initiating treatment in this patient?
A. Start with a higher dose of levothyroxine, as elderly patients need more thyroid hormone.
B. Monitor the patient closely for signs of myxedema coma while increasing the dose.
C. Start with a lower dose and gradually increase it to avoid potential cardiovascular side effects.
D. Administer the full daily dose at bedtime to maximize absorption.
C. "Start with a lower dose and gradually increase it to avoid potential cardiovascular side effects."
A 60-year-old male is diagnosed with an inguinal hernia. The nurse explains to the patient that this condition involves:
A. Protrusion of abdominal contents through a defect in the diaphragm
B. Protrusion of the bladder through the abdominal wall
C. Protrusion of bowel or abdominal tissue through the inguinal canal
D. Herniation of the gallbladder through the abdominal wall
C. Protrusion of bowel or abdominal tissue through the inguinal canal
Case:
A 52-year-old female presents with complaints of fatigue, constipation, dry skin, and weight gain over the past 3 months. She also reports feeling cold all the time. Her lab results reveal elevated TSH and low T3 and T4 levels.
Question 3:
Which of the following is the most appropriate initial treatment for this patient?
A. Methimazole
B. Radioactive iodine
C. Levothyroxine
D. Propranolol
C. Levothyroxine
A 30-year-old woman complains of heat intolerance, weight loss, palpitations, and anxiety. Her labs show suppressed TSH and elevated T3/T4.
Question 1:
What is the most likely diagnosis?
A. Hashimoto’s thyroiditis
B. Graves’ disease
C. Myxedema coma
D. Hypothyroidism
B. Graves’ disease
A nurse is educating a newly diagnosed patient with Type 1 diabetes about insulin. Which statement by the patient indicates understanding of how insulin works in the body?
A. "Insulin helps my liver produce more glucose when I'm stressed."
B. "Insulin helps my body break down fats for energy."
C. "Insulin allows glucose to enter my cells and be used for energy."
D. "Insulin raises my blood sugar when it gets too low."
C."Insulin allows glucose to enter my cells and be used for energy."
Case:
A 68-year-old male patient presents with complaints of frequent urination, difficulty starting a urine stream, and nocturia. His physical exam reveals an enlarged prostate. His laboratory results show normal kidney function, and his prostate-specific antigen (PSA) level is slightly elevated.
Question 1:
What is the most likely cause of this patient’s symptoms?
A. Prostate cancer
B. Prostatitis
C. Benign Prostatic Hyperplasia (BPH)
D. Acute urinary retention
C. Benign Prostatic Hyperplasia (BPH)
A 30-year-old sexually active male presents with unilateral scrotal pain, swelling, and redness. His sexual history includes multiple partners and inconsistent condom use. Based on these clinical clues, which of the following is the most likely diagnosis?
A. Epididymitis
B. Testicular torsion
C. Hydrocele
D. Inguinal hernia
A. Epididymitis
Case:
A 52-year-old female presents with complaints of fatigue, constipation, dry skin, and weight gain over the past 3 months. She also reports feeling cold all the time. Her lab results reveal elevated TSH and low T3 and T4 levels.
What should the nurse include in patient teaching about levothyroxine therapy?
A. Take with calcium supplements for best absorption
B. Expect rapid resolution of symptoms within 24 hours
C. Take on an empty stomach in the morning
D. Stop the medication once symptoms improve
C. Take on an empty stomach in the morning
Case:
A 65-year-old male with Type 2 Diabetes presents with diaphoresis, confusion, and shakiness. His capillary glucose reads 52 mg/dL.
Question 2:
Which result best indicates long-term glucose control?
A. Fasting glucose of 105 mg/dL
B. HgbA1c of 6.5%
C. Capillary glucose of 150 mg/dL
D. Random glucose of 180 mg/dL
B. HgbA1c of 6.5%
A 50-year-old patient with newly diagnosed Type 2 diabetes is learning about insulin regulation. The nurse explains the process of insulin secretion in response to blood glucose levels. Which of the following statements best describes the feedback loop that regulates insulin secretion?
A. "Insulin secretion decreases when blood glucose levels rise to prevent hyperglycemia."
B. "Insulin secretion increases when blood glucose levels are high, promoting glucose uptake by cells."
C. "Insulin secretion is independent of blood glucose levels and is controlled by the hypothalamus."
D. "Insulin secretion increases to reduce glucose uptake when the body is in a state of starvation."
B."Insulin secretion increases when blood glucose levels are high, promoting glucose uptake by cells."
Case:
A 68-year-old male patient presents with complaints of frequent urination, difficulty starting a urine stream, and nocturia. His physical exam reveals an enlarged prostate. His laboratory results show normal kidney function, and his prostate-specific antigen (PSA) level is slightly elevated.
Question 2:
Which of the following is the most common pharmacological treatment for BPH?
A. Alpha-blockers (e.g., tamsulosin)
B. Anticholinergics
C. Nitrates
D. 5-alpha-reductase inhibitors (e.g., finasteride)
A. Alpha-blockers (e.g., tamsulosin)
A 25-year-old female presents with lower abdominal pain, vaginal discharge, fever, and painful intercourse. She has a history of multiple sexual partners and inconsistent condom use. The nurse suspects pelvic inflammatory disease (PID). What is the most appropriate initial intervention?
A. Administer intravenous antibiotics
B. Perform a pelvic ultrasound
C. Provide hormonal contraception
D. Encourage oral rehydration therapy
A. Administer intravenous antibiotics
Case:
A 16-year-old female with Type 1 Diabetes is admitted for hyperglycemia. She admits to skipping insulin doses occasionally.
Question 1:
Which of the following best explains the pathophysiology of her condition?
A. Insulin resistance at the receptor level
B. Autoimmune destruction of pancreatic alpha cells
C. Absolute deficiency of insulin due to beta-cell destruction
D. Overproduction of insulin with poor glucose uptake
C. Absolute deficiency of insulin due to beta-cell destruction
Case:
A 30-year-old woman complains of heat intolerance, weight loss, palpitations, and anxiety. Her labs show suppressed TSH and elevated T3/T4.
Question 2:
Which assessment finding is most consistent with Graves' disease?
A. Facial puffiness and dry skin
B. Bradycardia and cold intolerance
C. Exophthalmos and goiter
D. Menstrual irregularities and brittle nails
C. Exophthalmos and goiter
A nurse is assessing a patient with Type 1 diabetes who presents with severe hyperglycemia. The patient is experiencing rapid breathing, fruity-smelling breath, and confusion. Which condition is most likely causing these symptoms?
A. Diabetic ketoacidosis (DKA)
B. Hyperosmolar hyperglycemic state (HHS)
C. Hypoglycemia
D. Thyroid storm
A.
"Diabetic ketoacidosis (DKA)"
Case:
A 60-year-old male patient with BPH is also being treated for angina with nitrates. The nurse needs to provide education on potential interactions between his medications.
Question:
Which of the following medications should not be taken with nitrates due to the risk of serious hypotension?
A. Tamsulosin
B. Finasteride
C. Sildenafil
D. Doxazosin
C. Sildenafil
A nurse is educating a 30-year-old woman diagnosed with PID on how to prevent future infections. The nurse includes all of the following instructions EXCEPT:
A. Always use condoms during sexual activity
B. Limit the number of sexual partners
C. Use oral contraceptives to prevent pregnancy
D. Avoid douching and using vaginal deodorants
C. Use oral contraceptives to prevent pregnancy