We can work on Patho Exam 2

101. The level of TSH in Graves’ disease is usually:

a.

high.

b.

low.

c.

normal.

____ 102. Upon palpation of the neck of a patient with Graves’ disease, what would the nurse expect to find?

a.

Normal-sized thyroid

b.

Small discrete thyroid nodule

c.

Multiple discrete thyroid nodules

d.

Diffuse thyroid enlargement

____ 103. What are clinical manifestations of hypothyroidism?

a.

Intolerance to heat, tachycardia, and weight loss

b.

Oligomenorrhea, fatigue, and warm skin

c.

Restlessness, increased appetite, and metrorrhagia

d.

Constipation, decreased heat rate, and lethargy

____ 104. Diagnosing thyroid carcinoma is best done with:

a.

measurement of serum thyroid levels.

b.

radioisotope scanning.

c.

ultrasonography.

d.

fine-needle aspiration biopsy.

____ 105. Renal failure is the most common cause of _____ hyperparathyroidism.

a.

primary

b.

secondary

c.

exogenous

d.

inflammatory

____ 106. What is the most common cause of hypoparathyroidism?

a.

Pituitary hyposecretion

b.

Parathyroid adenoma

c.

Parathyroid gland damage

d.

Autoimmune parathyroid disease

____ 107. An adult female had a thyroidectomy this morning. She develops muscle spasms, increased deep tendon reflexes, and laryngeal spasm. What is the most common cause of these findings?

a.

Calcium deficit due to reduced parathormone

b.

Overuse of radioactive iodine given pre-operatively

c.

A history of insufficient dietary intake of iodine

d.

An increase in serum phosphorous caused by reduced calcitonin

____ 108. What is the most probable cause of low serum calcium following thyroidectomy?

a.

Hyperparathyroidism secondary to Graves’ disease

b.

Myxedema secondary to surgery

c.

Hypoparathyroidism caused by surgical injury

d.

Hypothyroidism caused by lack of thyroid replacement

____ 109. A male patient with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500 mg/dl; urine glucose and ketones positive; serum K+ 2 mEq/L; serum Na+ 130 mEq/L. He reports that he has been sick with the “flu” for 1 week. What relationship do these values have to his insulin deficiency?

a.

Increased glucose use causes the shift of fluid from the intravascular to the intracellular space.

b.

Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis.

c.

Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis.

d.

Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss.

____ 110. What is a description of diabetes mellitus type 2?

a.

There is a resistance to insulin by insulin-sensitive tissues.

b.

The patient uses lispro instead of regular insulin.

c.

There is an increased glucagon secretion from -cells of the pancreas.

d.

There are insulin autoantibodies that destroy ß-cells in the pancreas.

____ 111. A patient with diabetes mellitus type 1 experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. What is the most probable cause of these symptoms?

a.

Hyperglycemia caused by incorrect insulin administration

b.

Dawn phenomenon from eating a snack before bed time

c.

Hypoglycemia caused by increased exercise

d.

Somogyi effect from insulin sensitivity

____ 112. Which clinical finding occurs first in metabolic acidosis of the patient with type 1 diabetes mellitus?

a.

Ketones in the urine

b.

Palpitations, anxiety, and confusion

c.

Hyperlipidemia

d.

Kussmaul respirations

____ 113. Why does hyperkalemia develop in diabetic ketoacidosis?

a.

Because sodium is low, which stimulates aldosterone to retain sodium and potassium

b.

Because hydrogen shifts into the cell in exchange for potassium to compensate for metabolic acidosis

c.

Because phosphorus shifts into the cell in exchange for potassium due to the lack of insulin

d.

Because the blood is concentrated due to the loss of water from polyuria

____ 114. What is a difference in clinical manifestations between diabetic ketoacidosis and hyperglycemic, hyperosmolar non-ketosis syndrome?

a.

Fluid loss

b.

Glycosuria

c.

Increased serum glucose

d.

Kussmaul respirations

____ 115. Hypoglycemia followed by rebound hyperglycemia is seen in:

a.

the Somogyi effect.

b.

the dawn phenomenon.

c.

diabetic ketoacidosis (DKA).

d.

hyperosmolar hyperglycemic nonketosis syndrome (HHNKS).

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