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NRNP-6540 Endocrine, Metabolic and Nutritional Disorders

NRNP-6540 Endocrine, Metabolic and Nutritional Disorders

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NRNP-6540 Endocrine, Metabolic and Nutritional Disorders

NRNP-6540 Endocrine, Metabolic and Nutritional Disorders Week 9 Knowledge Check Quiz questions and answers
Question 1 

/ 1 pts
Which of the following BMI choices would be considered obesity?



BMI 21 or greater


BMI 24 or greater


BMI 30 or greater


BMI 34 or greater


Question 2

/ 1 pts

The NP recognizes that all of the following patients have an increased risk of developing adverse effects from metformin (Glucophage) except:


Patients who drink lots of alcohol


Patients who are dehydrated


Patients with renal disease


Patients who are overweight

Metformin (Glucophage) often causes weight loss. Metformin may rarely cause a serious, life threatening condition called lactic acidosis. Patients with dehydration, renal disease, and alcoholism, especially binge drinking, increased their risk for developing lactic acidosis.

Question 3

/ 1 pts

 Stefanie is a 70 y/o female with 2 year history of Type II  diabetes, presents to your office for her routine follow up visit. Which of the following would you recommend on an annual basis for an elderly patient with Type II Diabetes?




An eye examination with an ophthalmologist


Ankle-brachial index




Bone density scan

Patients with Type 2 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist shortly after the diagnosis of diabetes. Subsequent examinations for Type 1 and Type 2 Diabetic patients should be repeated annually by an ophthalmologist. Examinations will be required more frequently if retinopathy is progressing. 

NRNP-6540 Endocrine, Metabolic and Nutritional Disorders


Question 4 

/ 1 pts
The NP is reviewing annual labs on a patient with Type II diabetes.  The urine glucose level is over 200.  What medication would the NP suspect that patient is taking?











Question 5

/ 1 pts

A 66-year-old male patient who has hypothyroidism takes level thyroxine daily. Based on the following lab results, how should the nurse practitioner proceed?

TSH 28.2 mIU/L Normal Values: 

0.4-3.8 mIU/L

Free T4 0.05 ng/dL Normal Values: 

0.8-2.8 ng/dL


Total Cholesterol 272 mg/dL Normal Values: 

<200 mg/dl

LDL Cholesterol 189 mg/dL Normal Values: 


HDL Cholesterol 34 mg/dL Normal Values: 


Triglycerides 142 mg/dL Normal Values: 




Begin statin therapy


Encourage diet modifications


Encourage lifestyle modifications


Adjust levothyroxine dose

Dyslipidemia is a common finding when TSH values exceed 10 mIU/L. In patients who have hypothyroidism, there is decreased catabolism of LDL, primarily due to a reduction of cell surface receptors for LDL. This causes an accumulation of LDL cholesterol. The NP should first treat the TSH to 10 mIU/L or less. Lipids should be treated if they remain elevated after TSH is less than 10 mIU/L.

NRNP-6540 Endocrine, Metabolic and Nutritional Disorders

Question 6

/ 1 pts
The most appropriate time to begin screening for renal nephropathy in a patient with Type I Diabetes is:



Two to three years after diagnosis



At diagnosis



Once annually after diagnosis


Five years after diagnosis

Patients with Type I Diabetes should be screened for renal nephropathy five years after diagnosis. Since nephropathy takes several years to develop, it is highly improbable that a newly diagnosed patient will have no properties secondary to diabetes. Diabetic nephropathy is usually diagnosed based on the presence of albuminuria and/or reduced eGFR in the absence of signs or symptoms of other primary causes of kidney damage.

Question 7


/ 1 pts
Identify the lab findings consistent with primary hypothyroidism


Elevated thyroid stimulating hormone and decreased T4 level



Decreased thyroid stimulating hormone and elevated free thyroxine level



Elevated thyroid stimulating hormone and elevated free T4 level



Decreased thyroid stimulating hormone and low free T4

NRNP-6540 Endocrine, Metabolic and Nutritional Disorders

Question 8

/ 1 pts
According to the clinical practice guideline by the American Association of Clinical Endocrinology, the NP should consider initiating insulin therapy when the HgA1c reaches what level?



Greater than 8


Greater than 9

Greater than 10


Greater than 11


Question 9

/ 1 pts
A 70-year-old male is seen for his annual evaluation.   The patient completins of episodes of blurred vision but denies pain and photophobis.    During funduscopic examination, the nurse practitioner appreciates retinal drusen. This presentation is consistent with







Herpes opthalmicus


Macular degeneration

Macular degeneration is typically characterized by loss of central vision. Early complaints and findings include patchy or blurry vision and the presence of retinal drusen, pale yellow deposits visible upon ophthalmic examination.&nbsp;

Question 10

/ 1 pts
Mrs Thompson presents today with concerns of functional decline, progressive appetite loss, and no willingness to eat or drink. The  NP recognizes that these are symptoms of:


Adult failure to thrive


Hashimotos thyroiditis


Acute pancreatitis


None of the above, as this is a normal part of aging.

Miss Johnson’s symptoms are consistent with adult failure to thrive. It is important that the NP recognizes that this is not a normal part of aging and it should be assessed properly.

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