NSG 533 - Advanced Pharmacology
Exam 1
Question:
In order to determine how much T4 replacement a patient needs to re-
establish a euthyroid state, the NP considers:
- the TSH value
- the patient's T4
- the patient's body weight
- the patient's gender
Answer:
- the patient's body weight
Replacement is based on body weight and is usually calculated in kg. The patients weight is calculated in kg and multplied by 1.6 to determine the replacement needed in one day. This is the amount that should be prescribed provided the patient is otherwise healthy, is less than 50 y/o, and has no evidence of underlying cardiac disease.
Rx pearl: start low and go slow, then titrate slowly up; if you calculate dose
and start that right away, you will send the heart into afib (that never goes away)
- / 4
Question:
A patient has been diagnosed today with T2DM. A criterion for diagnosis is:
- An abnormal blood glucose
- Proteinuria
- A fasting glucose > or equal to 126 and confirmed on a previous day
- An abnormal postprandial glucose
Answer:
- A fasting glucose > or equal to 126 and confirmed on a previous day
T2DM is dx after a random fasting glucose greater than or equal to 126 mg/dL and confirmed on a subsequent day. Other diagnostic criteria include a random glucose >200mg/dL with polyuria, polydipsia, or polyphagia; or an A1C greater than or equal to 6.5% (and confirmed on a subsequent day). A glucose tolerance test may also be used for diagnosis, but this is usually reserved for pregnant women.
Question:
The most appropriate screen for diabetic nephropathy is:
- Creatinine clearance and eGFR
- Urinary albumin to creatinine ratio and eGFR
- microalbuminuria
- serum creatinine
Answer:
- Urinary albumin to creatinine ratio and eGFR
- / 4
At least once per year in all patients who have T2DM.
Question:
A patient has 2 fasting glucose values (121mg/dL and 126mg/dL) that were
measured on 2 seperate days in the same week. This patient :
- has normal values
- has impaired fasting glucose
- has T2DM
- should have an A1C performed
Answer:
- should have an A1C performed
This patient has elevated glucose readings. One indicates impaired fasting glucose and the other T2DM. Further testing should be done. A1c is a good choice to confirm dx of T2DM (>6.5%)
Question:
A diabetic patient with albuminuria has been placed on an ACEI. How soon can the antiproteinuric affect of the ACEI be realized for this patient?
- 6-8 weeks
- 3 months
- 6 months
- 3-5 years
Answer: 3 / 4
- 6-8 weeks
The effect can be realized as early as 6-8 weeks after starting an ACEI or ARB. Monitor the patient's serum Cr and K levels with dose changes because both can increase to unacceptable levels when drugs affecting the RAAS are used.
Question:
Mr. Smith, an overweight 48 y/o with undiagnosed T2DM presents to your clinic. Which of these symptoms is not associated with T2DM.
- fatigue
- constipation
- athlete's foot
- impetigo
Answer:
- constipation
Question:
Hyperthyroidism may affect the blood pressure
- by producing an increase in systolic/diastolic readings
- by producing a decrease in diastolic
- when the heart rate is increased
- with unpredictable results
Answer:
- / 4