NURS 6501 ADVANCED PATHOPHYSIOLOGY

NURS 6501 ADVANCED PATHOPHYSIOLOGY

WALDEN UNIVERSITY MIDTERM EXAM ACTUAL

EXAM AND PRACTICE EXAM TEST BANK ACCURATE

AND VERIFIED QUESTIONS WITH DETAILED

ANSWERS GRADED A

Mr. Wayne is a 42-year-old male who has hypertension and was recently diagnosed with mixed hyperlipidemia. He has been trying lifestyle changes for three months and his medications include lisinopril 10mg daily and one multivitamin daily. He comes into the office today to review his labs. His BP is 130/80, HR 90, BMI 34.8. His exam is unremarkable except for mild non-pitting edema to the ankles bilaterally. The nurse practitioner knows that, as part of the metabolic derangement, which of the following conditions is often observed in the early stages of development of Type 2 Diabetes Mellitus and often before abnormalities in the blood glucose are seen?

• Hyperlipidemia
• Retinopathy
• Atherosclerosis

D- ANSWER✔✔Hyperlipidemia A 36 year old female presents to the clinic with a history of fatigue for the past few months. She admits to mild constipation that is not troublesome for her. She reports a 5 lb weight gain over the past 6 months, which she attributes to living a more sedentary life due to her fatigue. Her thyroid does not seem enlarged, although her face is slightly puffy. The remainder of her exam is unremarkable. The nurse 1 / 4

practitioner orders thyroid function studies, which show an elevated Thyroid Stimulating Hormone (TSH).What is the most likely diagnosis?

• Grave's disease
• Addison's disease

C.

• Hypothyroidism - ANSWER✔✔Hypothyroidism

Mrs. Patterson, a 62-year-old female, presents to the clinic to review lab results. Her only complaint is fatigue. Which two laboratory results would lead the Nurse Practitioner to suspect primary hyperparathyroidism?

• Hypercalcemia and hypophosphatemia
• Elevated Vitamin D level and Hypocalcemia

C.

• Hyperkalemia and hypophosphatemia - ANSWER✔✔A. Hypercalcemia and hypophosphetemia

A 55-year-old male had a fasting blood glucose level of 160 mg/dL 1 month ago. Today, his fasting glucose level is 140 mg/dL. He has a history of HTN that is controlled with an ACE inhibitor. He has no other medical problems. He is 5'11" and weighs 215 lbs. His father had DM, but the family history is otherwise noncontributory. This patient is asymptomatic, and his physical examination is unremarkable.What is the most likely diagnosis?

• Maturity Onset Diabetes of the Young (MODY) 2 / 4

• Addison's disease

C.

• Cushing's syndrome - ANSWER✔✔C. type 2 diabetes

A 13-year-old male has been drinking large quantities of fluids and has an insatiable appetite, even for a teenager. However, he is losing weight and has become more tired and listless over the past month. A complete blood count is normal, but he is found to have a fasting serum glucose of 175 mg/dL. A diagnosis of type 1 diabetes is made. What is the probable inheritance pattern of his underlying disease?

• Autosomal dominant

B.

• X-linked recessive
• Autosomal recessive - ANSWER✔✔B. Multifactorial

Ms. Jackson, a 45 y/o female, complains of fatigue, weight gain, lack of concentration, and swelling for almost one year. The Nurse Practitioner thinks the patient could have hypothyroidism based on her clinical presentation. Which lab values would help to confirm Ms. Jackson's diagnosis of hypothyroidism?A.

• Increased TSH and increased T3
• Decreased TSH and increased total T4
• Decreased TSH and decreased free T4 - ANSWER✔✔A. increased tsh and decreased free t4 3 / 4

Mr. Mann, age 50, presents to the Emergency Department with his wife for complaints of palpitations, feeling of panic with shakiness, headache, nausea for the past two hours. Upon arrival BP is 210/105. His medical history is significant for GERD and HTN. He takes Prilosec OTC daily and lisinopril 10mg daily. He has no known medication allergies. His family history includes HTN and cardiovascular disease in father, osteoporosis, anxiety, and HTN in mother, and breast cancer in only sister. His wife states the patient did this a couple of weeks ago on two different occasions, but the symptoms went away in just one or two minutes. His physical exam reveals mild diaphoresis, epigastric tenderness, and generalized trembling.What diagnosis does this patient's presentation most closely represent?

• Myxedema Coma
• Addison's Disease
• Thyrotoxicosis
• - ANSWER✔✔D. pheochromocytoma

A 72-year-old male is brought to the ED in a coma. He was delivered to the ED from a nursing home and was reported by the nursing home staff to have had a seizure that lasted less than 1 minute. He was subsequently confused and soon thereafter entered a comatose state. His medical history is significant for Type II DM requiring insulin, HTN, and mild CHF. In the ED, the patient is very lethargic and responds only to painful stimuli. His vital signs are stable. The list of differential diagnoses that can cause seizure and coma. What is the most important diagnostic study to do immediately?

• Serum toxicology
• CT head without contrast
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