Mallory Christ
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Quiz sobre NURS 6895 Endocrine (Exam 2), criado por Mallory Christ em 24-10-2021.

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NURS 6895 Endocrine (Exam 2)

Questão 1 de 23

1

Which of the following systemic changes does diabetes cause?

Selecione uma ou mais das seguintes:

  • Delayed gastric emptying

  • Altered airway anatomy

  • Autonomic changes (such as decreased HR variability)

  • Increased risk of wound infection

  • Increased risk of nerve injury

  • Development of hypothyroidism

Explicação

Questão 2 de 23

1

Insulin therapy is 1 of the 6 predicators for a major adverse cardiac event (MACE) on the RCRI scale

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 3 de 23

1

Diabetic patients should take their prescribed sulfonyurea on the morning of surgery

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 4 de 23

1

When should an diabetic patient hold their prescribed metformin preoperatively?

Selecione uma das seguintes:

  • If they are completing a bowel prep before surgery

  • If they have renal impairment

  • If the fasting period is brief

  • Both A & B

Explicação

Questão 5 de 23

1

Preoperatively, diabetic patients should take their long acting insulin and hold their short acting insulin

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 6 de 23

1

Which of the following is important consideration for patients with hyperthyroidism who report dysphagia and dyspnea when lying flat?

Selecione uma das seguintes:

  • Ensure patient takes morning dose of thyroxine on the morning of surgery

  • Be prepared to administer glucocorticoids intraoperatively

  • Have a dose of magnesium drawn up in case the patient goes into Torsades

  • Do NOT administer a paralytic to these patients

  • All of the above

Explicação

Questão 7 de 23

1

Your patient has Hashimoto thyroiditis. During your preop assessment, you notice they are bradycardic. What should you do?

Selecione uma das seguintes:

  • Obtain labs (TSH & T4 levels) and proceed with surgery if they are normal

  • Order a transesophogeal echocardiogram (TEE)

  • Reschedule the surgery and refer them to their endocrinologist

  • Proceed with surgery as this is a normal finding of Hashimotos

Explicação

Questão 8 de 23

1

If your preoperative patient took glucocorticoids within the last _________, you should complete a thorough assessment (what steroid they took, for how long, if they tapered, etc) due to concern for development of adrenal insufficiency

Selecione uma das seguintes:

  • 2 weeks

  • 1 month

  • 3 months

  • 1 year

Explicação

Questão 9 de 23

1

20 mg prednisone per day is considered high dose glucocorticoids

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 10 de 23

1

Your patient has adrenal insufficiency and develops severe hypotension immediately after induction. What should you do?

Selecione uma das seguintes:

  • Administer stress dose steroids

  • Administer fluid boluses

  • Start vasopressors immediately

  • There is not a need to do anything as the hypotension will likely self resolve within minutes

Explicação

Questão 11 de 23

1

What are symptoms of adrenal insufficiency?

Selecione uma ou mais das seguintes:

  • Fatigue

  • Myalgias & arthralgias

  • Nausea/vomiting & loss of appetite

  • CNS stimulation & anxiety

  • Weight gain

  • Development of goiter

  • Hypotension refractory to vasopressor therapy & fluid

Explicação

Questão 12 de 23

1

In a patient with acromegaly, what assessment finding would indicate compression of the left recurrent laryngeal nerve?

Selecione uma das seguintes:

  • Severe hypertension

  • Presence of a "buffalo hump"

  • Voice hoarseness and stridor

  • Narrowing of the subglottic opening

Explicação

Questão 13 de 23

1

If a patient has a carcinoid tumor and develops carcinoid syndrome, what are their symptoms and where does the tumor drain?

Selecione uma das seguintes:

  • Symptoms are flushing, diarrhea, tachycardia, and bronchospasm. The tumor drains into portal circulation

  • Symptoms are flushing, diarrhea, tachycardia, and bronchospasm. The tumor does NOT drain into portal circulation

  • Symptoms are cold intolerance, constipation, and bradycardia. The tumor drains into portal circulation

  • Symptoms are cold intolerance, constipation, and bradycardia. The tumor does NOT drain into portal circulation

Explicação

Questão 14 de 23

1

What are the three symptoms of a pheochromocytoma?

Selecione uma ou mais das seguintes:

  • Headache

  • Hypoglycemia

  • Presence of a goiter

  • Diaphoresis

  • Bradycardia

  • Tachycardia

Explicação

Questão 15 de 23

1

Which of the following is an appropriate consideration for a patient with a pheochromocytoma?

Selecione uma das seguintes:

  • Prepare to discharge patient home several hours after surgery

  • Ensure patient is appropriately alpha blocked (with phenoxybenzamine) prior to operating

  • Instruct patient to hold morning meds the day of surgery

  • Continue octreotide drip throughout entire surgery

Explicação

Questão 16 de 23

1

Your patient is confused, lethargic, and is having seizures. They are euvolemic and do not appear fluid overloaded, but their urine is concentrated. What do you suspect?

Selecione uma das seguintes:

  • Hyponatremia due to SIADH

  • Hyponatremia due to diabetes insipidus

  • Pheochromocytoma

  • Adrenal insufficiency

Explicação

Questão 17 de 23

1

At what rate should you correct hyponatremia?

Selecione uma das seguintes:

  • 0.5 mEq/L/hr

  • 1 mEq/L/hr

  • 5 mEq/L/hr

  • As quickly as possible to avoid neurologic injury

Explicação

Questão 18 de 23

1

Hypoparathyroidism is the most common cause of hypercalcemia

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 19 de 23

1

Intraoperatively, your patient's labs come back showing a calcium of 3.5 mg/dL. Which is the most important consideration?

Selecione uma das seguintes:

  • You will monitor the ECG closely for ST segment changes, T wave abnormalities, or a shortened QT interval

  • You will aggressively treat the hypertension that is likely to ensue

  • You will correct the calcium slowly to prevent neurological damage

  • You will not plan on extubating this patient due to risk of laryngospasm

Explicação

Questão 20 de 23

1

Your patient has a BMI of 37. What is their BMI classification?

Selecione uma das seguintes:

  • Normal

  • Overweight

  • Obese

  • Severely obese

  • Morbidly obese

Explicação

Questão 21 de 23

1

What is the single biggest indicator of a difficult airway?

Selecione uma das seguintes:

  • BMI over 40

  • Male gender

  • Presence of metabolic syndrome

  • Large neck circumference

Explicação

Questão 22 de 23

1

For which condition would you want your patient on an octreotide drip going into surgery?

Selecione uma das seguintes:

  • Acromegaly

  • Carcinoid tumor

  • Pheochromocytoma

  • Adrenal insufficiency

Explicação

Questão 23 de 23

1

Your patient has a(n) __________ diagnosis. Prior to surgery, you must ensure they have a recent echocardiogram (within one year) to evaluate their ejection fraction due to risk of left ventricular hypertrophy.

Selecione uma das seguintes:

  • Pheochromocytoma

  • Adrenal insufficiency

  • Acromegaly

  • Cushing Syndrome

Explicação