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NURS 6895 Endocrine (Exam 2)

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Quiz on NURS 6895 Endocrine (Exam 2), created by Mallory Christ on 24/10/2021.
Mallory Christ
Quiz by Mallory Christ, updated more than 1 year ago
Mallory Christ
Created by Mallory Christ about 3 years ago
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Question 1

Question
Which of the following systemic changes does diabetes cause?
Answer
  • 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

Question 2

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

Question 3

Question
Diabetic patients should take their prescribed sulfonyurea on the morning of surgery
Answer
  • True
  • False

Question 4

Question
When should an diabetic patient hold their prescribed metformin preoperatively?
Answer
  • If they are completing a bowel prep before surgery
  • If they have renal impairment
  • If the fasting period is brief
  • Both A & B

Question 5

Question
Preoperatively, diabetic patients should take their long acting insulin and hold their short acting insulin
Answer
  • True
  • False

Question 6

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

Question 7

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

Question 8

Question
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
Answer
  • 2 weeks
  • 1 month
  • 3 months
  • 1 year

Question 9

Question
20 mg prednisone per day is considered high dose glucocorticoids
Answer
  • True
  • False

Question 10

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

Question 11

Question
What are symptoms of adrenal insufficiency?
Answer
  • Fatigue
  • Myalgias & arthralgias
  • Nausea/vomiting & loss of appetite
  • CNS stimulation & anxiety
  • Weight gain
  • Development of goiter
  • Hypotension refractory to vasopressor therapy & fluid

Question 12

Question
In a patient with acromegaly, what assessment finding would indicate compression of the left recurrent laryngeal nerve?
Answer
  • Severe hypertension
  • Presence of a "buffalo hump"
  • Voice hoarseness and stridor
  • Narrowing of the subglottic opening

Question 13

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

Question 14

Question
What are the three symptoms of a pheochromocytoma?
Answer
  • Headache
  • Hypoglycemia
  • Presence of a goiter
  • Diaphoresis
  • Bradycardia
  • Tachycardia

Question 15

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

Question 16

Question
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?
Answer
  • Hyponatremia due to SIADH
  • Hyponatremia due to diabetes insipidus
  • Pheochromocytoma
  • Adrenal insufficiency

Question 17

Question
At what rate should you correct hyponatremia?
Answer
  • 0.5 mEq/L/hr
  • 1 mEq/L/hr
  • 5 mEq/L/hr
  • As quickly as possible to avoid neurologic injury

Question 18

Question
Hypoparathyroidism is the most common cause of hypercalcemia
Answer
  • True
  • False

Question 19

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

Question 20

Question
Your patient has a BMI of 37. What is their BMI classification?
Answer
  • Normal
  • Overweight
  • Obese
  • Severely obese
  • Morbidly obese

Question 21

Question
What is the single biggest indicator of a difficult airway?
Answer
  • BMI over 40
  • Male gender
  • Presence of metabolic syndrome
  • Large neck circumference

Question 22

Question
For which condition would you want your patient on an octreotide drip going into surgery?
Answer
  • Acromegaly
  • Carcinoid tumor
  • Pheochromocytoma
  • Adrenal insufficiency

Question 23

Question
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.
Answer
  • Pheochromocytoma
  • Adrenal insufficiency
  • Acromegaly
  • Cushing Syndrome
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