Module 4 NCLEX study questions
30. Nonpharmacologic treatment for dysmenorrhea include which of the following? Heat to lower abdomen Cold to the lower abdomen Luke warm water to abdomen Sticky patch to the abdomen Sticky patch to the lower back
A
18. An early symtom of endometrial cancer includes which of the following? (Select the best response) Abnormal uterine bleeding. Abnormal coccyx bleeding. Abnormal ulcerative bleeding. Abnormal nose bleeding.
A
21. An older female client with a positive family history of hypothyroid goiters presents with rapid enlargement of the thyroid causing her voice to change. What is the most common the cause of this in this client? Hashimoto's thyroiditis Exophthalmos Exophthalmos Hyperthyroidism
A
23. The nurse understands that the most common cause of goiters worldwide is related to a lack of what in the diet? Iodine Kale Vitamin D Potassium
A
24. The questionaire that is used to determine the severity of prostate problems is which of the following? The American Urological Association Symptom Index for BPH The American Diabetic and Prostate Association for BPH The New Zeland Medical Association for BPH The Autosomal Medical Association of BPH Survivors.
A
26. What is the medication of choice for an ectopic pregnancy? (Select the best response) Methotrexate Metoprolol Librium Acetamenaphin
A
27. What type of screening is important to implement for BPH? PSA BNP CNP BLT ANP
A
28. What type of blood test may be done when screening a patient for prostate cancer? PSA BMP A1C CBC
A
29. Antibiotics that are used to treat prostatis include which of the following? Trimethoprim Sulfamethazole Dexamethazone Acetamenophen
A
3. Which diagnostic test may confirm the existence of leomyomas in female clients? ultrasound MRI renal biopsy KUB
A
14. A client with hypoparathyroidism may experience which of the following if their calcium becomes low? (select the best response) Trousseau's sign Hyperphotophobia Hyperglycemia Stinging of lips Abdominal pain
A
16. The nurse is caring for a client who has been diagnosed with Stage I cervical cancer. What is the recommended treatement for this stage of cervical cancer? Radiation with radical hysterectomy Chemothreapy with radical hysterectomy Watchful waiting with no hysterectomy Delayed radiation therapy and no hysterectomy. HIDE ANSWER
A
15. Explain the differences in type I and type II DM. Fill in the blank.
...
2. What are some of the differences in type I and type II DM? OPEN RESPONCE
...
31. What important patient teaching is needed for clients who have had prostate surgery? OPEN ENDED
...
6. If a client has polyuria, polyphasia, and unexplained weight loss with a hyperglycemic crisis where glucose is greater than or equal to 200 mg/dL. What might the nurse see as a diagnosis for this client in the EHR? OPEN RESPONSE
...
14. The nurse is discussing the HPV vaccination. When should the nurse include as the deadline for administration of the HPV vaccine? (Select the best response) Prior to the first sexual intercourse and between 11-12 years After the first sexual intercourse and between 16-18 years When the client has regular intercourse between 17-18 years During the first week of having sexual intercourse between 20-21 years HIDE ANSWER
A
12. Which of the following might the nurse suspect if a client wakens with hyperglycemia? (select the best response) Dawns phenomenon Diabetic ketoacidosis Hoshimotos Prediabetes
A
1. The nurse knows that the cause of her client's leomyomas are unknown. However, the nurse also knows that the growth of the client's leomyomas depend on which of the following? Select the best response Estrogen and progesterone Testosterone and aldosterone Antidiuretic hormone and BNP Serotonin and dopamine
A
10. The nurse is teaching the client about the storage of insulin when discharged home. The nurse should explain that heat and extreme freezing does what to the insulin? Alters the molecular structure. Heat makes the insulin effective. Freezing preserves the molecular structure. Store under a heat lamp to the insulin fresh.
A
36. The nurse is taking care of a patient with Syndrome of inappropriate ADH and is looking at the urine specific gravity and serum sodium osmolality labs, what would they read? Hyponatremia, and high specific gravity >1.030 Hyponatremia and low specific gravity< 1.005 Hypernatremia and high specific gravity > 1.030 Hypernatremia and low specific
A
44. The nurse knows that in order to diagnosis IGT she must first have a : (select the best response) OGTT values are 140-199 mg/dL OGTT values are 50-70 mg/dL Edema in the facial area. Na 2+ level of 160mg/dL
A
51. What helps maintain aldosterone? Extracellular fluid volume Testosterone Pituitary gland Intracellular fluid volume
A
8. The student nurse is studying the causes of goiters. Which of the following foods can increase the risk for goiters? (Select the best response) Broccoli Lettuce Spinach Potatoes
A
9. Client teaching is very important. Which of the following should be included in the client teaching related to thyroiditis? Teach client not to discontinue medications abruptly Teach client to discontinue medications abruptly Teach the client that swallowing difficulty is normal Teach the client side effects of medications are not important.
A
9. The nurse is caring for a client who has just had cervical polyps removed. What wilL happen to the polyps that were removed? (select the best response) They wiil be sent to the lab to be evaluated for malignancy They will be send to the blood bank to access the blood type in the polyp. They will be evaluated by the physician and disposed of in the biohazard bin. They will be sent home with the client so that if any other polyps develop the client knows what to look for.
A
Client teaching is very important. Which of the following should be included in the client teaching related to thyroiditis? Teach client not to discontinue medications abruptly Teach client to discontinue medications abruptly Teach the client that swallowing difficulty is normal Teach the client side effects of medications are not important.
A
The nurse is going into a client's room to administer insulin. What type of shot will the nurse administer to the client? Subcutaneous Intermuscular Intradermal z track
A
The nurse is telling the client about Hemoglobin A1C. The nurse should tell the client to get his AIC checked how often? (Select the best response). Every 3 months Every 8 months Every 1.5 months Every other day
A
The student nurse is studying the causes of goiters. Which of the following foods can increase the risk for goiters? (Select the best response) Broccoli Lettuce Spinach Potatoes
A
Which patient is at the highest risk for cervical cancer? A 21 year old who reports first sexual partner at the age of 14 and that she has had at least 10 sexual partners A 60 year old with a history of syphilis and cigarette smoking A 32 year old in a monogamous relationship who declined the HPV vaccine None of these patients are at risk for cervical cancer
A
Your patient is suffering from Diabetic Ketoacidosis. Which disease process does DKA normally present itself in? Type 1 Diabetes Type 2 Diabetes Prediabetes Hypoglycemia
A
6. The nurse knows the cause of polycystic ovarian syndrome (PCOS) is usually unknown. However, which of the following are thought to contribute to this condition? (Select all that appy) Ovaries production of estrogen. An excess amount of testosterone. Not enough production of progesterone. To much production vitamin B-12 Imbalance of all fluid and electrolytes
A,B,C
Which of the following is true regarding Intermediate-acting insulins? They normally appear cloudy, the nurse should roll them between the palms of the hand It can be given IV The nurse should give this 30 min before meals The onset of action is 5-10 minutes
A, Rationale: Intermediate insulins should not be given IV, they should be given at bedtime, and the onset of action is 1.5-4 hours
4. Which of the following is the most common cause of hyperthyroidism? Hashimoto's thyroiditis. Graves disease. Type I diabetes. Type 2 diabetes. CHECK BOOK ANSWER
A, SHOULD BE HYPOTHYROIDISM
13. The tests that would be intiated to determine the diagnosis of cervical cancer include which of the following? (Select all that apply) Pap HPV MRI BMP AST
A,B
6. The nurse is assessing a patient for prediabetes by measuring the fasting glucose levels and then administering a 2-hr OGTT with a glucose load of 75 g. Which lab findings are suggestive of prediabetes? SATA OGTT of 140-199mg/dL Fasting plasma glucose of 100-125 mg/dL Fasting plasma glucose >125 mg/dL OGTT >200 mg/dL OGTT 70-150 mg/dL
A,B
8. What are the side effects of metformin some client's experince? (SATA) Lactic acidosis Diarrhea Nausea/Vomiting Headache Cough
A,B
The knowledgeable nurse knows that clients with prediabetes often present in what way? (Select all that apply and select the best responses) Not feeling symptoms of DM Not understaning symptoms of DM Knowing the symptoms are DM related. With pressure wounds on the coccyz. As clients who regularly do glucose checks
A,B
11. The nurse has received order to administer metformin for a client who has a history of kidney disease. What knowledge should the nurse possess to prevent harm and a medication error from happening? Do not use metformin with kidney disease. Discontinue metformin 1-2 days before any invasive procedure. Resume metformin 48 hours if there are no kideny problems. Resume metformin if the client shows signs of kidney infection
A,B,C
15. Treatment options for clients with cervical cancer include which of the following vaccinations? (select all that apply) Gardasil Gardasil 9 Cervarix Varicella Diptheria
A,B,C
20. The interprofessional care diagnostic assessments for ovarian cancer include which of the following? (Select all that apply) History and physical examination Pelvic examination Abdominal and transvaginal ultrasound Diagnostic of kidneys, ureters, and bladder Diagnostic of bilateral lungs
A,B,C
21. Interprofessional care for clients with ovarian cancer include which of the following? Removal of the ovaries Removal of fallopian tubes Use of oral contraceptive pills Use of tampons and maxi pads Use of opioids and sedatives
A,B,C
23. Diagnostic of vulvular cancer include which of the following? (Select all that apply) physical examination colposcopy biopsy results potassium levels creatinine levels
A,B,C
25. A female client is seen in the ER with symptoms of TSS. What symptoms would the patient have? SATA Sunburn-like rash Vomiting Weakness Constipation
A,B,C
3. The nurse knows that gestational diabetes occurs during pregnancy. Which of the following are risk factors that can occur with gestational diabetes? (SATA) Increased risk for cesearn deliery. Increased risk of prenatal death. Increased risk of birth injury. Decreased risk of neonatal complications Decreased risk for baby with low birth weight
A,B,C
34. Though most clients will not experience symptoms with Type 2 Diabetes, they may also experience? (Select all that apply) Fatigue Infections Polydipsia Anuria Oliguria
A,B,C
45. A nurse is educating a patient on the conditions that cause of DM, the nurse knows to include what information? SATA Genetics can be a contributing factor Autoimmune system can be a contributing factor Obesity and lack of exercise can be contributing factors. Diverticulitis can be a contributing factor.
A,B,C
49. A woman diagnosed with PCOS might have which of the following clinical manifestations? SATA (Select the most correct responses) Irregular periods Facial hair Facial hair Headaches Brittle nails
A,B,C
5. The nursing student is learning about growth hormone testing. Which of the following should the nursing student learn about the factors that influence the results of the growth hormone test. (SATA) Time of day Food intake Stress gllucose caffeine intake
A,B,C
7. The nurse is caring for a client who has been diagnosed with PCOS for years but has not saught treatment. Which of the following may the client develop due to the lack of treatment of PCOS? Cardiovascular disease Abnormal insulin resistance Type II diabetes mellutus Type 1 diabetes mellitus Diabetic ketoacidosis
A,B,C
17. A cleint has been diagnosed with thyroiditis. Which manifestations would be expected. (SATA) Ear pain Fever Chills SOB Redness
A,B,C,D
2. The nurse is performing an assessment on a client with hypoparathyroidism. What clinical manifestations might the nurse notice while assessing this client? (Select all that apply) Headache Visual changes Loss of smell Nausea/ Vomiting Improved alertness
A,B,C,D
22. The nurse is caring for a client with vulvar cancer. What signs and symptoms may this client manifest? (select all that apply) itching burning pain bleeding no discharge
A,B,C,D
26. Interprofessional care for BPH include which of the following? (Select all that apply) Restore Bladder Drainage Relieve the client's symptoms Prevent complications of BPH Treat complications of BPH Discard colletion of Intake & Output
A,B,C,D
3. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would look for a potential history of which of the following relating to possible causes of SIADH? (Select all that apply) Cancer Head injury Stroke Infection Immunocompetence
A,B,C,D
4. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). The client has a foley catheter inserted. Which of the following might the nurse notice while assessing this client? (Select all that apply) Decreased urine output Client complains of thirst. Client complains of dyspnea. Client complaints of fatigue Client expresses feeling rested.
A,B,C,D
48. What are the clinical manifestations for hyperthyroidism? SATA. Diaphoresis Weight loss Heat intolerance Hypertension Lethargy and fatigue
A,B,C,D
7. The nurse is reviewing the nursing management for a client with diabetes insipidus (DI). which of the following is included in the nursing management for this client? (Select all that apply) Monitor BP Monitor HR Monitor output. Monitor hydration. Monitor Ca 2+.
A,B,C,D
9. Dysmenorrhea is one of the most common gynecological problems characterized by painful menses with abdominal cramping. Which of the following are pharmacologic and nonpharmacologic therapies for primary dysmenorrhea (SATA) NSAIDS Oral contraceptives Heat to the lower abdomen Physical exercise Treating the least common cause
A,B,C,D
A nurse has been told to educate a client who has been diagnosed on prediabetes. what would the include in this education? (Select all that apply) Information on diet Information on weight Information on injections Information on exercise Information on the late show
A,B,C,D
The nurse educator is educating a class on potential medical causes related to the development of diabetes. Which of th efollowign are infuential factors to the development of diabetes? (Select all that apply) Infection Injury Cushings Hyperthyroid Red birth mark
A,B,C,D
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). The client has a foley catheter inserted. Which of the following might the nurse notice while assessing this client? (Select all that apply) Decreased urine output Client complains of thirst. Client complains of dyspnea. Client complaints of fatigue Client expresses feeling rested.
A,B,C,D
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would look for a potential history of which of the following relating to possible causes of SIADH? (Select all that apply) Cancer Head injury Stroke Infection Immunocompetence
A,B,C,D
The nurse is covering risk factors for the development of DM. which of the following are risk factors for the development of DM? (Select all that apply) Obesity at young age Sedentary job/lifestyle Consuming all carbs Consuming all glucose Exercising regularly
A,B,C,D
The nurse is performing an assessment on a client with hypoparathyroidism. What clinical manifestations might the nurse notice while assessing this client? (Select all that apply) Headache Visual changes Loss of smell Nausea/ Vomiting Improved alertness
A,B,C,D
The nurse is reviewing the nursing management for a client with diabetes insipidus (DI). which of the following is included in the nursing management for this client? (Select all that apply) Monitor BP Monitor HR Monitor output. Monitor hydration. Monitor Ca 2+.
A,B,C,D
11. The nurse is educating her team on the risk factors for cervical cancer in women. Which of the following are risk factors the nurse will include in this education? (select all that apply) Infetion with high strains of HPV The client is immunocompromised The client is low social economic status The client has or had chlamydia infection The client has smoked for many years
A,B,C,D,E
You are caring for a patient diagnosed with type 2 diabetes who is taking short acting insulin, long acting insulin, and a statin. What are some important lab values to monitor? Cholesterol (LDL) A1C Potassium CBG
A,B,C,D: Statins lower LDL cholesterol so you need to monitor to make sure the medication is working. Insulin, especially in large doses, causes a decrease in serum potassium. The A1C shows a 3 month average of glucose levels.
10. What are the typical symptoms of Dysmenorrhea (SATA)? Colicky abdominal pain Radiating pain to certain areas Nausea/ diarrhea Chest pain Fatigue
A,B,C,E
17. Endometrial cancer is one of the most common forms of cancer. Which of the following are risk factors the nurse should have knowledge of relating to the development of endometrial cancer? (select all that apply) Estrogen exposure. Increased obesity. Increased aging. Decreased aging. Not having children.
A,B,C,E
4. Conditions that may contribute to causing diabetes include which of the following? (SATA) Cushings. Hyperthyroidism Pancreatitis Lupus parenteral nutrition
A,B,C,E
42. A nurse knows a client with hemoglobin A1c greater than 6 puts them at higher risk of developing complications. To reduce the risk of developing complications for cardiovascular and cerebrovascular disease a nurse should teach the client to do which of the following? Select all that apply. Monitor cholesterol (HDL, LDL, triglycerides) yearly and monitor blood pressure to keep less than 130/80. Check a hemoglobin A1C every 3 months Encourage the client to wear a medical identification bracelet Teach the client to report headache, no numbness in the distal extremities, non-swollen feet, and infrequent urination. Encourage a diet of low-fat meals and yearly eye examination.
A,B,C,E
5. The nurse is caring for a client with SIADH. Which of the following are included in the nursing management for this client? (Select all that apply) Monitor intake and output Monitor client's vital signs Monitor client's daily weights Monitor client's chloride levels Monitor client's sodium levels
A,B,C,E
The nurse is caring for a client with SIADH. Which of the following are included in the nursing management for this client? (Select all that apply) Monitor intake and output Monitor client's vital signs Monitor client's daily weights Monitor client's chloride levels Monitor client's sodium levels
A,B,C,E
28. What is included in the nurses role for BPH? (Select all that apply) Catheter irrigation PRN or as ordered Monitoring of continuous bladder irrigation Do not secure the foley bag below the bladder Assess client for bleeding and clotting. Irrigate the catheter without giving pain medication
A,B,D
4. The nurse is caring for a client with several leomyomas. Depending on the size and criteria of the leomyomas which of the following are possible treatment options the nurse may expect to see in the client's EHR? (Select all that apply) Myeomectomy as treatment Hysterectomy as treatment Lymphectomy as treatment Uterine artery emmoblization Coronary artery bypass surgery
A,B,D
5. The nurse is reviewing medications that can assist in inducing diabetes. Which of the following medications contribute to possible development of diabetes? Antipsychotics Corticosteroids NSAIDS Thiazides Antihypertensives
A,B,D
6. The nurse educator is teaching on potential causes of diabetes insipidus (DI). Which of the following are potential causes of DI the nurse educator should include in the lesson? Brain tumor CNS infection SNS infection Head injury Renal cyst
A,B,D
The nurse educator is teaching on potential causes of diabetes insipidus (DI). Which of the following are potential causes of DI the nurse educator should include in the lesson? Brain tumor CNS infection SNS infection Head injury Renal cyst
A,B,D
3. The nurse is performing a gerontologic assessment on a client relating to the changes that occur in the endocrine system with age. Which of the following changes occur in the endocrine system should the nurse have knowledge of that occurs with age? (SATA) Atrophy of the thyroid gland occurs. Increases in secretion of PTH. Decreases in secretion of PTH. Decline in estrogen in women. Decline in testosterone in men.
A,B,D,E
30. The nurse is taking care of a client with an order for continuous bladder irrigation. What action(s) would the nurse expect to take? Select all that apply. Assess for bleeding and clots. Teach patient Kegel exercises after catheter removal. Insert a new catheter every eight hours. Manually irrigate catheter if bladder spasms or decreased outflow occurs. Discontinue CBI and notify physician if obstruction occurs.
A,B,D,E
hitney Tatum Diabetic Ketoacidosis can lead to death if left untreated. Which clinical manifestations should the nurse recognize in a client with diabetes that could indicate diabetic ketoacidosis? (SATA) Fruity breath odor Kussmaul's respirations High fever Lethargy and weakness Protruding eyeballs Weak, rapid pulse
A,B,D,F
A client has just been diagnosed with DM. What dynamics have likely occured in his body even befoe diagnosis? (Select all that apply) Damage to the heart may have already occurred Damage to the kidneys may have already occurred. Damage to the outer layer of the skin has occurred Damage to the intellect of the individual has occurred Damage to the clients vision may have already occurred.
A,B,E
22. What diagnostic study can be measured in order to determine whether a goiter is associated with normal thyroid function, hyperthyroidism, or hypothyroidism? SATA TSH Urinalysis T4 levels FSH PTH
A,C
41. Which of the following should the nurse palpate during a focused assessment? (SATA) (select the most correct/ common responses) Extremities Head Neck Abdomen Ears
A,C
43. The nurse knows to administer insulin in accordance to mealtimes, which insulins are administered at what time? Rapid acting within 15 minutes prior to meal time Rapid acting within a hour after mealtime Short acting within 30-45 minutes prior to meal time Short acting within 2 hours after mealtime
A,C
20. The nurse is teaching a newly diagnosed type II diabetic how to administer insulin. Which of the following statements by the nurse are correct? (SATA) "Should rotate sites of injection to allow for better absorption of insulin." "You should always administer insulin at a 45 degree angle." "Roll the insulin pen in your hand 10-20 times to warm the insulin to room temperature before injection." "You should leave the needle in for 5 seconds to ensure insulin is absorbed." " You should aways check glucose 2 hours before insulin administration."
A,C,D
5. A patient presents to the doctors office for a yearly checkup. The nurse will acknowledge which of the following as risk factors for diabetes mellitus? (SATA) Obesity Healthy lifestyle Gestational Diabetes Family History
A,C,D
The nurse should know that Pelvic Inflammatory Disease (PID) is an infectious condition of the pelvic cavity that may involve (SATA) Fallopian tubes Urethra Ovaries Pelvic peritoneum
A,C,D
2. The nurse is caring for a client with leomyomas. The nurse knows that some of the symtpoms the client may present with include which of the following? Select all that apply abnornal uterine bleeding light uterine bleeding heavy aching painful s/s abdominal or pelvic pain painful sexual intercourse
A,C,D,E
1. The nurse is reviewing insulin resistance. What should the nurse understand from this review? Body tissues respond to insulin Body tissues do not respond to insulin Insulin receptors are partly responsive Insulin receptors are fully responsive
B
46. The nurse knows that the diagnosis of DM includes: (SATA) A1C of 6.5% or higher AIC of 7.5% or higher Fasting blood glucose greater than or equal to 126 mg/dL Two hour plasma glucose level greater than or equal to 200 mg/dL Hyperglycemia/ hyperglycemic crisis with a random plasma glucose greater than or equal to 200 mg/dL
A,C,D,E
8. Nursing management for PCOS includes which of the following? Select all that apply Teach weight management Teach client to be sedentary Teach about exercise benefits Teach about montioring lipids Teach about monitoring hirtuism
A,C,D,E
2. The nurse is performing and endocrine assessment on a client. What would the nurse inquire about regarding the client's elimination? (SATA) Do you go to the bathroom a lot at night? What is your activity level's each day? Have you ever had a kidney stone? Do you experience fatigue with activity? Have you noticed bowel elimination changes?
A,C,E
33. Which of the following are clinical manifestations of Type 1 Diabetes? (Select all that apply) Sudden weight loss Little urine output Polydipsia Decreased appetite Ketoacidosis
A,C,E
Allison Beames A client comes in for a parathyroid hormone (PTH) blood study. What is the nurses responsibility after the study is completed? Wait one hour then refrigerate specimen Immediately refrigerate the specimen Keep sample on ice Keep specimen at room temperature
ANS: C. Information found on page 9 of Wynn's module 4 objectives under "Diagnostic Studies and Nursing Responsibilities - Parathyroid Studies" I think the information is from the 10th edition because it is a little different from the 11th!
How would you treat a preoperative client who is experiencing hypoglycemia, and has a CBG of 60? Choose the best response. You would want to administer 50% dextrose IV push via doctor's orders You would feed the client graham crackers and peanut butter or give them honey You would administer Humalog insulin You would retake the client's CBG because obviously that is a wrong result.
ANS: A
Perla Lopez A patient has recently been experiencing a sudden loss in weight, as well as polydipsia. What could the patient be diagnosed with? Type 1 Diabetes Mellitus Prediabetes Type 2 Diabetes Mellitus Gestational Diabetes
ANS: A Rationale: With Type 1 diabetes mellitus the patient usually has a hx of recent & sudden weight loss & the classic symptoms of polydipsia, polyuria, and polyphagia. Chap. 48, Pg. 1122 (10th edition).
A client's EHR shows a history of diabetes, asthma and COPD. What order is contraindicated for this type of client? Aspirin daily Afrezza 1 puff 20 mins before meals Metformin daily Lantus daily Anna Brown
ANS: B
The dawn phenomenon affects a majority of people with diabetes. This phenomenon tends to be most severe in which populations? gerontologic Adolescence and young adulthood Pregnancy Males
ANS: B Rationale: during adolescence and young adulthood, growth hormone is at its peak. Dawns phenomenon involves two counterregulatory hormones, growth hormone and cortisol) that are excreted in increased amounts in the early mornings. These hormones cause hyperglycemia present upon waking.
What are the manifestations of Hypoglycemia? SATA Progression to DKA Rapid heart rate Blurred vision Nausea Numbness of fingers, toes, mouth
ANS: B,E Rationale: Symptoms of hypoglycemia includes blood glucose <70 mg/dL, cold, clammy skin, numbness of fingers, toes, mouth, rapid heartbeat, emotional changes, headache, nervousness, tremors, faintness, dizziness, unsteady gait, slurred speech, hunger, changes in vision, seizures, coma. Table 48-16.
Taylor Petrey Your diabetic patient is taking Metformin. What is a common side effect they may be experiencing? Constipation Decreased appetite Diarrhea Rash
ANS: C
Which of the following patient's are contraindicated for taking Liraglutide (Victoza)? A 65 year old male with a history of heart disease A 15 year old female diabetic A 30 year old female with a history of medullary thyroid cancer A 55 year old male with a history of BPH
ANS: C Rationale: drug alert state not to sue in patients with a personal or family hx of medullary thyroid cancer and that pancreatitis has been associated with this drugs use
A client is going to have an aldosterone blood study done. What position is NOT the required position for the client to be in before the specimen is drawn? Supine Sitting Standing Trendelenburg
ANS: D Information found on page 1102 (11th edition) in table 47.6
2.) A patient is experiencing dawn phenomenon, what is it? a. Waking up with hyperglycemia b. Waking up with hypoglycemia c. Waking up to urinate d. Sleep all day and night
Answer A
Kierra 1.) In a patient with hypoparathyroidism what may occur? a. Tingling b. Nausea c. Trousseau sign d. Diarrhea
Answer C
Which of the following are the most accurate tests of thyroid function? TSH and free T4 TSH and free T3 Free T3 and Free T4 Reverse T3 and TSH
Answer is A: TSH and free T4
2. A young adult patient who is being seen in the clinic has excessive secretion of the anterior pituitary hormones. Which laboratory test result should the nurse expect? A. Increased urinary cortisol B. Decreased serum thyroxine C. Elevated serum aldosterone D. Low urinary catecholamines
Answer: A Rationale: Increased secretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary gland will lead to an increase in serum and urinary cortisol levels. An increase, rather than a decrease, in thyroxine level would be expected with increased secretion of thyroid-stimulating hormone (TSH) by the anterior pituitary. The anterior pituitary does not control aldosterone and catecholamine levels.
A nurse is providing education to a patient who has a Syndrome of Inappropriate Antidiuretic Hormone (SIADH), the nurse knows that the patient has received proper education when they state: SATA "This syndrome is most common in older adults". "Small cell lung cancer is one of the most common causes". "A common symptom is weight loss". "Other diagnostic studies I might have include a chest x-ray".
Answer: A & B, weight gain is a common manifestation of SIADH, and diagnostic studies for SIADH include serum sodium levels, and "simultaneous measurements of urine and serum osmolality".
2. A client comes into the office with symptoms of fatigued, dry flaky skin and memory problems. After a H&P and lab work that included TSH, T3 and T4, the client is diagnosed with hypothyroidism. The nurse should identify which of the follow as part of the nursing management of a client with hypothyroidism? Select all that apply. a. Thyroid replacement b. Monitor thyroid hormone levels and adjust dosage as needed c. Nutritional therapy to promote healthy heart diet ie dash diet d. Discuss measures to minimize constipation e. Discuss the importance of taking medication same time everyday till hormone level normalizes
Answer: A, B D
Mary 1. A nurse knows a client with hemoglobin A1c greater than 6 puts them at higher risk of developing complications. To reduce the risk of developing complications for cardiovascular and cerebrovascular disease a nurse should teach the client to do which of the following? Select all that apply. a. Monitor cholesterol (HDL, LDL, triglycerides) yearly and monitor blood pressure to keep less than 130/80. b. Check a hemoglobin A1C every 3 months c. Encourage the client to wear a medical identification d. Teach the client to report short of breath, headache, numbness in the distal extremities, swollen feet, infrequent urination. e. Encourage a diet of low-fat meals that are high in fruits, vegetables, and whole grains. f. Encourage yearly eye exams to ensure the health of the eyes and protect vision.
Answer: A, B, D
What are the risk factors for hypothyroidism? SATA. Older age Being male African American Having Type 2 DM Being female
Answer: A, E - whites, those with type 1 DM, older adults, and females are more at risk
Which of the following groups of people have an increased prevalence of diabetes mellitus? SATA Hispanics Native Americans Whites African Americans Asians Russian Americans Pacific Islanders
Answer: A,B,D,E,G: page 1125
A nurse has been ordered to collect a blood sample for a growth hormone blood study from a client. What does the nurse need to consider? SATA The patient should be fasting Emotional and physical status does not affect the results Sample should be sent to lab immediately Further evaluation requires no other tests Needs to indicate patient fasting status and recent activity on lab slip
Answer: A,C,E Rational: GH levels are affected by time of day, food intake, and stress. Further Evaluation requires a stimulation test. The nurse needs to make sure that the patient has been fasting. Emotional and physical status may alter results. Indicate fasting status and recent activity level on the laboratory slip. Send a blood sample to the laboratory immediately.
A nurse has been ordered to collect a blood sample for a growth hormone blood study from a client. What does the nurse need to consider? SATA The patient should be fasting Emotional and physical status does not affect the results Sample should be sent to lab immediately Further evaluation requires no other tests Needs to indicate patient fasting status and recent activity on lab slip
Answer: A,C,E Rational: GH levels are affected by time of day, food intake, and stress. Further Evaluation requires a stimulation test. The nurse needs to make sure that the patient has been fasting. Emotional and physical status may alter results. Indicate fasting status and recent activity level on the laboratory slip. Send blood sample to the laboratory immediately.
The nurse knows that in order to prevent hypoglcemia, insulin should be administered when in relation to their meal? 1 hour Immediately before 1 hour after meal time 30 minutes before meal time
Answer: A. The CBG should also be measured within 30 minutes of insulin administration in order to get the most accurate dosing.
Your patient has just had thyroid surgery. What should you watch out for? Hypothyroidism Infection Airway Obstruction Vocal Cord Paralysis Hypoparathyroidism
Answer: All of the above are possible complications following surgery on the thyroid, page 1154 in 11th edition book
1. The nurse is caring for a client with hypopituitarism. The nurse knows that a deficiency of which of the following labs are life threatening regarding hypopituitarism? T3 & T4 TSH & ACTH BUN & Creatinine K2+ & Cl-
B
The nurse knows that a patient with a SIADH diagnosis can suffer from hyponatremia that may have to be corrected. When correcting hyponatremia the nurse knows that it must be done _______ and that the sodium levels should not increase more than _________ mEq/L in the first 24 hours. Quickly; 10 to 14 Slowly; 8 to 12 Quickly; 3.5 to 5 Slowly; 4 to 6
Answer: B, "In cases of severe hyponatremia (less than 120 mEq/L), especially in the presence of neurologic manifestations such as seizures, small amounts of IV hypertonic saline solution (3% sodium chloride) may be slowly given. It is important to correct hyponatremia slowly. The level should not increase by more than 8 to 12 mEq/L in the first 24 hours". (Pg 49 of Wynns' document.)
What are the common features of myxedema? SATA. Sunken looking eyes Dull, puffy skin Prominent tongue Periorbital edema New facial hair on women
Answer: B, C, D. Myxedema presents in patients with severe, long-standing hypothyroidism. It includes puffiness, facial and periorbital edema, and a masklike affect. It can also include coarse, sparse hair, but not new or extra hair.
What would the nurse include in culturally competent care when exploring treatment options for a newly diagnosed diabetic patient? Tell the patient they have limited food options, and must make selections from a standardized list Explore influences of culture on food choices and meal planning, and consider the patient's cultural food preferences when teaching about nutrition Tell the patient they must permanently eliminate their favorite meal from their diet. Inform the patient that they will never be able to enjoy their family's traditional sweets again.
Answer: B: page 1125
A nurse needs to calculate the BMI for a patient that is 240 lbs and 5'7". What would the patient's BMI be?
Answer: BMI 37.6 Rational: weight (kg)/ height (m)^2 * 703 or weight (lbs)/ height (in)^2 * 703
A nurse needs to calculate the BMI for a patient that is 240 lbs and 5'7". What would the patient's BMI be?
Answer: BMI 37.6 Rational: weight (kg)/ height (m)^2 or weight (lbs)/ height (in)^2 * 703
Haylie Sigmon The nurse is teaching a newly diagnosed type II diabetic how to administer insulin. Which of the following statements by the nurse are correct? (SATA) "Should rotate sites of injection to allow for better absorption of insulin." "You should always administer insulin at a 45 degree angle." "Roll the insulin pen in your hand 10-20 times to warm the insulin to room temperature before injection." "You should leave the needle in for 5 seconds to ensure insulin is absorbed."
Answer: Correct: A, C, D. Incorrect: Insulin is to be administered at a 90 degree angle. In some cases when a patient is very thin or muscular it is appropriate to administer at a 45 degree angle.
Which of the following statements by the patients is not accurate regarding exercising with diabetes? "Exercise does not have to be rigorous to be effective." "I will choose exercises that I like to do." "It is best to exercise in the morning before breakfast." "It is important that my shoes fit properly when exercising."
Answer: Correct: C, the best time to exercise for diabetics is after meals when glucose levels are rising. Incorrect: A, B, D, these are all correct statements.
1. What are the clinical manifestations for hyperthyroidism? SATA. a. Lethargy and fatigue b. Weight gain c. Intolerance to cold d. Diaphoresis e. Weight loss f. Heat intolerance g. Hypertension
Answer: D, E, F, and G. A, B, and C are clinical manifestations of hypothyroidism
When reviewing discharge meds with a patient and going over levothyroxine, the nurse includes which of the following in the education? Distribute the dose evenly among three mealtimes Take the medication with breakfast Take the medication on a full stomach about 30 minutes after dinner Take the medication on an empty stomach about 30 minutes to an hour before breakfast
Answer: D. Synthroid, or levothyroxine, is a thyroid hormone replacement therapy. It should be taken in the morning before breakfast to encourage stable levels of thyroid hormone throughout the day and to keep the medication from causing insomnia at night.
Acromegaly is a disorder caused by an overproduction of which hormone? TSH GH T3 T4
Answer: GH
2. The nurse checks the MAR for her patient and sees that the physician has ordered metformin for the client. What side effects can this medication cause? Choose the best answer. a. Diarrhea b. Constipation c. Metabolic alkalosis d. Adverse cardiovascular events
Answer: The answer is A. Metformin can cause diarrhea. B and C are not correct. D is also not correct; the drug rosiglitazone (Avandia) is in the Thiazolidinediones drug category and can cause adverse cardiovascular events such as MI.
True or False: Growth Hormone, Thyroid-Stimulating Hormone, and Prolactin levels peak during sleep. True False
Answer: True, page 1090 in 11th edition book
2. What are the differences between Type1 and Type2 Diabetes? Fill in the blank
Answer: Type one is a genetic disorder, often developed at a young age in which insulin is not produced or is produced in very low quantities. Type two can also have a genetic factor but it's often triggered by environmental factors such as sedentary lifestyle, and poor diet.
The nurse knows the proper ordering of self monitoring of blood glucose in patient teaching would be: Wash hands and have a dry finger before puncturing Record results and compare with personal target goals Warm hands in warm water or let arms hang dependently for a few mins before finger puncture is made Follow instructions on monitor for checking blood Use the side of your finger to lance Set a lancing device to make sure the puncture is just deep enough to get a drop of blood.
Answer: a, c, e, f, d, b
A patient is having a Water Deprivation study done to differentiate the causes of their Diabetes Insipidus. The patient's nurse would know that during the study it is important to do the following: (SATA). A. Assess urine volume and specific gravity B. Send hourly urine samples to the lab for osmolality determination. C. Send blood samples for sodium and osmolality every 2 hours. D. Maintain fluid intake of 200 ml an hour E. Discontinue test and rehydrate if weight drops >2kg at anytime
Answers : A, B, C, E. Rationale: Patient is NPO for test. Severe dehydration may occur so close assessment of urine volume, specific gravity and osmolality are vital. Also, serum sodium and osmolality should be assessed every 2 hours. If weight loss >2kg occurs at anytime during the test, discontinue immediately and rehydrated patient.
Mikelah Walters: The nurse knows that manifestations of DKA include: Dehydration Tachycardia Bradycardia Sweet fruity breath Kussmaul respirations
Answers: a,b,d,e
10. The nurse is assessing a client with Graves disease. Which of the might the nurse notice regarding the client's eye appearance upon assessment? (Select the best response) Normal eye appearance Protruding eye appearance Redness of the scleral Yellwoing of the eyelid
B
19. The knowledgeable nurse knows that the causes of ovarian cancer includes which of the following? (select all that apply) first degree relative with ovarian cancer history of breast cancer history of colon cancer history of melanoma history of liver cancers
B
24. A female client presents with amenorrhea and wants to know the cause of it. What is a common cause of amenorrhea? (Select the most correct response) Abnormal uterine bleeding (AUB) Menopause Premenstrual syndrome Dysmenorrhea
B
25. Invasive procedures for BPH include which of the following? TUNA TURP TUVP TUMT
B
47. Which of the following is the correct equation for calculating your patient's BMI? BMI = weight (lbs) / heigh (inches) BMI = weight (kg) / height (meters)^2 BMI = body fat % / height (meters) BMI = height (inches) / weight (ounces)
B
5. The nurse is caring for a client who has a 3mm ovarian cyst that does not appear to be cancerous. What action may be taken for this client? Select the best response watchful waiting and return in 1-2 weeks watchful waiting and return in 4-6 weeks watchful waiting and return in 7-8 weeks watchful waiting and return in 10-12 weeks
B
6. The nurse is learning about CT scans. What is the CT scan used to detect? Tumor color. Tumor size. Tumor weight. Tumor texture.
B
9. The nurse is to administer intermediate NPH insulin. When should the nurse administer this insulin? At breakfast At bedtime At lunch time Before exercise
B
During the prediabetic phase the nurse knows that what is likely occuring with blood glucose levels? Glucose is elevated enough to receive a diagnosis of DM Glucose is elevated but not enough to receive a diagnosis of DM Glucose levels are lower indicating a confirmed diagnosis of DM Glucose levels are balanced but a diagnosis of DM is confirmed.
B
The nurse is assessing a client with Graves disease. Which of the might the nurse notice regarding the client's eye appearance upon assessment? (Select the best response) Normal eye appearance Protruding eye appearance Redness of the scleral Yellwoing of the eyelid
B
The nurse is caring for a client with gestational diabetes. It is very important to educate the client on diet during the preganancy period. How much does gestational diabetes increase the risk for the development of type II DM? ( Select the best response). 10% 63% 55% 22%
B
The nurse is caring for a client with hypopituitarism. The nurse knows that a deficiency of which of the following labs are life threatening regarding hypopituitarism? T3 & T4 TSH & ACTH BUN & Creatinine K2+ & Cl-
B
12. Although the client with cervical cancer often shows no symptoms. Sometimes they produced a clear water discharge that becomes what as the disease progresses? (select all that appy) Discharge stays clear over time. Disharge becomes odorous over time. Discharge becomes darker over time Discharge becomes pink over time Discharge becomes mucousy over time.
B,C
10. The student nurse is studying cancers of the female reproductive system. Which of the following cancers are the ones the student is likely studying? (select all that apply) Prostate cancer Ovarian cancer Endometrial cancer Cervical cancer Testicular cancer
B,C,D
7. When reviewing the drug, metformin, we as nurses need to keep in mind what contraindications? COPD Heart disease Liver disease Kidney disease Asthmatic attacks
B,C,D
19. A client has just been diagnosed with prediabetes. The client asks what they can do to prevent the development of type 2 diabetes. Which of the following factors would the nurse suggest to the client? (SATA) Stay sedentary to prevent complications Monitor blood glucose and A1C Maintain a healthy weight Monitor for diabetic symptoms Make healthier food choices
B,C,D,E
37. The nurse is discussing the causes of SIADH with her patient, she is also teaching about the fluid restrictions for chronic SIADH. What would the nurse be informing about? SATA Fluid restriction of < 500 mL/day Fluid restriction of 800-1000 mL/day Encephalitis/meningitis Small cell lung cancer Thiazide diuretics
B,C,D,E
1. The nurse is performing and assessment of the endocrine system. Which of the following options would the nurse inquire about under the nutritional -metabolic area when inquiring about the client's health history. (SATA) What is your day usually like? What is your current weight? Do you have thinning hair? Do you have changes in activity? Do you have a change in appetite?
B,C,E
A nurse is caring for a patient with Hyperglycemic Hyperosmolar Syndrome. What symptoms could be present in this patient (SATA)? Kussmaul breathing Polydipsia Polyuria Fruity smell on breath
B,C: Kussmaul breathing and a fruity smell on their breath is present in DKA and not HHS
35. The nurse is caring for a client post pituitary surgery. Which of the following are nursing responsibilities for this client's care? (SATA) Teach the client to cough deeply Provide mouth rinses every 4 hours Maintain patient in supine position Monitor for change in LOC Instruct client to lye prone
B,D
A nurse is reviewing the medical record of a client who is menopausal. Which of the following findings should the nurse expect? (Select all that apply) Increased vaginal secretions Decreased bone density Increased HDL level Decreased skin elasticity Increased pubic hair growth Decreased follicle stimulating hormone level
B,D
2. What are the manifestations of a cortisol deficiency or ACTH (adrenocorticotropic hormone) deficiency? SATA Dark dry patches on the skin Weakness and fatigue Higher immune function Diminished body hair in the axillary and pubic regions Headache
B,D,E
8. The nurse receives a new order from the HCP to ensure a cortisol level is drawn on a client. What must be considered when drawing a cortisol level and when should it be drawn? (SATA) Cortisol levels should be drawn in the evening. Cortisol levels should be drawn in the morning. Cortisol never increases during any part of the day. Cortisol levels tend to be higher in the morning. Cortisol levels tend to be lower in the evening.
B,D,E
A nurse in a provider's office is obtaining a history from a client who is undergoing evaluation for benign prostate hyperplasia (BPH). The nurse should identify which of the following are indicative of this condition? (Select all that apply) Backache Frequent urinary tract infections Weight loss Hematuria Urinary incontinence
B,D,E
11. A nurse comes in during hourly rounding to check on their patient and finds them tremoring and complaining of numbness and dizziness. The nurse also notes that the patients' speech is slurred. The nurse knows that these are symptoms of, which of the following? (Select the best response) Hyperglycemia Diabetic Ketoacidosis Hypoglycemia Insulin overdose
C
13. The nurse knows that rapid acting insulins include humalog, novolog, and apidra, she also knows that food should be administered within 15 minutes of insulin administration. What is the onset and the peak of rapid acting insulin? (Select the most correct response) Onset: 12-15 min/ Peak: 2.5-3 hrs Onset : 30 min-1 hr/ Peak: 2.5-5 hrs Onset:10-30 min/ peak: 30min-3 hrs onset : 10-30 min/ Peak 2.5-5 hrs HIDE ANSWER
C
16. The nurse knows that which genetic factors below can contribute to obesity and a slow metabolism? BRCA gene EGFR gene T3/T4 Hormones KRAS gene
C
18. The nurse is teaching about Hashimoto Thyroiditis. The nurse knows which is a hallmark sign? Localized pain Fever Goiter Exopthalamos
C
39. Which of the following statements by the patients is NOT accurate regarding exercising with diabetes? "Exercise does not have to be rigorous to be effective." "I will choose exercises that I like to do." "It is best to exercise in the morning before breakfast." "It is important that my shoes fit properly when exercising."
C
4. During an assessment of a patient with acromegaly, the nurse would expect the patient to report, which of the following? (Select the best response) Infertility Dry, irritated skin body image issues increase in height 2 inches each year.
C
40. A patient has been newly diagnosed with type 2 diabetes. Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease? (Select the best response) Ideal weight Activity level Value system Elimination
C
50. A1C testing measures blood glucose levels over what amount of time? 3 days 1 month 2-3 months 8-9 months
C
7. The goals for diabetic (DM) management are to do which of the following? (SATA) Increase symptoms of DM. Decrease symptoms of DM Prevent progression of DM Prevent long-term DM complications. Prevent hyper and hypoglycemic episodes.
C,D,E
2. Which of the following are positive ways to prevent diabetes? Select all that apply. A. Avoid cigarette smoking and tobacco use B. Limit alcohol consumption to moderate levels C. Drink three 8 oz glasses of juice per day D. Increase exercise levels E. Follow a diet low in fat
Correct Answer: A, B, D, E (Preventing Diabetes box on page 1126)
1. What actions should the nurse anticipate while treating a patient with Leuprolide (Lupron)? Select all that apply. A. Assess patient for pregnancy. B. Monitor patient for dysrhythmias and palpitations. C. Administer the medication with fruit juice only. D. Teach the patient to use nonhormonal contraceptive measures during therapy.
Correct answer: A, B, D. (Drug alert, page 1239)
A nurse is teaching about acromegaly to students. The nurse may include what clinical manifestations of acromegaly? (SATA) Thickening and enlargement of the bony and soft tissues on the face, feet, and head occur. Longer bones in arm & legs Carpal tunnel syndrome Diabetes
Correct: A, C, D A. The excess GH results in an overgrowth of soft tissues and bones in the hands, feet, and face. B. false because the problem develops after epiphyseal closure, the bones of the arms and legs do not grow longer. C. Carpal tunnel syndrome and peripheral neuropathy may be present. D. Since GH antagonizes the action of insulin, glucose intolerance and manifestations of diabetes may occur, including polydipsia (increased thirst) and polyuria (increased urination).
Josie G When reviewing the drug, metformin, we as nurses need to keep in mind what contraindications? COPD Heart disease Kidney disease Liver disease Asthma
Correct: B,C,D - page 112
If a pt is taking the drug metformin, we need to be aware of what side effects? Cough n/v Diahrrea Lactic acidosis HA
Correct: C,D - page 1119 - Also must be held 1-2 days before IV contrast is given and 2 days after
1. A client works the nightshift at a local shopping center. Why would their sleep schedule be an important factor for cortisol lab findings? Select the best response Because they work the nightshift they won't produce cortisol. Blood samples should be taken in the morning when they get off work because they have been up all night Their cortisol levels will be high in the morning and low in the evening Their cortisol levels will be high in the morning and low in the evening
D
29. The rate of continuous bladder irrigation is determined by: Number of clots observed Age of the ciient Reason for ordering CBI Overall color of drainage
D
3. A patient reports they do not consume enough iodine in their diet. What condition are they most susceptible to? Pheochromocytoma Hyperthyroidism Thyroid storm Hypothyroidism
D
38. A patient reports having anxiety, headaches with dizziness, and abdominal bloating occurring before her menstrual periods. Which action should the nurse take first? (Select the most correct response) Recommend NSAIDs such as ibuprofen to control symptoms. Suggest that the patient try exercise to relieve her symptoms. Teach the patient about lifestyle changes to reduce premenstrual syndrome (PMS) symptoms. Ask the patient to keep track of her symptoms in a diary for 3 months.
D
8. The knowledgeable nurse understands that which of the following is a rapid acting insulin? Novolin R Glargine Humilin R Lispro
D
A patient reports they do not consume enough iodine in their diet. What condition are they most susceptible to? Pheochromocytoma Hyperthyroidism Thyroid storm Hypothyroidism
D
27. What risk factors occur with Estrogen deficiency? SATA Rheumatoid arthritis Diabetes Mellitus Osteoarthritis Osterperosis Arteriosclerosis
D,E
7. There is no specific preparation for drawing a TSH, T3, or T4 on a client? ( True or False)
TRUE, CHECK ANSWER
The nurse understands that all of the following are signs and symptoms of pituitary hypofunction except: vision changes Headache Increased sense of smell N/V Seizures
The answer is C; it actually causes a loss of smell
A patient is post-opt from a thyroidectomy. The surgical site is clean, dry and intact with no excessive swelling noted. What position is best for this patient to be in? Fowler's Prone Trendelenburg Semi-Fowler's
The answer is D: Semi-Fowler's The patient should expect some hoarseness for 3 or 4 days after surgery because of edema. Keep the patient in a semi-Fowler's position and support the patient's head with pillows.
Leena Durkin A diabetic client is taking Amaryl. Why would you want to hold this medication before surgery?
The client is most likely NPO for surgery. Administering their regular dose of Amaryl prior to surgery while they are also NPO increases their chance of becoming Hypoglycemic.
A client has been informed he has pre-diabetes if lifestyle modifications fail to work for this client then what is this client at risk for developing __________________________?
Type. II DM
The nurse on the endocrine floor knows to monitor which labs for thyroid dysfunction in hypothyroidism and hyperthyroidism? (Marisol) p. 1157 Serum TSH & free T4 Total serum T3 & T4 Thyroid peroxidase (TPO) antibodies Serum ALT & AST- wrong (these are for liver fxn) Hbg A1c- wrong- (these are for glucose/diabetics)
a,b,c
The nurse taking care of a patient with hypothyroidism knows the importance of health management, what would she educate the patient in relation to drug therapy? SATA (Marisol) p. 1158 You only will take the medication for one month--- wrong (it is a life-long med) Take the thyroid hormone medication in the morning Take the thyroid medication before eating There is no need for follow-up care- wrong-- (needs regular follow-up) Our thyroid hormone levels will need to be monitored
b,c,e