Fitzgerald Practice Questions Endocrine

The mechanism of action of radioactive iodine in the treatment of Graves' disease is to: A. destroy the overactive thyroid tissue. B. reduce production of TSH. C. alter thyroid metabolic rate. D. relieve distress caused by increased thyroid size.

A. destroy the overactive thyroid tissue.

Laboratory findings in heatstroke usually include: A. elevated total creatine kinase. B. anemia. C. metabolic alkalosis. D. hypokalemia.

A. elevated total creatine kinase.

Which of the following is a possible consequence of obesity? (More than one can apply.) A. obstructive apnea B. steatohepatitis C. female infertility D. endometrial cancer

A. obstructive apnea B. steatohepatitis C. female infertility D. endometrial cancer

Which of the following medications is a helpful treatment option for relief of tremor and tachycardia seen with untreated hyperthyroidism? A. propranolol B. diazepam C. carbamazepine D. verapamil

A. propranolol

Possible adverse outcomes from heatstroke include: A. rhabdomyolysis. B. thrombocytopenia. C. hypernatremia. D. leukopenia.

A. rhabdomyolysis.

The use of which of the following medications is often associated with weight gain? A. risperidone (Risperdal®) B. topiramate (Topamax®) C. metformin (Glucophage®) D. sitagliptin (Januvia®)

A. risperidone (Risperdal®)

Which is following is the least helpful test for the assessment of thyroid disease? A. total T4 B. thyroid-stimulating hormone (TSH) C. free T4 D. thyroid peroxidase (TPO) antibodies

A. total T4

When advising a person who will be using orlistat (Xenical®, Alli®) as part of a weight loss program, the NP provides the following information about when to take the medication: A. within an hour of each meal that contains fat. B. before any food with high carbohydrate content. C. only in the morning, to avoid sleep disturbance. D. up to 3 hours after any meal, regardless of types of food eaten.

A. within an hour of each meal that contains fat.

The most commonly utilized intervention for patients with heatstroke is: A. total body ice packing. B. rehydration. C. management of hyperammonemia. D. electrolyte supplementation.

B. rehydration.

A pound of fat contains approximately _____ stored calories. A. 2500 B. 3000 C. 3500 D. 4000

C. 3500

Periodic routine screening for hypothyroidism is indicated in the presence of which of the following clinical conditions? A. digoxin use B. male gender C. Down syndrome D. alcoholism

C. Down syndrome

Hypothyroidism most often develops as a result of: A. primary pituitary failure. B. thyroid neoplasia. C. autoimmune thyroiditis. D. radioactive iodine exposure.

C. autoimmune thyroiditis.

Physical examination findings in patients with Graves' disease include: A. muscle tenderness. B. coarse, dry skin. C. eyelid retraction. D. delayed relaxation phase of the patellar reflex.

C. eyelid retraction.

Which of the following is the most cost-effective method of distinguishing a malignant from a benign thyroid nodule? A. ultrasound B. magnetic resonance (MRI) imaging C. fine-needle aspiration biopsy D. radioactive iodine scan

C. fine-needle aspiration biopsy

TSH is released by the: A. thyroid follicles. B. adrenal cortex. C. hypothalamus. D. anterior lobe of the pituitary.

D. anterior lobe of the pituitary.

Increased risk of thyroid disorder is found in individuals who are: A. obese. B. hypertensive. C. treated with systemic corticosteroids. D. elderly.

D. elderly.

The action of which of the following is believed to be most responsible for the sensation of satiety? A. norepinephrine B. epinephrine C. dopamine D. serotonin

D. serotonin

In the report of a thyroid scan done on a 48-year-old woman with a thyroid mass, a "cold spot" is reported. This finding is most consistent with: A. autonomously functioning adenoma. B. Graves' disease. C. Hashimoto's disease. D. thyroid cyst.

D. thyroid cyst.

A fixed, painless thyroid mass accompanied by hoarseness and dysphagia should raise the suspicion of: A. adenomatous lesion. B. Graves' disease. C. Hashimoto's disease. D. thyroid malignancy.

D. thyroid malignancy.

Risk factors for heatstroke include all of the following except: A. obesity. B. use of beta-adrenergic antagonists. C. excessive activity. D. use of a vasodilator.

D. use of a vasodilator.

True or False: Phentermine's mechanism of action in weight loss is as a product that reduces gastrointestinal (GI) motility.

FALSE

True or False: In general, weight lost post-gastric bypass is significantly more when compared with the postoperative course of a restrictive procedure such as adjustable gastric band or gastric sleeve.

TRUE

True or False: Lorcaserin (Belviq®) should not be used with medications that have a serotonergic effect.

TRUE

True or False: Phentermine/topiramate (Qsymia®) carries a warning about potential teratogenic effects.

TRUE

True or False: Use of naltrexone/bupropion (Contrave®) is associated with increased risk of suicidal ideation.

TRUE

The commonly recommended physical activity level of 10,000 steps per day is roughly the equivalent of walking ____ miles. A. 1 to 2 B. 2 to 3 C. 3 to 4 D. 4 to 5

D. 4 to 5

At minimum, at what interval should TSH be reassessed after a levothyroxine dosage is adjusted? A. 1 to 2 weeks B. 2 to 4 weeks C. 4 to 6 weeks D. 6 to 8 weeks

D. 6 to 8 weeks

Which of the following is an example of an appropriate question to pose to a person with obesity who is in the precontemplation change stage? A. "How do you feel about your weight?" B. "What are barriers you see to losing weight?" C. "What is your personal goal for weight loss?" D. "How do you envision my helping you meet your weight loss goal?"

A. "How do you feel about your weight?"

You are counseling a patient who is considering gastric bypass surgery for weight loss. You advise the following. (More than one can apply.) A. Calcium absorption will be reduced. B. Rapid weight loss after obesity surgery can contribute to the development of gallstones. C. Chronic constipation is a common postoperative adverse effect. D. Lifelong vitamin B12 supplementation is recommended.

A. Calcium absorption will be reduced. B. Rapid weight loss after obesity surgery can contribute to the development of gallstones. D. Lifelong vitamin B12 supplementation is recommended.

The findings of a painless thyroid mass and TSH level of less than 0.1 IU/mL in a 35-year-old woman is most consistent with: A. autonomously functioning adenoma. B. Graves' disease. C. Hashimoto's disease. D. thyroid malignancy.

A. autonomously functioning adenoma.

Possible consequences of excessive levothyroxine use include: A. bone thinning. B. fatigue. C. renal impairment. D. constipation.

A. bone thinning.

You advise a 58-year-old woman with hypothyroidism about the correct use of levothyroxine. She also takes a calcium supplement. All of the following should be shared with the patient except which instruction? A. "Take the medication on an empty stomach." B. "To help with adherence, take your calcium supplement at the same time as your thyroid medication." C. "You should take the medication at approximately the same time every day." D. "Do not take your medication with soy milk."

B. "To help with adherence, take your calcium supplement at the same time as your thyroid medication."

Which of the following is an example of an appropriate question to pose to a person with obesity who is in the contemplation change stage? A. "How do you feel about your weight?" B. "What are barriers you see to losing weight?" C. "What is your personal goal for weight loss?" D. "How do you envision my helping you meet your weight loss goal?"

B. "What are barriers you see to losing weight?"

In a person with obesity, weight loss of _______ % or more yields an immediate reduction in death rates from cardiovascular and cerebrovascular disease. A. 5 B. 10 C. 15 D. 20

B. 10

With the use of weight loss medications, if the patient has not achieved a 5% weight loss by week ______ of treatment, the therapy should be discontinued. A. 6 B. 12 C. 18 D. 24

B. 12

Obesity is defined as having a body mass index (BMI) equal to or greater than _______ kg/m2. A. 25 B. 30 C. 35 D. 40

B. 30

When counseling about malabsorptive bariatric surgery, the NP provides the following information: A. Most people achieve ideal BMI postoperatively. B. The most dramatic weight losses are seen in the first few postoperative months. C. The death rate directly attributable to surgery is about 10%. D. Weight loss will continue for years postoperatively in most patients.

B. The most dramatic weight losses are seen in the first few postoperative months.

A 48-year-old woman with newly diagnosed hypothyroidism asks about a "natural thyroid" medication she read about online and provides the drug's name: desiccated thyroid. As you counsel her about this medication, you consider all of the following except: A. this product contains a fixed dose of T3 and T4. B. the medication is a plant-based product. C. its pharmacokinetics differ significantly when compared to levothyroxine. D. the majority of the study on treatment for hypothyroidism has been done using levothyroxine.

B. the medication is a plant-based product.

As part of an evaluation of a 3-cm, round, mobile thyroid mass, you obtain a thyroid ultrasound scan revealing a fluid-filled structure. The most likely diagnosis is: A. adenoma. B. thyroid cyst. C. multinodular goiter. D. vascular lesion.

B. thyroid cyst.

In prescribing levothyroxine therapy for an elderly patient, which of the following statements is true? A. Elderly persons require a rapid initiation of levothyroxine therapy. B. TSH should be checked about 2 days after dosage adjustment. C. The levothyroxine dose needed by elderly persons is 75% or less of that needed by younger adults. D. TSH should be suppressed to a nondetectable level.

C. The levothyroxine dose needed by elderly persons is 75% or less of that needed by younger adults.

Identify each of the following findings as associated with hyperthyroidism, hypothyroidism, or both: heat intolerance smooth, silky skin Goiter frequent, low-volume, loose stools secondary hypertriglyceridemia amenorrhea or oligomenorrhea coarse, dry skin menorrhagia hyperreflexia with a characteristic "quick out-quick back" action at the patellar reflex proximal muscle weakness

heat intolerance: Hyperthyroidism smooth, silky skin: Hyperthyroidism Goiter: Both frequent, low-volume, loose stools: Hyperthyroidism secondary hypertriglyceridemia: Hypothyroidism amenorrhea or oligomenorrhea: Hyperthyroidism coarse, dry skin: Hypothyroidism menorrhagia: Hypothyroidism hyperreflexia with a characteristic "quick out-quick back" action at the patellar reflex: Hyperthyroidism proximal muscle weakness: Hyperthyroidism