FNP Review Dunphy-Chapter 17 Endocrine and

FNP Review Dunphy-Chapter 17 Endocrine and Metabolic Problems Latest Update 2025-2026 170 Questions and 100% Verified Correct Answers Guaranteed A+ A 35-year-old client presents with a fasting plasma glucose of 118 mg/dL and a HbA1C of 5.7%. Which of the following statements is true about these measurements?

• The client has prediabetes
• The client has diabetes mellitus
• The client has metabolic syndrome

D. The client has normal FPG and HbA1C - CORRECT ANSWER: A

A client presents with clinical manifestations of hyperthyroidism. The differential diagnoses include Graves' disease and subacute thyroiditis. Which of the following findings is consistent with subacute thyroiditis?

• a 24 hour radioactive iodine uptake (RAIU) demonstrating increased uptake
• a 24 hour radioactive iodine uptake demonstrating decreased uptake
• a 24 hour RAIU demonstrating a "cold" nodule

D. a fine-needle aspiration is required for diagnosis - CORRECT ANSWER: B

A client with diabetes complains of paresthesias. Which of the following medications can cause sensory changes?

• Glipizide
• Sitagliptin (Januvia)
• Metformin

D. Exenatide (Byetta) - CORRECT ANSWER: C

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A client with diabetes on a sulfonylurea and metformin with an HbA1C of 6.5% is complaining of episodes of low blood sugar. Which of the following changes would be the most appropriate?

• Decrease the dosage of metformin
• Discontinue the metformin
• Increase carbohydrate intake

D. Decrease the dosage of the sulfonylurea - CORRECT ANSWER: D

A client with diabetes presents with a medication list that includes lisinopril and losartan.Which of the following statements is true regarding this combination?

• additional blood pressure and renal benefit is gained using an ACE inhibitor and ARB
• This combination will lead to excessive lowering of the potassium
• this was probably a provider error or patient misunderstanding
• combination therapy is recommended for patients with hypertension - CORRECT

ANSWER: C

A client with Graves' disease is prescribed a beta-adrenergic antagonist. Which of the following comorbid conditions will be exacerbated with the initiation of the propranolol?

• tachycardia
• hypertension
• hyperlipidemia

D. asthma - CORRECT ANSWER: D

A client with hyperthyroidism presents with a complaint of a "gritty" feeling in her eyes.Over the past week, her visual acuity has diminished, and her ability to see colors has changed. She also has a feeling of pressure behind her eyes. The next step for the nurse practitioner is to

• order a thyroid ultrasound
• refer the client for immediate evaluation by an ophthalmologist
• order a total T4 2 / 4

D. prescribe a beta-adrenergic blocker - CORRECT ANSWER: B

A client with type 2 diabetes is on the maximum dosage of three oral antidiabetic agents, and the HbA1C remains at 8.5%. The practitioner initiates basal insulin. Which of the following would be an appropriate order?

• Insulin glargine (Lantus) 10 units nightly
• Insulin detemir (Levemir) 10 units before each meal
• Insulin aspart (NovoLog) 10 units before each meal

D. Regular insulin before each meal - CORRECT ANSWER: A

A fetus with intrauterine growth retardation (IUGR) is prone to hypoglycemia at birth because of

• an imbalance in insulin-glucagon secretion resulting from hyperinsulinemia from islet

cell hyperplasia

• few carbon stores in the form of glycogen and body fat

C. an inborn error of metabolism: glycogen storage disease

D. a complication of birth asphyxia - CORRECT ANSWER: B

A low TSH can lead to

• osteoporosis
• weight gain
• bradycardia

D. brittle hair - CORRECT ANSWER: A

A newly diagnosed client with diabetes who has an HbA1C of 7.5 is started on therapeutic lifestyle changes (TLCs) and medical nutritional therapy (MNT). Which oral antidiabetic agent is recommended as monotherapy?

• Glipizide (Glucotrol)
• Sitagliptin (Januvia) 3 / 4

• Exenatide (Byetta)

D. Metformin (Glucophage) - CORRECT ANSWER: D

ACE inhibitors are given to clients with diabetes who have

• an elevated glycohemoglobin level
• insulin sensitivity
• persistent albuminuria

D. an elevated serum creatinine level - CORRECT ANSWER: C

After a subtotal thyroidectomy, it is crucial to assess

• Heart tones.
• For peripheral edema.
• Speaking ability.

D. Skin turgor. - CORRECT ANSWER: C

After an oral cholecystogram, Sam complains of burning on urination. This is because of

• a mild reaction to the contrast medium
• biliary obstruction
• contraction of the gallbladder

D. the presence of dye in the urine - CORRECT ANSWER: D

After establishing clinical and biochemical euthyroidism after a thyroidectomy, you should perform a measurement of the serum thyroid-stimulating hormone (TSH) level every

• 3 months
• 6 months
• 1 year
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