Hypothyroidism and Diabetes Management

An APN is assessing an older adult diagnosed with Alzheimer's disease. Which of the following manifestations is LEAST likely to be seen in this client?

How does delirium differ from dementia?

Which of the following is NOT a typical characteristic of delirium in an elderly patient?

When treating an older adult with Alzheimer's disease, which class of medications offers the most benefit for cognitive symptoms?

When managing a patient with dementia, what benefit do cholinesterase inhibitors provide?

Which test would be most appropriate for the initial assessment of an elderly patient presenting with memory problems, specifically to gather insight on the patient's abilities at home?

Which of the following assessments is LEAST likely to be included as part of the nurse practitioner’s assessment for Alzheimer's disease?

A 60-year-old patient with moderate cognitive deficits due to Alzheimer's disease has been started on a cholinesterase inhibitor. What best describes the primary goal of this medication in this scenario?

Which laboratory assay is most sensitive for screening an ambulatory patient for primary hypothyroidism?

Bariatric surgery is generally recommended for patients with what condition?

Which of the following is NOT a diagnostic criterion for metabolic syndrome?

In patients with metabolic syndrome, what would be an expected finding?

Meglitinide analogs (Prandin) are used in type 2 diabetes to minimize the risk of what?

An Advanced Practice Nurse (APN) is determining the appropriate T4 replacement dosage for a 35-year-old hypothyroid woman. Which patient factor is MOST critical for the APN to consider in order to establish a euthyroid state?

A 40-year-old patient with newly diagnosed type 2 DM is on metformin 1000 mg BID, but their latest HbA1c is 8.1%. What is the most appropriate next step?

A patient is suspected of having hypothyroidism. Which of the following laboratory findings is MOST indicative of this condition?

In the progression of hypothyroidism, which change in hormone levels typically occurs FIRST?

An active 72-year-old patient with type 2 DM is on metformin 500 mg BID with HbA1c of 7.4%. The patient feels well and has no symptoms. What would you recommend?

A 42-year-old diabetic patient is on metformin and a sulfonylurea with well-controlled HbA1c of 6.5%, but is complaining of dizziness and low blood sugar episodes. Which change is most appropriate?

After initiating thyroid replacement therapy, when is the OPTIMAL time to measure TSH levels to assess the effectiveness of the treatment?

A 75-year-old patient, weighing 155 pounds and with no significant medical history, is diagnosed with hypothyroidism. Which of the following is the MOST appropriate initial starting dose of levothyroxine?

A 70-year-old woman presents with weight loss, palpitations, and constipation. Her TSH is 0.03 mIU/L (reference range: 0.4-4.0 mIU/L) and free T4 is 33 pmol/L (reference range: 9-25 pmol/L). What is the MOST appropriate next step in evaluating her thyroid function?

A patient with known hypothyroidism has been stable on levothyroxine for several years. They start taking an iron supplement for iron deficiency anemia. How should their levothyroxine dosage be adjusted?

Which of the following symptoms, if present in a patient already diagnosed with hypothyroidism and on thyroid replacement therapy, would raise suspicion for poor medication adherence or inadequate dosage?

Why is Metformin typically discontinued before and after a procedure involving contrast dye?

A newly diagnosed 120 kg type 1 diabetic patient is being started on insulin. Which of the following is the MOST appropriate initial daily insulin dose?

Which test is LEAST useful in the initial evaluation of a patient newly diagnosed with type 2 diabetes?

An appropriate intervention for microalbuminuria in a patient with diabetes mellitus includes which of the following?

Early morning hyperglycemia without preceding nocturnal hypoglycemia is BEST described as what phenomenon?

How often should Hemoglobin A1c (HbA1c) be tested in patients with well-controlled diabetes?

A diabetic patient on insulin experiences elevated morning blood sugar levels despite increased insulin dosages. Nighttime glucose monitoring reveals hypoglycemia at 3:00 AM. How should this phenomenon be managed?

A primary care nurse practitioner is deciding on an initial pharmacological treatment for an older adult male with Alzheimer's disease. Which class of medication is the most appropriate first choice?

When managing a patient with dementia, which outcome is most likely to be achieved with Cholinesterase inhibitors?

A 65-year-old male is seen for a checkup. Which intervention represents secondary prevention in this patient?

What type of assessment provides information on the functional performance of complex activities in an elderly patient presenting with memory problems?

Which of the following is LEAST likely to be included as part of a standard nurse practitioner's assessment for Alzheimer's disease?

When evaluating a patient for dementia, which initial tests are the MOST appropriate to include?

A 60-year-old patient with moderate cognitive deficit due to Alzheimer's disease is started on a cholinesterase inhibitor. What is the primary purpose of this medication?

A patient presents with an elevated thyroid-stimulating hormone (TSH) level and a normal thyroxine (T4) level. Which condition is the MOST likely diagnosis?

Which of the following are established criteria for the diagnosis of type 2 diabetes mellitus?

A 72-year-old male with hypertension is prescribed amlodipine 5mg daily, lisinopril 5mg daily, and enalapril 5mg daily. Which guideline, applicable to this regimen according to Beers and STOPP criteria, would prompt consideration of deprescribing a medication?

An 81-year-old patient on seven medications is suspected of medication non-adherence due to forgetfulness. What is the MOST effective initial intervention?

A 78-year-old patient scores 22 on an MMSE during an annual physical. How should this result be interpreted?

A 76-year-old male received a Td immunization six years ago and a flu shot in November. He has no record of other vaccinations. Which TWO immunizations should the nurse practitioner recommend?

An 80-year-old woman has experienced two falls in the past year. Which of the following is the MOST appropriate initial intervention for fall prevention?

A nurse practitioner is discussing fall prevention with a 70-year-old patient. Which statement by the patient indicates a need for further teaching?

A nurse practitioner is evaluating a 77-year-old woman who recently had an unwitnessed fall. The patient reports no mobility limitations or obvious risk factors, stating, "I suddenly found myself on the floor" and did not attempt to break the fall. This statement MOST strongly suggests:

An APN is assessing an older adult diagnosed with Alzheimer's disease. Which assessment finding is MOST indicative of the disease progression, rather than other age-related changes?