Metabolic and Endocrine 2010

Minimum Passing Grade: 75%

There are 50 questions in this exam. You have 1 hour to finish the exam. There are
8 metabolic and endocrine questions in the NPTE. 2 questions for Clinical
Application, 1 for Examination, 3 for Differential Diagnosis, 2 for Intervention.

Time Allowed for Exam: 1 hrs 0 mins

1.Your patient complains that she feels anxious and shaky. You see in her chart that she
has diabetes. She has an elevated heart rate and is perspiring excessively. What is
happening to your patient?
a) Her blood sugar is dropping
b) Her blood sugar is rising
c) She is dehydrated
d) She needs oxygen

2.Your patient is diagnosed with stage 4 pancreatic cancer. The physician told the
patient that he has less than 6 months to live. All of the following are appropriate
interventions except:
a) Provide a message of hope tempered with realism.
b) Avoid relaying information to the patient that might make your patient worry.
c) Lay adequate groundwork or preparation for expected changes.
d) Help to re-establish personal dignity and self-worth.

3.Your patient has a blood glucose level of 260mg/dL. What is your best course of
action?
a) continue therapy; no modifications necessary.
b) postpone therapy and consult with the nurse as soon as possible.
c) give him orange juice or candy
d) continue therapy but monitor closely

4.Your patient who is terminal ill, insists that he is fine. He even jokes about himself and
is not motivated to participate in treatment. Which stage of dying is your patient in?
a) Denial
b) Repression
c) Projection
d) Displacement

5.Grief is a normal process being experienced after bearing a significant loss of loved
one. What characteristic of grief process exhibits fatigue, sighing, hyperventilation,
anorexia and insomnia?
a) Phobia
b) Panic
c) Somatic symptoms
d) Paranoia

6.Your patient manifests continued repetition of a movement, word or expression. He

states that he gets stuck and repeats the same activity over and over again. What do
you call this condition?
 a) Dysrhythmias
b) Seizure
c) Perseveration
d) Catatonia

7.Which of the following symptoms is not true for posttraumatic stress disorder?

a) Re-experiencing the traumatic event.

b) Psychic numbing with increased responsiveness
c) Detachment from the external world, and survival guilt
d) Exaggerated autonomic arousal

8.Your patient just came back from Afghanistan. He stated that half of his troop was
killed in a crossfire. What type of disorder is caused by exposure to a traumatic event
that produces a variety of stress-related symptoms?
a) Posttraumatic stress disorder
b) Anxiety disorder
c) Adrenal disorder
d) Thyroid disorder

9.Personality behaviors are patterns of thinking, responding, and recognizing that are
relatively stable in various situations. What category of adapting mechanism has a
tendency of covering up a weakness by stressing a desirable or strong trait?
a) Compensation
b) Repression
c) Displacement
d) Denial

10.This state is characterized by severe sadness which interferes with function and
decreased interest or pleasure in activities. Which state of psychiatric conditions
demonstrates altered mood characterized by morbid sadness, dejection and sense of
melancholy?
a) Depression
b) Anxiety
c) Hypotension
d) Ataxia

11.Your patient tells you that she was molested by her uncle when she was 8 years old.
When you ask her about this event, she cannot recall the place, when it happened and
all the circumstances about the event. This adaptive mechanism is called:
a) Compensation
b) Denial
c) Repression
d) Regression

12.Your patient's MRI has revealed a pituitary tumor. The physician stated that this
caused your patient to develop Cushing's Syndrome. All of the following are signs of
cushing's syndrome except?
a) Muscular atrophy
b) Obesity
c) Round moon face
 d) Increased glucose tolerance

13.Male patient presents with history of Parkinson disease, seen by physician the patient
states that his the patients mobility is giving him some concerns, especially with being at
risk for falling. What is the pathophysiologic cause of this condition ?
a) Decrease in the hormone epinephrine.
b) Decrease in the hormone serotonin.
c) Decrease of the hormone dopamine.
d) Decrease in the hormone histamine.

14.Irene 72 year old, diagnosed with diabetes type 2. What can cause this condition?
a) Smoking.
b) Obesity.
c) Alcohol.
d) Poor diet.

15.Your patient has a diagnosis of diabetes mellitus. The nurse stated that your patient's
blood glucose level is high. Which of the following symptoms do you expect to find?
a) Excessive thirst, urination.
b) Nausea and vomiting.
c) Pyrexia, hypotension.
d) Blurred vision, dizziness.

16.You are treating an infant with a diagnosis of Taysachs Disease. What developmental
milestone is affected in children ?
a) Sensory perception.
b) Mental ability.
c) Motor and cognitive skills.
d) Hormone growth.

17.Gestational diabetes is a temporary condition that occurs during pregnancy.

Gestational diabetes affects two to four percent of all pregnancies and involves an
increased risk of developing diabetes for both mother and child. Which stage of
pregnancy (in weeks) is gestational diabetes usually diagnosed?
a) 18th - 22nd
b) 24th - 28th
c) 30th -32nd
d) 34th -36th

18.Osteoporosis is a progressive disease that is found in both male and females over
the age of fifty. What is the most accurate testing tool?
a) Blood test.
b) Bone density.
c) x-ray.
d) CT scan.

19.Jackie 50 year old, presents with concerns over the changes on her breast,
especially around the nipple. The physician examines and diagnoses Paget's disease of
the breast. Which is the best diagnostic tool for this condition?
a) chest x-ray
b) Mammogram
 c) CT scan
d) Surgery

20.What is the common term for severe hypothyroidism with symptoms of swelling of
hands, feet and face that can lead to coma and death?
a) Thyrotoxicosis
b) Myxedema
c) Neuropathy
d) Neuropathy Retinopathy

21.Which type of adrenal disorder results from prolonged steroid therapy and rapid
withdrawal of drugs?
a) Secondary adrenal insufficiency
b) Glucocorticoid
c) Adrenal corticoids
d) Addison�s disease

22.Which syndrome related to metabolic and endocrine results to partial or complete

failure of adrenocortical function and decreased production of cortisol and aldosterone?
a) Thyroid disorder
b) Hypertension
c) Adrenal disorder
d) Retinopathy

23.Which type of diabetes mellitus results from inadequate utilization of insulin and also
known as adult-onset?
a) Metabolic syndrome
b) Type I
c) Type II
d) Secondary diabetes

24.This type of disease is a syndrome of disordered metabolism and usually a

combination of genetic and ecological causes resulting to high blood sugar levels. What
type of disorder is being described which causes a complex disorder of carbohydrate, fat
and protein metabolism due to absence of insulin secretion?
a) Adrenal disorder
b) Pituitary disorder
c) Diabetes mellitus
d) Lipid disorder

25.Diabetes can cause blindness due to changes in the blood vessels of the retina.
What is this syndrome associated with diabetes that causes retinal damage?
a) Dyslipidemia
b) Retinopathy
c) Hypoglycemic coma
d) Hyperglycemic coma

26.Your patient suffered a major thermal burn. You are positioning your patient when
your patient complains of syncope. This is a result of:
a) Intravascular hypovolemia
 b) Shock
c) Orthostatic hypotension
d) Severe pain

27.You are treating a patient diagnosed with hepatitis B, you should avoid direct contact
with:
a) any part of the patient
b) patient's blood
c) droplet spray from patient's coughing
d) patient's hands

28.You initiated a scoliosis screening program for your local school. It would be best to
assess:
a) 2nd and 3rd graders
b) 4th and 5th graders
c) 6th and 7th graders
d) 8th and 9th graders

29.You are treating a patient diagnosed with Lyme Disease. Your patient tells you that
she has been suffering from arthritic changes for 1 year already. You should focus on:
a) small joints of the hands and feet
b) the knees
c) lumbosacral spine
d) cervical and thoracic spine

30.The parent of 27 month old boy complains that her kid was slightly delayed in
walking, and is currently just beginning to talk. He also has a slight "wandering eye" in
which at times he becomes cross-eyed. As you evaluate the patient, you expect all of
the following except:
a) Eyes align in the same direction
b) Vision loss in one eye, includes a loss of the ability to see in 3-D
c) Uncoordinated eye movements
d) loss of depth perception

31.You are ambulating a patient when she lost her balance and sustained a deep wound
on the lateral thigh. Where should you apply pressure to control bleeding?
a) profunda femoris artery
b) lateral thigh
c) lateral malleolus
d) fermoral triangle

32.The APGAR score of a new born after birth is 6. Four minutes later, it is 9. What do
you expect?
a) require intubation
b) Heart rate greater than 100 beats per minute; good respiration
c) heart rate less than 100 beats per minute; good respiration
d) require resuscitation
33.You are working in a nursing home. You took off for one week and when you came
back, you saw on the chart that your patient is exhibiting decerebrate posturing. You
recommend:
a) that the patient stays in the nursing home
b) that the patient should be transferred to an acute care hospital immediately
c) that the patient should go home
d) that the patient be placed in hospice care

34.You are working in a neonatal setting. You noticed that the new born is in supine. His
position is as follows: shoulders abducted and externally rotated; elbows flexed; hips
abducted and externally rotated; knees flexed. This would indicate:
a) flexor tone synergy
b) extensor tone synergy
c) normal tone
d) flaccid tone

35.To prevent contractures in the anterior neck of a burn patient, the neck should be
positioned in:
a) flexion
b) extension
c) neutral
d) slight rotation
36.You are treating a patient who is undergoing estrogen replacement therapy. This
patient is susceptible to:
a) blood clots
b) mood swings
c) heart disease
d) weight gain

37.You are instructing the parents of a 1 year old baby to perform stretching. The baby
has clubfoot. The parents should stretch in the direction of:
a) plantarflexion and inversion
b) plantarflexion and eversion
c) dorsiflexion and inversion
d) dorsiflexion and eversion

38.You are treating a patient when you noticed his wound. It has a yellow/green
discharge and foul smelling. This patient has a wound that is:
a) purulent
b) healing
c) infected with staphylococcus
d) infected with pseudomonas

39.Your 85 year old patient is s/p rotator cuff repair. This is your fifth consecutive visit to
your patient. You should contact the primary care physician if your patient:
a) c/o that the surgical site is still painful
b) fails to recognize you
c) is noncompliant
d) shoulder flexion is still 0-50 degrees.
40.You received an order from the medical doctor to perform bronchial hygiene on a
patient diagnosed with cystic fibrosis. You read that this patient suffered acute
respiratory failure as a result of an infection. You should:
a) administer 2x daily
b) administer 3x daily
c) not administer
d) administer once daily

41.You are ambulating a patient when suddenly your patient lost consciousness and fell.
The first thing you should do is:
a) write an incident report
b) notify the physician immediately
c) call Emergency Medical Services
d) check for responsiveness

42.You have a patient diagnosed with Benign Paroxysmal Positional Vertigo. The best
treatment plan would include:
a) Postural stability exercises
b) Canalith repositioning treatment
c) Proprioceptive Training
d) Progressive Resistive Exercises

43.You are scheduled to treat a patient with HIV. You have an open wound. You should:
a) wear gloves
b) refuse to treat the patient
c) treat the patient following universal precautions
d) wear gloves, gown and mask

44.You are treating a young athlete with supracondylar humeral epiphyseal fracture.
Which complication is likely?
a) arrested growth
b) radial nerve palsy
c) malunion
d) infection

45.You are treating a 2 year old patient with spastic diplegia. Relaxation is best
accomplished by:
a) positioning in prone
b) icing
c) slow rocking
d) hot packs

46.You are performing an evaluation on a patient. Here are your findings: hypertrophic
accessory breathing muscles; pain and paresthesia when lifing arms overhead. His job
is a manual laborer which entails mowing lawns. You suspect your patient has:
a) thoracic outlet syndrome
b) brachial plexus neuropathy
c) carpal tunnel syndrome
d) cervical radiculopathy
47.You are treating a patient with developmental delay. Your patient's developmental
level is at 5 months. Intervention would include:
a) rolling from prone to supine
b) rolling from supine to prone
c) pivot prone positioning
d) unsupported sitting

48.Some of our body functions are: digestion, use of nutrients, growth and development,
electrolyte and water balance, and reproductive functions. What body system uses
hormones to relay information to cells and organs and regulate many of the body
functions?
a) Respiratory
b) Metabolic
c) Endocrine
d) Digestive

49.You are performing AROM on the upper extremity of a patient when the IV line has
dislodged. The first thing you should do is:
a) check for responsiveness
b) notify the nurse immediately
c) apply direct pressure to the site
d) elevate the limb

50.Your patient has stage 4 colon CA. He is very angry. Anger can be manifested as all
of the following except:
a) depression
b) projection
c) noncompliance
d) displacement