Med-surg: neuro, endocrine & renal worksheet with answers

Which symptoms are typical of a prolactinoma in a woman?

1. AVery dark skin creases and a craving for salt
2. BMilky nipple discharge and irregular periods
3. CKidney stones, bone pain and constipation
4. DWeight loss with heat intolerance and a fine tremor

What is the most important risk factor for bladder cancer?

1. AFrequent urinary infections in childhood
2. BDrinking a lot of water
3. CA diet high in fruit
4. DSmoking

Which isolation precautions are used for a patient with suspected meningococcal meningitis?

1. ADroplet precautions until about 24 hours of effective antibiotics
2. BNo extra precautions, because it is not infectious
3. CContact precautions only, with gloves for skin contact
4. DAirborne precautions in a negative pressure room for 2 weeks

A patient on insulin asks about drinking alcohol. Which advice is correct?

1. AAlcohol raises glucose, so extra insulin should be taken first
2. BAlcohol can cause hypos, even the next day, so eat carbs with it
3. CAlcohol has no effect on blood glucose in people with diabetes
4. DAlcohol should replace a meal on the days it is drunk

Which approach helps most when talking to a patient with expressive aphasia?

1. AAsk questions that can be answered with yes, no or a gesture
2. BAvoid talking to them until their speech has recovered
3. CSpeak louder, because the patient cannot hear well
4. DFinish their sentences quickly to save them effort

Why do patients with CKD often take phosphate binders with meals?

1. AThey replace the missing hormone erythropoietin
2. BThey lower blood potassium by binding it in the gut
3. CThey bind food phosphate that the kidneys cannot excrete
4. DThey increase the absorption of phosphate from food in the gut

A patient with acute ischaemic stroke is not a thrombolysis candidate. On day 1 the BP is 190/100 mmHg with no other emergency. What is generally appropriate?

1. AGive nitrate spray every 5 minutes until below 120 mmHg
2. BLie the patient flat and give a large fluid bolus
3. CLower it rapidly to 110/70 mmHg with IV drugs
4. DAvoid aggressive lowering and follow the stroke team's targets

An older patient with type 2 diabetes has glucose 48 mmol/L, osmolality 365 mOsm/kg, no significant ketones and confusion. What is the first priority?

1. AA large IV insulin bolus to bring glucose to normal within an hour
2. BOral glucose to prevent hypoglycaemia during treatment
3. CCareful IV fluids with close checks of osmolality, sodium and glucose
4. DStrict fluid restriction to avoid cerebral oedema