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

Why should people with diabetic neuropathy avoid walking barefoot?

1. AInsulin is absorbed less well from the feet and the legs
2. BThey may not feel an injury, so it can go unnoticed
3. CWalking barefoot raises the blood glucose
4. DBare feet lose too much heat through the skin

Which head position is generally used for a patient with raised intracranial pressure?

1. AHead lower than the body (Trendelenburg)
2. BHead raised to about 30°, with the neck straight
3. CLying flat, with the head turned well to one side
4. DSitting upright, with the neck bent forward

What is spinal shock?

1. AA very low blood pressure caused by blood loss after trauma
2. BA severe allergic reaction to spinal anaesthetic
3. CA temporary loss of reflexes and tone below a spinal cord injury
4. DA permanent loss of feeling in both hands only, from nerve damage

A patient taking dapagliflozin (an SGLT2 inhibitor) is vomiting, with blood ketones of 4.5 mmol/L but a glucose of only 11 mmol/L. What should be suspected?

1. AHypoglycaemia caused by the vomiting
2. BEuglycaemic diabetic ketoacidosis
3. CA normal side effect needing no action
4. DHyperosmolar hyperglycaemic state

In the first trimester of pregnancy, why is propylthiouracil often preferred to carbimazole for hyperthyroidism?

1. APropylthiouracil works faster than any other drug
2. BCarbimazole has a higher risk of birth defects early on
3. CPropylthiouracil has no side effects at all
4. DCarbimazole cannot cross into the mother's blood

A patient with a right-hemisphere stroke ignores food on the left side of the plate. What is this called?

1. ALeft-sided neglect
2. BCerebellar ataxia
3. CExpressive aphasia
4. DDysphagia

A patient with Parkinson's disease is nil by mouth after abdominal surgery. Their levodopa is due. What is the best action?

1. AGive the tablets with a sip of water anyway
2. BContact the prescriber or pharmacist about another route
3. COmit the dose until the patient can swallow again
4. DGive double the dose once eating restarts

A patient with a brain tumour on high-dose dexamethasone has a capillary glucose of 16 mmol/L (288 mg/dL). They have no history of diabetes. What is the best explanation?

1. AA lab error, because steroids lower blood glucose
2. BNormal for this patient, so no action is needed
3. CSteroid-induced hyperglycaemia, which needs monitoring and treatment
4. DA sign that the brain tumour has now spread to the pancreas