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An older male adult presents to your clinic after finding a lump in his neck while shaving. Physical exam reveals a firm 2 cm ...and non-tender nodule located on the right lobe of the thyroid gland; right posterior cervical lymphadenopany is also appreciated.

• The patient's thyroid should be immediately ablated with radioactive iodine and he should be referred to an endocrinologist.
• Order a TSH and refer to a surgeon for a fine needle biopsy
• Prescribe levothyroxine 0.25 mg daily with a six week follow up visit
• No interventions are necessary at this time; schedule a six month follow up visit.
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An older male adult presents to your clinic after finding a lump in his neck while shaving. Physical exam reveals a firm 2 cm ...and non-tender nodule located on the right lobe of the thyroid gland; right posterior cervical lymphadenopany is also appreciated.

• The patient's thyroid should be immediately ablated with radioactive iodine and he should be referred to an endocrinologist.
• Order a TSH and refer to a surgeon for a fine needle biopsy
• Prescribe levothyroxine 0.25 mg daily with a six week follow up visit
• No interventions are necessary at this time; schedule a six month follow up visit.
• Order a TSH and refer to a surgeon for a fine needle biopsy
The vegetarian patient with gout asks the clinician about food that he should avoid, The clinician should advise the patient to avoid which of the following foods?

• Rice
• Carrots
• Potatoes
• Spinach
• Spinach
The optimal treatment goal for glycemic control for type II diabetes is:

• Hg A1C of 7.0% to 8.0%
• Hg A1C of less than 10%
• Hg A1C of 4.0% to 60%
• Hg A1C of 6.5% to 7.0%
Hg A1C of 6.5% to 7.0%
Which of the following is essential for diagnosing thyroid cancer?

• Thyroid US
• MRI
• CT
• Fine Needle Biopsy
• Fine Needle Biopsy
A patient with type II diabetes asks the clinician why she needs to exercise, In order to answer her, the clinician needs to have an understanding about the effect exercise has on the on the patients with type II DM?

• Reduces postprandial blood glucose
• All the answers
• Reduces triglycerides and increases high density lipoprotein (HDL)
• Reduces total cholesterol
• All the answers
What is the leading cause of death in the adult diabetic patient?

• Renal failure
• Gangrenous ulcer
• Blindness
• Ischemic Heart disease
• Ischemic Heart Disease
The clinician has been doing diabetic teaching for a patient with type I diabetes. Which of the following statements by the patient indicate that teaching has been effective?

• As long as I don't need glasses, I don't have to worry about going blind.
• My optometrist checks my eyes
• I will see my eye doctor when my vision gets blurry
• I know that I have to have my eyes checked every year
• I know that I have to have my eyes checked every year
Sally is a new patient who is 66 inches in height and weighs 200 lbs. Her fasting plasma glucose level is 200 mg/dl, what is your initial treatment?

• Diet exercise and exogenous insulin
• Diet exercise and oral medications
• Diet and exercise for a 12-week trial
• No tx at this time
• Diet and exercise for a 12-week trial
A patient with type II diabetes comes to your office after reading about metformin in a magazine. Which of the following would be a contraindication for taking metformin?

• Ketoacidosis
• All of the other answers
• Cirrhosis
• Hypoglycemic episodes
• All of the other answers
Obesity is defined as having a BMI equal or greater than ___ kg/m2

• 30
• 40
• 35
• 25
• 30
A patient comes into the clinic with type 1 DM and is complaining of feeling nervous and clammy. He states that that he gave himself insulin but this morning was late for work and did not eat breakfast. Which actions should the clinician take? • Ask him about his eating habits • Have him drink 4-6 oz of juice • Check his serum blood sugar • Call 911• Have him drink 4-6 oz of juiceWhat is the most common cause of ACTH independent cases of Cushing's Syndrome? • Pheochromcytoma • An adrenal tumor • A pituitary tumor • Iatrogenic causes resulting from therapeutic doses of synthetic Glucocorticoids• Iatrogenic cause resulting from therapeutic doses of synthetic Glucorticoids.Mr. S. presents in the clinic with pain tenderness erythema and swelling of his left great toe. The clinician suspects gout, which of the following should the clinician suspect in the initial test results for this patient? • Elevated uric acid level • Decreased urine pH • Elevated BUN • Decreased CRP• Elevated uric acid levelA 45 year old female presents to your office with a six month hx of fatigue, 20 lb weight gain, lethargy, cold, hair loss and constipation. What should the clinician suspect? • Hypothyroidism • DM • CHF • Thyroid cancer• HypothyroidismCalvin is being seen in the office for the first time. He has had diabetes for 10 years, he reports he has never been hypertensive and he would like to know why he is on Vasotec. What do you tell him? • Most clients with diabetes end up with hypertension and we just prevent it • It has been shown that ACE inhibitors also treat insulin resistance • ACE inhibitors reduce albuminuria and slow the progression diabetes • Antihypertensive agents have been shown to prevent the buildup of fatty acids in the blood treat of the client with diabetes and therefore they help prevent strokes.• It has been shown that ACE inhibitors ACE inhibitors reduce albuminuria and slow the progression diabetesJoyce is seen in the clinic complaining of vague symptoms of feeling nervous and irritable, and that her hair will not hold a curl anymore. On physical exam, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis could be which of the following? • Myxedema • Cushing's Syndrome • Pan-hypopituitism • Thyrotoxicosis• ThyrotoxicosisIncreased iodine uptake, hyper vascularity, increased T3 production and thyroid gland enlargement are all hallmark signs of: • Cushing's Syndrome • Cushing's Disease • Graves' Disease • Addisons Disease• Graves' DiseaseThe clinical presentation of type 1 DM includes all of the following except: • Weight gain • Ketosis • Polydipsia • Polyuria• Weight gainWhich of the following laboratory findings should the clinican expect in a patient with untreated Graves disease? • Elevated TSH • Elevated TRH • Elevated T4 • All of the above• Elevated T4An adult male presents to the clinic with complaints of polyuria, polydipsia and weight loss, what lab result would you expect? • A random serum glucose of 150 mg/dl • A fasting serum glucose of 80 mg/dl • An Hg A1C of 6.0 • An Hg A1C of 14%An Hg A1C of 14%The most common cause of hyperthyroidism is: • Thyroid cancer • Graves' disease • Pituitary tumor • Hashimotos dz• Graves' diseaseHow often should the clinician examine the feet of a person with Type 1 diabetes? • Only on initial visit • Once a year • Only when the patient complains of a foot problem • Every visit• Every visitAfter 6 months of synthroid therapy, the clinician should expect which of the following in the repeat TSH? • Low TSH • Undetectable TSH • Elevated TSH • Normal TSH• Normal TSHThe clinican prescribe glipizide for a diabetic patient. Which statement made the patient signifies that teaching has been effective? • I'll take my pill 30 min before I eat • Since I only eat two meals a day, I can take the pill between my meals • It is important to take my medication right after I eat. • I'll take my glipizide before bedtime• I'll take my pill 30 min before I eatThe clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should they have? • Free T3 and T4 • TSH and thyrotoxin antibodies • High sensitivity thyroid stimulating hormone TSH and free T4 • Free T4 and serum calcium• High sensitivity thyroid stimulating hormone TSH and free T4Which of the following is the most likely etiology for hypercalcemia in the medically well, asymptomatic adult patient? • Hyperparathyroidism • Hypothyroidism • Hypopituitarism • Hyperthyroidism• HyperparathyroidismAfter removing a tack from a type 2 diabetic heel, and evaluating the site for infection, what is the best plan for this patient? • Refer to a podiatrist for a foot care tx plan • Send her for acupuncture txs • Suggest the use of a heating pad to improve circulation • All of the above• Refer to a podiatrist for a foot care tx planA diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good, what is the best response? • All of the answers • Monitoring glucose will promote a sense of control • Control of glucose will help postpone or delay complications • It will help establish a routine• All of the answersAlice, age 48, has a benign thyroid nodule. The most common treatment involves: - Surgery - Watchful waiting with an annual follow-up - Radioactive iodine therapy - Administration of levothyroxine therapy- Watchful waiting with an annual follow-upWhich of the following is a sign of hypothyroidism? - A thyroid bruit - Warm, smooth, moist skin - Gynecomastia - Brittle hair- Brittle hairACE inhibitors are given to clients with diabetes who have: - An elevated serum creatinine level - Persistent proteinuria - Insulin sensitivity - an elevated glycohemoglobin level- persistent proteinuriaA newly diagnosed client with diabetes who has an HbA1c of 7.5 is started on therapeutic lifestyle changes (TLC) and medical nutritional therapy (MNT). Which oral antidiabetic agent is recommended as monotherapy? - Sitagliptin (Januvia) - Glipizide - Metformin - Exenatide (Byetta)- MetforminThe patient is 66 inches in height weighing 200 pounds and newly diagnosed with Type 2 diabetes mellitus. Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment? a. No treatment at this time b. Diet and exercise for 6 - week trial c. Diet, exercise and oral medications d. Diet, exercise and exogenous insulinDiet and exercise for 6 - week trialThe clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit? a. High sensitivity thyroid stimulating hormone (TSH) and free T4 b. Free T4 and serum calcium c. Free T3 and T4 d. TSH and thyroxin antibodiesHigh sensitivity thyroid stimulating hormone (TSH) and free T4The patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer her, the clinician must have which of these understandings about the effect exercise has on the patient with type 2 diabetes? a. Reduces postprandial blood glucose b. Reduces triglycerides and increases high-denisty lipoprotein (HDL) c. Reduces cholesterol d. All of the aboved. All of the aboveA patient with type 1 diabetes comes to the clinic and is complaining of feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first? a. Check his blood sugar b. Call 911 c. Have him drink 4 oz of juice d. Ask him about his usual eating habitsHave him drink 4 oz of juiceA patient with type 2 diabetes comes to the clinic after reading about Metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking Metformin? a. Ketoacidosis b. Hypoglycemic episodes c. Cirrhosis d. All of the aboveAll of the aboveA 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical exam, the clinician notices a sinus bradycardia, muscular stiffness, coarse, dry hair, and a delay in relaxation in deep tendon reflexes (DTRs). Which of the following tests should be ordered next? a. Serum calcium b. Electrolytes c. Thyroid-stimulating hormone (TSH) d. Urine specific gravityThyroid-stimulating hormone (TSH)The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been effective? a. "As long as I don't need glasses, I don't have to worry about going blind." b. "I know I need to have my eyes checked every year." c. "My optometrist checks my eyes." d. "I will see my eye doctor when my vision gets blurry.""I know I need to have my eyes checked every year."A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of "my feet feel like they are on fire." He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment? a. Tricyclic antidepressants b. Vitamin B12 injections c. Capsacin cream d. InsulinTricyclic antidepressantsAfter removing a tack from a type 2 diabetic's heel and evaluating the site for infection, what is the best plan for this patient? a. Suggest she use a heating pad to improve circulation b. Refer to a podiatrist for a foot care treatment plan c. Send her for acupuncture treatments d. All of the aboveRefer to a podiatrist for a foot care treatment planJoyce is seen in the clinic complaining of vague symptoms of feeling nervous and irritable and that her hair will not hold a permanent wave anymore. On physical examination, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis should include which of the following conditions? a. Myxedema b. Cushing's syndrome c. Thyrotoxicosis d. Pan-hypopituitarismThyrotoxicosisThe patient is prescribed radioactive iodine (RAI) and asks the clinician how this drug works. The clinician's response should include which of the following data? a. RAI prevents the peripheral conversion of T4 to T3. b. RAI binds free T4. c. RAI destroys thyroid tissue. d. RAI reduces freely circulating iodine.RAI destroys thyroid tissueA patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease? a. Sinus bradycardia b. Supraventricular tachycardia c. Atrial fibrillation d. U wavesSinus bradycardiaAfter 6 months of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? a. Elevated thyroid-stimulating hormone (TSH) b. Normal TSH c. Low TSH d. Undetectable TSHNormal TSHWhich of the following laboratory findings should the clinician expect in a patient with untreated Graves' disease? a. Elevated thyroid-stimulating hormone (TSH) b. Elevated T4 c. Elevated TRH d. All of the aboveElevated T4The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective? a. "I'll take my pill at least 30 minutes before breakfast." b. "I'll take my Glucotrol before bedtime." c. "It is important to take my medication right after I eat." d. "Since I only like to eat two meals a day, I can take the pill between my meals.""I'll take my pill at least 30 minutes before breakfast."A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate? a. "Control of glucose will help postpone or delay complications." b. "It will help establish a routine." c. "Monitoring glucose will promote a sense of control." d. All of the aboveAll of the aboveHow often should the clinician examine the feet of a person with diabetes? a. Once a year b. Every 3 months c. Every 6 months d. Every visitEvery visitThe clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient? a. Overweight b. Moderate obesity c. Mild obesity d. Morbid obesityMild obesityMr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician suspect in the initial test results for this patient? a. Elevated uric acid level b. Decreased urine pH c. Elevated blood urea nitrogen (BUN) d. Decreased C-reactive protein (CRP)Elevated uric acid levelMr. W, 53 years old, is seen in the clinic with concerns about his left foot. He has a 40-year history of type 1 diabetes with "fairly good" control on twice-daily insulin. He denies injury but states that he tripped a few months previous and that his foot is sore when he walks. Physical examination reveals an edematous, erythemic, and warm foot. There is a superficial ulcer on the plantar surface. Which of the following is the most likely diagnosis? a. Fallen arch b. Charcot joint c. Arthritis d. Sprained ankleCharcot jointWhich of the following tests should you order to confirm Mr. W's diagnosis? a. Bone scan b. X-ray of the foot c. Computed tomography (CT) scan d. Culture of the ulcerX-ray of the footThe vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods? a. Rice b. Spinach c. Carrots d. PotatoesSpinachThe clinician should question the patient with suspected gout about use of which of these medications that may be a risk factor? a. Low-dose aspirin b. Ethambutol c. Thiazide diuretics d. All of the aboveAll of the aboveThe clinician finds numerous nodules on the thyroid of a 65-year-old woman. The clinician suspects thyroid cancer. Which of the following information would be most significant for this patient? a. A history of tonsillectomy in the 1940s b. Recent exposure to mumps c. Vegetarian diet d. Allergy to iodineA history of tonsillectomy in the 1940sWhich of the following is essential for diagnosing thyroid cancer? a. Fine needle aspiration b. Computed tomography (CT) scan c. Thyroid ultrasound d. Magnetic resonance imaging (MRI)Fine needle aspirationMinnie is pregnant. She has hypothyroidism and has been on the same levothyroxine medication for years. What might you expect to do with her levothyroxine medication? a. Increase the dosage b. Maintain her established dose c. Decrease her dosage D. Increase the dosage during the first trimester, then decrease it during the second and third trimesters.Increase the dosageMandy has type 2 diabetes. She says she heard that if she becomes pregnant, she must go on insulin therapy. How do you respond? A. "You're under good glycemic control now with your oral agents. As long as you stay in good control, you'll stay on the medication you are on now." B. "Don't worry about it now; wait until you get pregnant." C. "Insulin is commonly used during pregnancy. Some oral agents are now being used." D. "You need to start on insulin therapy now before you get pregnant. You'll also need it throughout your pregnancy.""Insulin is commonly used during pregnancy. Some oral agents are now being used."The most common worldwide cause of hypothyroidism is: A. An autoimmune process. B. Hashimoto's thyroiditis. C. Iodine deficiency. D. Iatrogenic hypothyroidism.Iodine deficiencyMorton has type 2 diabetes. His treatment, which includes diet, exercise, and oral antidiabetic agents, is insufficient to achieve acceptable glycemic control. Your next course of action is to: A. Increase the dosage of the oral antidiabetic agents. B. Add a nighttime dosage of long-acting insulin to the regimen. C. Discontinue the oral antidiabetic agents and start insulin therapy. D. Suggest treatment using an insulin pump.Add a nighttime dosage of long-acting insulin to the regimen.Why is parathyroid hormone secretion increased during pregnancy? A. To meet the increased stress demands on the mother B. To meet the increased requirements for calcium and vitamin D for fetal skeletal growth C. To help prevent neural tube defects in the fetus D. To help promote neurological growth of the developing brain in the fetusTo meet the increased requirements for calcium and vitamin D for fetal skeletal growthJoy has gout. In teaching her about her disease, which food do you tell her is allowed in her diet? A. Asparagus B. Beans C. Broccoli D. MushroomsBroccoliThe following is a client's self-monitoring blood glucose log. The client receives 20 units Novolin 70/30 in the morning (a.m.) and 20 units Novolin 70/30 in the evening (p.m.): Fasting a.m. pre-dinner: 90, 150, 105, 144, 101, 172, 98, 201. What changes would you make? A. Increase the p.m. insulin. B. Increase the a.m. insulin. C. Add NovoLog at bedtime (hs). D. Increase the a.m. and p.m. insulin.Increase the a.m. insulin.An elderly client with hyperthyroidism may present with atypical symptoms. Which of the following manifestations are commonly seen in the elderly with hyperthyroidism? A. Adrenergic findings such as tachycardia B. Weight gain, depression, heat intolerance C. Atrial fibrillation, depression, and weight loss D. Heat intolerance, hyperreflexia, and anorexiaAtrial fibrillation, depression, and weight lossWhich is the only treatment option that is curative for primary hyperparathyroidism? A. Type II calcimimetic cinacalcet B. Hormone therapy C. Parathyroidectomy D. BisphosphonatesParathyroidectomSidney has been taking a sulfonylurea for 5 years to treat his type 2 diabetes. He asks how long he needs to take the medication before he tries another medication. You tell him: A. "Sulfonylureas are usually effective for 7 to 10 years in most clients." B. "You'll probably be on this medication for the rest of your life." C. "After about 5 years, you will need to start on insulin therapy." D. "After a few years, you can stop altogether and just regulate your diabetes with your diet.""Sulfonylureas are usually effective for 7 to 10 years in most clients."Sara has diabetes and is now experiencing anhidrosis on the hands and feet, increased sweating on the face and trunk, dysphagia, anorexia, and heartburn. Which complication of diabetes do you suspect: A. Macrocirculation changes B. Microcirculation changes C. Somatic neuropathies D. Visceral neuropathiesVisceral neuropathiesWhen teaching Marcy how to use her new insulin pump, you tell her that she needs to monitor her blood glucose level: A. At least once a day. B. Only occasionally because glycemic levels are maintained very steadily. C. At least four times a day. D. On an as-needed basis when she feels she needs to give herself an extra dose of insulin.At least four times a day.Which of the following medications can produce gynecomastia? A. Cimetidine (Tagamet) B. Cholesterol-lowering medications C. Beta blockers D. AspirinCimetidine (Tagamet)Dan, age 45, is obese and has type 2 diabetes. He has been having trouble getting his glycohemoglobin under control. He's heard that exenatide (Byetta) causes weight loss and wants to try it. What do you tell him? A. "Let's adjust your oral antidiabetic agents instead." B. "That's a myth. People usually change their eating habits when taking this, and that's what causes the weight loss." C. "With type 2 diabetes, you never want to be on injectable insulin." D. "Let's try it. You're glycohemoglobin will be lowered and you may lose weight.""Let's try it. You're glycohemoglobin will be lowered and you may lose weight."Margie has hypoparathyroidism. Which of the following would you assess during your examination? A. Skin turgor B. Heart tones C. Chvostek's sign D. Homans' signChvostek's signJane has insulin-dependent diabetes mellitus and has been experiencing hyperglycemia before dinner. A possible solution to this problem is to: A. Adjust her morning dose of rapid-acting insulin. B. Increase her midafternoon snack. C. Add physical activity between lunch and dinner. D. Reduce the amount of carbohydrates at dinner.Add physical activity between lunch and dinner.Sandy is being treated for chronic hypocalcemia. When her serum calcium level returns to normal, you assess her urinary calcium level and note that it is greater than 250 mg in a 24-hour sample. This indicates that: A. Her vitamin D dosage should be increased. B. Her vitamin D dosage should be decreased. C. She needs to restrict foods high in calcium. D. She needs to eat more foods high in calcium.Her vitamin D dosage should be decreased.Which of the following serum laboratory findings are present in the client with Cushing's syndrome? A. Increased cortisol, decreased sodium, and decreased potassium levels B. Decreased cortisol, decreased potassium, and decreased glucose levels C. Increased cortisol, increased sodium, and decreased potassium levels D. Normal blood urea nitrogen, increased sodium, and decreased potassium levelsIncreased cortisol, increased sodium, and decreased potassium levelDiane has had Cushing's disease for 20 years and has been taking hydrocortisone since her diagnosis. Today, she appears with a thick trunk and thin extremities. She has a "moon face," a "buffalo hump," thin skin with visible capillaries, and a number of bruises that appear to be slow in healing. To what do you attribute these symptoms? A. Decreased adrenal androgen levels B. Malfunctioning of the adrenal cortex C. Excessive levels of circulating cortisol D. Ectopic secretion of adrenocorticotropic hormoneExcessive levels of circulating cortisolAfter a subtotal thyroidectomy, it is crucial to assess: A. Heart tones. B. For peripheral edema. C. Speaking ability. D. Skin turgor.Speaking ability.An elderly client with hyperthyroidism may present with atypical symptoms. Which of the following manifestations are commonly seen in the elderly with hyperthyroidism? A. Adrenergic findings such as tachycardia B. Weight gain, depression, heat intolerance C. Atrial fibrillation, depression, and weight loss D. Heat intolerance, hyperreflexia, and anorexiaAtrial fibrillation, depression, and weight lossMorton has type 2 diabetes. His treatment, which includes diet, exercise, and oral antidiabetic agents, is insufficient to achieve acceptable glycemic control. Your next course of action is to: A. Increase the dosage of the oral antidiabetic agents. B. Add a nighttime dosage of long-acting insulin to the regimen. C. Discontinue the oral antidiabetic agents and start insulin therapy. D. Suggest treatment using an insulin pumpAdd a nighttime dosage of long-acting insulin to the regimen.Sara has diabetes and is now experiencing anhidrosis on the hands and feet, increased sweating on the face and trunk, dysphagia, anorexia, and heartburn. Which complication of diabetes do you suspect? A. Macrocirculation changes B. Microcirculation changes C. Somatic neuropathies D. Visceral neuropathiesVisceral neuropathiesAn elderly client with hyperthyroidism may present with atypical symptoms. Which of the following manifestations are commonly seen in the elderly with hyperthyroidism? A. Adrenergic findings such as tachycardia B. Weight gain, depression, heat intolerance C. Atrial fibrillation, depression, and weight loss D. Heat intolerance, hyperreflexia, and anorexia FeedbackAtrial fibrillation, depression, and weight lossSidney has been taking a sulfonylurea for 5 years to treat his type 2 diabetes. He asks how long he needs to take the medication before he tries another medication. You tell him: A. "Sulfonylureas are usually effective for 7 to 10 years in most clients." B. "You'll probably be on this medication for the rest of your life." C. "After about 5 years, you will need to start on insulin therapy." D. "After a few years, you can stop altogether and just regulate your diabetes with your diet." Feedback"Sulfonylureas are usually effective for 7 to 10 years in most clients."Sandy is being treated for chronic hypocalcemia. When her serum calcium level returns to normal, you assess her urinary calcium level and note that it is greater than 250 mg in a 24-hour sample. This indicates that: A. Her vitamin D dosage should be increased. B. Her vitamin D dosage should be decreased. C. She needs to restrict foods high in calcium. D. She needs to eat more foods high in calcium. FeedbackHer vitamin D dosage should be increased.Margie has hypoparathyroidism. Which of the following would you assess during your examination? A. Skin turgor B. Heart tones C. Chvostek's sign D. Homans' signChvostek's signWhich of the following medications can produce gynecomastia? A. Cimetidine (Tagamet) B. Cholesterol-lowering medications C. Beta blockers D. AspirinCimetidine (Tagamet)