NR565 / NR 565 Advanced Pharmacology Final Exam: (Latest 2025/2026
Update) Comprehensive Q&A | Grade A | 100% Correct (Verified Answers) –
Nursing Program
Subject: Advanced Pharmacology (NR 565) – Final Exam: Thyroid Disorders, Diabetes Management,
Asthma/COPD, Smoking Cessation, GI Disorders, Infectious Disease, Vaccinations
Source: Final Exam Blueprint – Hypothyroidism/Hyperthyroidism, Antidiabetic Agents, Inhaled/Systemic
Respiratory Drugs, Antitubercular, GERD, PUD, Antidiarrheals, Immunizations
Format: Q&A Guide with Rationale – 100% Verified Answers
Verified: Latest 2025/2026 Update | Grade A Guaranteed
1: What are the signs and symptoms of hypothyroidism?
Correct Answer: Face is pale, puffy, expressionless; skin cold/dry; hair brittle with loss; heart rate and
temperature lowered; lethargy, fatigue, cold intolerance; impaired mentation. Severe = myxedema.
1. Hypothyroidism reduces metabolic rate throughout the body.
2. Myxedema is severe hypothyroidism with life-threatening complications.
3. Laboratory findings: elevated TSH, low free T4.
2: What are the signs and symptoms of hyperthyroidism?
Correct Answer: Rapid heart rate (tachycardia, arrhythmia); nervousness, insomnia, rapid
thought/speech; muscle weakness/atrophy; increased metabolic rate → heat intolerance, warm/moist
skin; weight loss despite increased appetite.
1. Graves disease is most common cause (autoimmune).
2. Thyroid storm is life-threatening exacerbation (fever, delirium, severe tachycardia).
3. Laboratory: low TSH, elevated free T4/T3.
3: What is the drug of choice for hypothyroidism treatment?
Correct Answer: Levothyroxine (Synthroid) – resolves signs/symptoms and normalizes TSH and free
T4
1. Levothyroxine is synthetic T4, converted to active T3 in tissues.
2. Monitor TSH 6-8 weeks after initiation/dose change, then at least annually.
3. Take on empty stomach 30-60 minutes before breakfast.
4: What is the primary pharmacologic treatment for hyperthyroidism?
Correct Answer: Thionamide drugs – methimazole and propylthiouracil (PTU) – suppress thyroid
hormone synthesis
1. Methimazole is first-line due to less liver toxicity than PTU.
2. PTU reserved for first trimester pregnancy (methimazole teratogenic).
3. β-blockers (propranolol) control tachycardia as adjunctive therapy.
, 5: What is the most dangerous toxicity of methimazole?
Correct Answer: Agranulocytosis (sore throat and fever should be reported immediately)
1. Agranulocytosis is rare but potentially fatal.
2. Check CBC with differential if signs of infection.
3. Liver function monitoring also needed.
6: What is the ideal HbA1c goal for diabetic, non-pregnant adults?
Correct Answer: Less than 7% (ADA recommendation)
1. Less stringent goal (HbA1c <8%) for history of severe hypoglycemia, limited life expectancy,
or advanced complications.
2. Measure HbA1c every 3 months until goal reached, then every 6 months.
3. HbA1c ≥6.5% is diagnostic for diabetes.
7: What is the first-line treatment for all patients with type 2 diabetes?
Correct Answer: Metformin and lifestyle changes (diet, exercise, weight management)
1. Metformin decreases hepatic glucose production and increases insulin sensitivity.
2. Metformin does not cause hypoglycemia or weight gain.
3. Contraindicated in renal disease, hepatic disease, acidosis, alcoholics, hypoxia.
8: Which oral antidiabetic drugs are most likely to cause hypoglycemia?
Correct Answer: Insulin, sulfonylureas (glyburide), meglitinides (repaglinide), amylin analogues
1. Sulfonylureas stimulate insulin release regardless of glucose level.
2. Metformin, DPP-4 inhibitors, GLP-1 agonists, SGLT2 inhibitors, TZDs are less likely to cause
hypoglycemia (unless combined with insulin/secretagogues).
Sulfonylureas also cause weight gain and photosensitivity.
9: What is the black box warning for pioglitazone (TZD)?
Correct Answer: Associated with heart failure (HF) secondary to renal retention of fluid. Discontinue
or reduce dose if HF diagnosed.
1. Contraindicated in patients with heart failure, bladder cancer, or history of bladder cancer.
2. Also increases risk of fractures in women.
3. May cause ovulation in anovulatory women (risk of unintended pregnancy).
10: What is the mechanism of action of SGLT2 inhibitors (canagliflozin)?
Correct Answer: Reduces reabsorption of glucose in kidney, increasing urinary excretion of glucose
1. Diuretic effect → monitor for dehydration and UTIs/vulvovaginal infections.
2. Also associated with euglycemic diabetic ketoacidosis (rare).
3. Examples: canagliflozin, dapagliflozin, empagliflozin.
Update) Comprehensive Q&A | Grade A | 100% Correct (Verified Answers) –
Nursing Program
Subject: Advanced Pharmacology (NR 565) – Final Exam: Thyroid Disorders, Diabetes Management,
Asthma/COPD, Smoking Cessation, GI Disorders, Infectious Disease, Vaccinations
Source: Final Exam Blueprint – Hypothyroidism/Hyperthyroidism, Antidiabetic Agents, Inhaled/Systemic
Respiratory Drugs, Antitubercular, GERD, PUD, Antidiarrheals, Immunizations
Format: Q&A Guide with Rationale – 100% Verified Answers
Verified: Latest 2025/2026 Update | Grade A Guaranteed
1: What are the signs and symptoms of hypothyroidism?
Correct Answer: Face is pale, puffy, expressionless; skin cold/dry; hair brittle with loss; heart rate and
temperature lowered; lethargy, fatigue, cold intolerance; impaired mentation. Severe = myxedema.
1. Hypothyroidism reduces metabolic rate throughout the body.
2. Myxedema is severe hypothyroidism with life-threatening complications.
3. Laboratory findings: elevated TSH, low free T4.
2: What are the signs and symptoms of hyperthyroidism?
Correct Answer: Rapid heart rate (tachycardia, arrhythmia); nervousness, insomnia, rapid
thought/speech; muscle weakness/atrophy; increased metabolic rate → heat intolerance, warm/moist
skin; weight loss despite increased appetite.
1. Graves disease is most common cause (autoimmune).
2. Thyroid storm is life-threatening exacerbation (fever, delirium, severe tachycardia).
3. Laboratory: low TSH, elevated free T4/T3.
3: What is the drug of choice for hypothyroidism treatment?
Correct Answer: Levothyroxine (Synthroid) – resolves signs/symptoms and normalizes TSH and free
T4
1. Levothyroxine is synthetic T4, converted to active T3 in tissues.
2. Monitor TSH 6-8 weeks after initiation/dose change, then at least annually.
3. Take on empty stomach 30-60 minutes before breakfast.
4: What is the primary pharmacologic treatment for hyperthyroidism?
Correct Answer: Thionamide drugs – methimazole and propylthiouracil (PTU) – suppress thyroid
hormone synthesis
1. Methimazole is first-line due to less liver toxicity than PTU.
2. PTU reserved for first trimester pregnancy (methimazole teratogenic).
3. β-blockers (propranolol) control tachycardia as adjunctive therapy.
, 5: What is the most dangerous toxicity of methimazole?
Correct Answer: Agranulocytosis (sore throat and fever should be reported immediately)
1. Agranulocytosis is rare but potentially fatal.
2. Check CBC with differential if signs of infection.
3. Liver function monitoring also needed.
6: What is the ideal HbA1c goal for diabetic, non-pregnant adults?
Correct Answer: Less than 7% (ADA recommendation)
1. Less stringent goal (HbA1c <8%) for history of severe hypoglycemia, limited life expectancy,
or advanced complications.
2. Measure HbA1c every 3 months until goal reached, then every 6 months.
3. HbA1c ≥6.5% is diagnostic for diabetes.
7: What is the first-line treatment for all patients with type 2 diabetes?
Correct Answer: Metformin and lifestyle changes (diet, exercise, weight management)
1. Metformin decreases hepatic glucose production and increases insulin sensitivity.
2. Metformin does not cause hypoglycemia or weight gain.
3. Contraindicated in renal disease, hepatic disease, acidosis, alcoholics, hypoxia.
8: Which oral antidiabetic drugs are most likely to cause hypoglycemia?
Correct Answer: Insulin, sulfonylureas (glyburide), meglitinides (repaglinide), amylin analogues
1. Sulfonylureas stimulate insulin release regardless of glucose level.
2. Metformin, DPP-4 inhibitors, GLP-1 agonists, SGLT2 inhibitors, TZDs are less likely to cause
hypoglycemia (unless combined with insulin/secretagogues).
Sulfonylureas also cause weight gain and photosensitivity.
9: What is the black box warning for pioglitazone (TZD)?
Correct Answer: Associated with heart failure (HF) secondary to renal retention of fluid. Discontinue
or reduce dose if HF diagnosed.
1. Contraindicated in patients with heart failure, bladder cancer, or history of bladder cancer.
2. Also increases risk of fractures in women.
3. May cause ovulation in anovulatory women (risk of unintended pregnancy).
10: What is the mechanism of action of SGLT2 inhibitors (canagliflozin)?
Correct Answer: Reduces reabsorption of glucose in kidney, increasing urinary excretion of glucose
1. Diuretic effect → monitor for dehydration and UTIs/vulvovaginal infections.
2. Also associated with euglycemic diabetic ketoacidosis (rare).
3. Examples: canagliflozin, dapagliflozin, empagliflozin.
