NR 565 Advanced Pharmacology Final Exam Preparation Bundle 2026–
2027 | Weeks 5–8 Complete Review Guide | Comprehensive Practice
Questions with Verified Answers and Rationales |
Pharmacotherapeutics, Clinical Decision-Making, Medication
Management, and Nursing Exam Success Resource
Section 1: Endocrine Pharmacology
Question 1
Untreated maternal hypothyroidism in early pregnancy most increases the risk of
which fetal problem?
• A. Cleft palate
• B. Reduced cognitive development
• C. Limb deformities
• D. Congenital heart block
Correct Answer: B
Rationale: Inadequate maternal thyroid hormone during early gestation can
impair fetal brain development, which may result in lower IQ and other
neurodevelopmental deficits, even if later treated.
Question 2
A 44-year-old with newly diagnosed Graves' disease is started on methimazole.
She reports severe palpitations and tremor while awaiting hormone levels to fall.
Which medication best controls these symptoms?
• A. Lisinopril
• B. Propranolol
• C. Verapamil
• D. Digoxin
,Correct Answer: B
Rationale: Nonselective beta-blockers such as propranolol blunt adrenergic
manifestations of hyperthyroidism, like tachycardia and tremor, while definitive
therapy is taking effect.
Question 3
A 52-year-old has a fasting plasma glucose of 132 mg/dL on two separate
mornings with no acute illness. According to ADA criteria, how should this be
classified?
• A. Normal glucose
• B. Impaired fasting glucose (prediabetes)
• C. Diabetes mellitus
• D. Impaired glucose tolerance
Correct Answer: C
Rationale: A fasting plasma glucose ≥126 mg/dL on two separate occasions is
diagnostic of diabetes mellitus according to ADA criteria.
Question 4
Which of the following is the first-line treatment for hyperthyroidism or Graves'
disease?
• A. Methimazole
• B. Metoprolol
• C. Allopurinol
• D. Levothyroxine
Correct Answer: A
,Rationale: Methimazole is first-line antithyroid therapy for Graves' disease
(except during the first trimester of pregnancy, when propylthiouracil [PTU] is
preferred). Beta-blockers treat symptoms but not the cause.
Question 5
What lab value suggests metformin might be contraindicated?
• A. eGFR <30 mL/min/1.73m²
• B. Creatinine 0.8 mg/dL
• C. WBC 7,800/µL
• D. BUN 17 mg/dL
Correct Answer: A
Rationale: Metformin is contraindicated when eGFR <30 mL/min/1.73m² due to
increased risk of lactic acidosis.
Question 6
Which of the following statements is NOT true regarding sulfonylureas?
• A. Sulfonylureas are safe to prescribe to pregnant and/or breastfeeding
women.
• B. Patients should be educated about signs and symptoms of hypoglycemia.
• C. Sulfonylureas cause a dose-dependent reduction in blood glucose.
• D. Sulfonylureas are indicated only for patients diagnosed with type 2
diabetes.
Correct Answer: A
Rationale: Sulfonylureas are not considered universally safe in
pregnancy/breastfeeding; insulin is typically preferred in pregnancy.
Hypoglycemia education is essential.
, Question 7
A patient is prescribed levothyroxine for hypothyroidism. What is the therapeutic
goal?
• A. Resolution of signs and symptoms of hypothyroidism
• B. Restoration of normal serum TSH and free T4 levels
• C. Both A and B
• D. Complete elimination of all thyroid symptoms within 2 weeks
Correct Answer: C
Rationale: The therapeutic goal of levothyroxine therapy is resolution of signs and
symptoms of hypothyroidism and restoration of normal laboratory values for
serum TSH and free T4.
Question 8
Signs and symptoms of hypothyroidism include all of the following EXCEPT:
• A. Pale, puffy face
• B. Cold, dry skin
• C. Tachycardia
• D. Lethargy and fatigue
Correct Answer: C
Rationale: Hypothyroidism presents with pale, puffy face; cold, dry skin; brittle
hair; lowered heart rate and temperature; lethargy, fatigue, and cold intolerance.
Tachycardia is a sign of hyperthyroidism.
Question 9
2027 | Weeks 5–8 Complete Review Guide | Comprehensive Practice
Questions with Verified Answers and Rationales |
Pharmacotherapeutics, Clinical Decision-Making, Medication
Management, and Nursing Exam Success Resource
Section 1: Endocrine Pharmacology
Question 1
Untreated maternal hypothyroidism in early pregnancy most increases the risk of
which fetal problem?
• A. Cleft palate
• B. Reduced cognitive development
• C. Limb deformities
• D. Congenital heart block
Correct Answer: B
Rationale: Inadequate maternal thyroid hormone during early gestation can
impair fetal brain development, which may result in lower IQ and other
neurodevelopmental deficits, even if later treated.
Question 2
A 44-year-old with newly diagnosed Graves' disease is started on methimazole.
She reports severe palpitations and tremor while awaiting hormone levels to fall.
Which medication best controls these symptoms?
• A. Lisinopril
• B. Propranolol
• C. Verapamil
• D. Digoxin
,Correct Answer: B
Rationale: Nonselective beta-blockers such as propranolol blunt adrenergic
manifestations of hyperthyroidism, like tachycardia and tremor, while definitive
therapy is taking effect.
Question 3
A 52-year-old has a fasting plasma glucose of 132 mg/dL on two separate
mornings with no acute illness. According to ADA criteria, how should this be
classified?
• A. Normal glucose
• B. Impaired fasting glucose (prediabetes)
• C. Diabetes mellitus
• D. Impaired glucose tolerance
Correct Answer: C
Rationale: A fasting plasma glucose ≥126 mg/dL on two separate occasions is
diagnostic of diabetes mellitus according to ADA criteria.
Question 4
Which of the following is the first-line treatment for hyperthyroidism or Graves'
disease?
• A. Methimazole
• B. Metoprolol
• C. Allopurinol
• D. Levothyroxine
Correct Answer: A
,Rationale: Methimazole is first-line antithyroid therapy for Graves' disease
(except during the first trimester of pregnancy, when propylthiouracil [PTU] is
preferred). Beta-blockers treat symptoms but not the cause.
Question 5
What lab value suggests metformin might be contraindicated?
• A. eGFR <30 mL/min/1.73m²
• B. Creatinine 0.8 mg/dL
• C. WBC 7,800/µL
• D. BUN 17 mg/dL
Correct Answer: A
Rationale: Metformin is contraindicated when eGFR <30 mL/min/1.73m² due to
increased risk of lactic acidosis.
Question 6
Which of the following statements is NOT true regarding sulfonylureas?
• A. Sulfonylureas are safe to prescribe to pregnant and/or breastfeeding
women.
• B. Patients should be educated about signs and symptoms of hypoglycemia.
• C. Sulfonylureas cause a dose-dependent reduction in blood glucose.
• D. Sulfonylureas are indicated only for patients diagnosed with type 2
diabetes.
Correct Answer: A
Rationale: Sulfonylureas are not considered universally safe in
pregnancy/breastfeeding; insulin is typically preferred in pregnancy.
Hypoglycemia education is essential.
, Question 7
A patient is prescribed levothyroxine for hypothyroidism. What is the therapeutic
goal?
• A. Resolution of signs and symptoms of hypothyroidism
• B. Restoration of normal serum TSH and free T4 levels
• C. Both A and B
• D. Complete elimination of all thyroid symptoms within 2 weeks
Correct Answer: C
Rationale: The therapeutic goal of levothyroxine therapy is resolution of signs and
symptoms of hypothyroidism and restoration of normal laboratory values for
serum TSH and free T4.
Question 8
Signs and symptoms of hypothyroidism include all of the following EXCEPT:
• A. Pale, puffy face
• B. Cold, dry skin
• C. Tachycardia
• D. Lethargy and fatigue
Correct Answer: C
Rationale: Hypothyroidism presents with pale, puffy face; cold, dry skin; brittle
hair; lowered heart rate and temperature; lethargy, fatigue, and cold intolerance.
Tachycardia is a sign of hyperthyroidism.
Question 9
