,NR 601 Week 5 Quiz: Thyroid Management &
Diabetes Care
Chamberlain University – Verified Questions &
Answers
Thyroid Disorders (Questions 1–20)
1. A 72-year-old female presents with fatigue,
weight gain, constipation, and dry skin. TSH is
12 mIU/L (normal 0.4–4.0). Free T4 is low. What
is the most appropriate initial treatment?
A. Levothyroxine 25 mcg daily
B. Liothyronine (T3) 5 mcg daily
C. Levothyroxine 100 mcg daily
D. No treatment; repeat TSH in 3 months
Answer: A. Levothyroxine 25 mcg daily
*Rationale: Older adults with hypothyroidism
should be started on low-dose levothyroxine
(25–50 mcg/day) to avoid cardiac
complications (arrhythmias, angina). Full
,replacement is 1.6 mcg/kg, but start low, go
slow. T3 is not recommended in elderly.*
2. A patient with known hypothyroidism on
levothyroxine 75 mcg daily has a follow-up TSH
of 8.5 mIU/L. She reports taking her medication
“when I remember.” Which intervention is most
appropriate?
A. Increase levothyroxine to 100 mcg daily
B. Assess adherence and timing of medication
C. Switch to liothyronine
D. Order a thyroid ultrasound
Answer: B. Assess adherence and timing of
medication
*Rationale: First rule out non-adherence or
improper administration (with food, calcium,
iron, proton pump inhibitors). Increase dose
only after adherence confirmed. TSH should be
checked 6–8 weeks after dose change.*
, 3. Whichmedicationcommonlyinterfereswith
mlevothyroxineabsorption?
A. Metoprolol
B. Calciumcarbonate
C.Lisinopril
m
D.Atorvastatin
Answer:B.Calciumcarbonate
Rationale:Calcium,iron,aluminumhydroxide
antacids,andprotonpumpinhibitorsreduce
m
levothyroxineabsorption.Separate
m
administrationbyatleast4hours.
m
4. A68-year-oldmalehasaTSHof0.1mIU/Lwith
normalfreeT4andT3.Heisasymptomatic.Whatis
m
mthemostappropriatemanagement?
A. Startmethimazole
B. Radioactiveiodineablation
C. ObserveandrepeatTSHin6–12months
D.Refertoendocrinology
m
Answer:C.ObserveandrepeatTSHin6–12months
*Rationale:Subclinicalhyperthyroidism(low
Diabetes Care
Chamberlain University – Verified Questions &
Answers
Thyroid Disorders (Questions 1–20)
1. A 72-year-old female presents with fatigue,
weight gain, constipation, and dry skin. TSH is
12 mIU/L (normal 0.4–4.0). Free T4 is low. What
is the most appropriate initial treatment?
A. Levothyroxine 25 mcg daily
B. Liothyronine (T3) 5 mcg daily
C. Levothyroxine 100 mcg daily
D. No treatment; repeat TSH in 3 months
Answer: A. Levothyroxine 25 mcg daily
*Rationale: Older adults with hypothyroidism
should be started on low-dose levothyroxine
(25–50 mcg/day) to avoid cardiac
complications (arrhythmias, angina). Full
,replacement is 1.6 mcg/kg, but start low, go
slow. T3 is not recommended in elderly.*
2. A patient with known hypothyroidism on
levothyroxine 75 mcg daily has a follow-up TSH
of 8.5 mIU/L. She reports taking her medication
“when I remember.” Which intervention is most
appropriate?
A. Increase levothyroxine to 100 mcg daily
B. Assess adherence and timing of medication
C. Switch to liothyronine
D. Order a thyroid ultrasound
Answer: B. Assess adherence and timing of
medication
*Rationale: First rule out non-adherence or
improper administration (with food, calcium,
iron, proton pump inhibitors). Increase dose
only after adherence confirmed. TSH should be
checked 6–8 weeks after dose change.*
, 3. Whichmedicationcommonlyinterfereswith
mlevothyroxineabsorption?
A. Metoprolol
B. Calciumcarbonate
C.Lisinopril
m
D.Atorvastatin
Answer:B.Calciumcarbonate
Rationale:Calcium,iron,aluminumhydroxide
antacids,andprotonpumpinhibitorsreduce
m
levothyroxineabsorption.Separate
m
administrationbyatleast4hours.
m
4. A68-year-oldmalehasaTSHof0.1mIU/Lwith
normalfreeT4andT3.Heisasymptomatic.Whatis
m
mthemostappropriatemanagement?
A. Startmethimazole
B. Radioactiveiodineablation
C. ObserveandrepeatTSHin6–12months
D.Refertoendocrinology
m
Answer:C.ObserveandrepeatTSHin6–12months
*Rationale:Subclinicalhyperthyroidism(low
