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
levothyroxineabsorption?
A. Metoprolol
B. Calciumcarbonate
C.Lisinopril
D.Atorvastatin
Answer:B.Calciumcarbonate
Rationale:Calcium,iron,aluminumhydroxide
antacids,andprotonpumpinhibitorsreduce
levothyroxineabsorption.Separate
administrationbyatleast4hours.
4. A68-year-oldmalehasaTSHof0.1mIU/Lwith
normalfreeT4andT3.Heisasymptomatic.Whatis
themostappropriatemanagement?
A. Startmethimazole
B. Radioactiveiodineablation
C. ObserveandrepeatTSHin6–12months
D.Refertoendocrinology
Answer:C.ObserveandrepeatTSHin6–12months
*Rationale:Subclinicalhyperthyroidism(low
, TSH,normalT3/T4)withoutsymptomsorcardiac
riskfactorsmaybeobserved.IfTSH<0.1withage
>65,atrialfibrillationriskincreased,consider
treatment.*
5. A74-year-oldfemalewithatrialfibrillationand
TSH<0.01mIU/LhaselevatedfreeT4.Whatisthe
first-linetreatment?
A. Methimazole
B. Propylthiouracil
C.Radioactiveiodine
D.Propranolol
Answer:C.Radioactiveiodine
Rationale:Olderadultswithovert
hyperthyroidismandcardiaccomorbidities
benefitfromdefinitivetreatment(RAIorsurgery).
Methimazoleisanoptionbuthassideeffects.
Beta-blockers(propranolol)forsymptom
controlbutdonottreatcause.
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
levothyroxineabsorption?
A. Metoprolol
B. Calciumcarbonate
C.Lisinopril
D.Atorvastatin
Answer:B.Calciumcarbonate
Rationale:Calcium,iron,aluminumhydroxide
antacids,andprotonpumpinhibitorsreduce
levothyroxineabsorption.Separate
administrationbyatleast4hours.
4. A68-year-oldmalehasaTSHof0.1mIU/Lwith
normalfreeT4andT3.Heisasymptomatic.Whatis
themostappropriatemanagement?
A. Startmethimazole
B. Radioactiveiodineablation
C. ObserveandrepeatTSHin6–12months
D.Refertoendocrinology
Answer:C.ObserveandrepeatTSHin6–12months
*Rationale:Subclinicalhyperthyroidism(low
, TSH,normalT3/T4)withoutsymptomsorcardiac
riskfactorsmaybeobserved.IfTSH<0.1withage
>65,atrialfibrillationriskincreased,consider
treatment.*
5. A74-year-oldfemalewithatrialfibrillationand
TSH<0.01mIU/LhaselevatedfreeT4.Whatisthe
first-linetreatment?
A. Methimazole
B. Propylthiouracil
C.Radioactiveiodine
D.Propranolol
Answer:C.Radioactiveiodine
Rationale:Olderadultswithovert
hyperthyroidismandcardiaccomorbidities
benefitfromdefinitivetreatment(RAIorsurgery).
Methimazoleisanoptionbuthassideeffects.
Beta-blockers(propranolol)forsymptom
controlbutdonottreatcause.
