NR565 (PHARMACOLOGY)
FINAL TEST QUESTIONS WITH
ACCURATE ANSWERS.
A+ GRADED
Signs and symptoms of hypothyroidism –
Face is pale, puffy, and expressionless. ✔️✔️
Skin is cold and dry. ✔️✔️
hair is brittle, and hair loss occurs. ✔️✔️
Heart rate and temperature are lowered. The patient lethargy, fatigue,
and intolerance to cold. ✔️✔️
Mentation may be impaired. ✔️✔️
Signs and symptoms of hyperthyroidism
Heart Rate is Rapid; Possible arrhythmia/angina ✔️✔️
Nervousness, insomnia, rapid thought flow, and rapid speech ✔️✔️
Skeletal muscles may weaken and atrophy ✔️✔️
Metabolic rate is raised, resulting in increased heat production, increased
body temperature, intolerance to heat, and skin that is warm and moist
✔️✔️
Weight loss occurs if caloric intake fails to match the increase in metabolic
rate ✔️✔️
Severe hypothyroidism - Correct Answer-Myxedema ✔️✔️
Hypothyroid Treatment - Correct Answer-Levothyroxine is the drug of choice for
most patients who require thyroid hormone replacement. ✔️✔️
Levothyroxine (Synthroid) Therapeutic Goal - Correct Answer-Resolution of signs
and symptoms of hypothyroidism and restoration of normal laboratory values for
serum thyroid-stimulating hormone (TSH) and free thyroxine (T4). ✔️✔️
Major forms of hyperthyroidism - Correct Answer-Graves disease and toxic
nodular goiter (also known as Plummer disease). ✔️✔️
Graves’ Disease - Correct Answer-Most common cause of excessive thyroid
hormone secretion ✔️✔️
What adjunctive therapy is good to prescribe to control symptoms of
hyperthyroidism other than thyroid specific medications? - Correct Answer-β-
Blockers and nonradioactive iodine may be used as adjunctive therapy. ✔️✔️
β-Blockers suppress tachycardia by blocking β-receptors on the heart. ✔️✔️
Nonradioactive iodine inhibits synthesis and release of thyroid hormones. ✔️✔️
,Monitoring needs and intervals for Levothyroxine - Correct Answer-Check TSH 6-
8 weeks after initiating therapy and after any dosage change. ✔️✔️
Check TSH at least once a year after serum TSH is stabilized. ✔️✔️
Hyperthyroid Treatment - Correct Answer-thioamide drugs—methimazole and
propylthiouracil (PTU)—suppress synthesis of thyroid hormones. ✔️✔️
Methimazole Therapeutic Goal - Correct Answer-(1) reduction of thyroid hormone
production in Graves' disease ✔️✔️, (2) control of hyperthyroidism until the effects
of radiation on the thyroid become manifest ✔️✔️, (3) suppression of thyroid
hormone production before subtotal thyroidectomy ✔️✔️, (4) treatment of
thyrotoxic crisis. ✔️✔️
Monitoring needs and intervals for Methimazole - Correct Answer-Check CBC with
differential if signs or symptoms of infection. Check LFTs if signs or symptoms of
liver dysfunction. ✔️✔️
High Risk Patients for Methimazole - Correct Answer-Should be avoided in the
first trimester of pregnancy. ✔️✔️
Methimazole Toxicity - Correct Answer-Agranulocytosis is the most dangerous
toxicity. ✔️✔️
PTU High Risk Warning - Correct Answer-Carries a risk for liver toxicity. Although
rare, the FDA recommends against using as a first-line treatment due to
potential for hepatic toxicity. ✔️✔️
Effects of maternal hypothyroidism on offspring and appropriate patient teaching
related to need for treatment. - Correct Answer-Can cause delay in mental
development and derangement of growth. In the absence of thyroid hormones,
the child develops a large and protruding tongue, potbelly, and dwarfish stature.
Development of the nervous system, bones, teeth, and muscles is impaired. ✔️✔️
Congenital Hypothyroidism Treatment - Correct Answer-requires replacement
therapy with thyroid hormones. If treatment is initiated within a few days of
birth, physical and mental development will be normal. Replacement therapy
should continue for 3 years, after which it should be stopped for 4 weeks to
determine whether thyroid deficiency is permanent or transient. ✔️✔️
Patient Teaching for Methimazole - Correct Answer-Tell your healthcare providers
that you are taking this drug. ✔️✔️
Check blood work as directed. ✔️✔️
Taking this drug may cause harm to the unborn baby if you are pregnant,
especially in the first trimester. ✔️✔️
If you are pregnant or become pregnant while taking this drug, call your
healthcare provider right away. ✔️✔️
Tell your healthcare provider if you are breast-feeding to discuss risks to the
baby. ✔️✔️
Have your baby's thyroid checked if you are using this drug and breast-feeding.
✔️✔️
, Agranulocytosis is the most dangerous toxicity risk for this medication but is very
rare. Sore throat and fever should be reported immediately. ✔️✔️
Patient Teaching for Levothyroxine - Correct Answer-works best if you take it on
an empty stomach, 30 to 60 minutes before breakfast. ✔️✔️
Take the medicine at the same time each day. ✔️✔️
Ideal HbA1C goal for diabetic, non-pregnant adults - Correct Answer-less than
7%. ✔️✔️
HbA1C 8% - Correct Answer-history of severe hypoglycemia, limited life
expectancy, or advanced microvascular or macrovascular complications ✔️✔️
HBA1C Value considered diagnostic of diabetes. - Correct Answer-a value of 6.5%
or greater ✔️✔️
HbA1C Measuring Interval - Correct Answer-every 3 months until value is <7%;
every 6 months thereafter ✔️✔️
HbA1C Goal for Older Adults - Correct Answer-<7.5% [58 mmol/mol]), while
those with multiple coexisting chronic illnesses, cognitive impairment, or
functional dependence should have less stringent glycemic goals (such as A1C
<8.0-8.5% [64-69 mmol/mol]). ✔️✔️
Criteria for the Diagnosis of Diabetes Mellitus –
Correct Answer--Fasting plasma glucose ≥126 mg/dL ✔️✔️
-Random plasma glucose ≥ 200 mg/dL plus symptoms of diabetes ✔️✔️
-Oral glucose tolerance test (OGTT): 2-h plasma glucose ≥200 mg/dL ✔️✔️
-Hemoglobin A1c 6.5% or higher ✔️✔️
T1DM Etiology and MOA - Correct Answer-Autoimmune process; Loss of
pancreatic β cells; ✔️✔️
T2DM Etiology and MOA - Correct Answer-Unknown—but there is a strong familial
association, suggesting that heredity is a risk factor; Insulin resistance and
inappropriate insulin secretion ✔️✔️
the total daily dose (TDD) of insulin calculation - Correct Answer-total weight of
the patient in kilograms (kg), multiplied by 0.6 units ✔️✔️
Basal insulin replacement - Correct Answer-50% of the total daily insulin dose
which replaces insulin from fasting (overnight) and between meals. ✔️✔️
Bolus insulin replacement - Correct Answer-50% of the total daily insulin dose
and provides carbohydrate coverage and high blood sugar correction. ✔️✔️
Biguanides Drug Class - Correct Answer-Metformin ✔️✔️
Metformin - Correct Answer-Decreases glucose production by the liver
(glucogenesis), increases tissue response to insulin; ✔️✔️
FINAL TEST QUESTIONS WITH
ACCURATE ANSWERS.
A+ GRADED
Signs and symptoms of hypothyroidism –
Face is pale, puffy, and expressionless. ✔️✔️
Skin is cold and dry. ✔️✔️
hair is brittle, and hair loss occurs. ✔️✔️
Heart rate and temperature are lowered. The patient lethargy, fatigue,
and intolerance to cold. ✔️✔️
Mentation may be impaired. ✔️✔️
Signs and symptoms of hyperthyroidism
Heart Rate is Rapid; Possible arrhythmia/angina ✔️✔️
Nervousness, insomnia, rapid thought flow, and rapid speech ✔️✔️
Skeletal muscles may weaken and atrophy ✔️✔️
Metabolic rate is raised, resulting in increased heat production, increased
body temperature, intolerance to heat, and skin that is warm and moist
✔️✔️
Weight loss occurs if caloric intake fails to match the increase in metabolic
rate ✔️✔️
Severe hypothyroidism - Correct Answer-Myxedema ✔️✔️
Hypothyroid Treatment - Correct Answer-Levothyroxine is the drug of choice for
most patients who require thyroid hormone replacement. ✔️✔️
Levothyroxine (Synthroid) Therapeutic Goal - Correct Answer-Resolution of signs
and symptoms of hypothyroidism and restoration of normal laboratory values for
serum thyroid-stimulating hormone (TSH) and free thyroxine (T4). ✔️✔️
Major forms of hyperthyroidism - Correct Answer-Graves disease and toxic
nodular goiter (also known as Plummer disease). ✔️✔️
Graves’ Disease - Correct Answer-Most common cause of excessive thyroid
hormone secretion ✔️✔️
What adjunctive therapy is good to prescribe to control symptoms of
hyperthyroidism other than thyroid specific medications? - Correct Answer-β-
Blockers and nonradioactive iodine may be used as adjunctive therapy. ✔️✔️
β-Blockers suppress tachycardia by blocking β-receptors on the heart. ✔️✔️
Nonradioactive iodine inhibits synthesis and release of thyroid hormones. ✔️✔️
,Monitoring needs and intervals for Levothyroxine - Correct Answer-Check TSH 6-
8 weeks after initiating therapy and after any dosage change. ✔️✔️
Check TSH at least once a year after serum TSH is stabilized. ✔️✔️
Hyperthyroid Treatment - Correct Answer-thioamide drugs—methimazole and
propylthiouracil (PTU)—suppress synthesis of thyroid hormones. ✔️✔️
Methimazole Therapeutic Goal - Correct Answer-(1) reduction of thyroid hormone
production in Graves' disease ✔️✔️, (2) control of hyperthyroidism until the effects
of radiation on the thyroid become manifest ✔️✔️, (3) suppression of thyroid
hormone production before subtotal thyroidectomy ✔️✔️, (4) treatment of
thyrotoxic crisis. ✔️✔️
Monitoring needs and intervals for Methimazole - Correct Answer-Check CBC with
differential if signs or symptoms of infection. Check LFTs if signs or symptoms of
liver dysfunction. ✔️✔️
High Risk Patients for Methimazole - Correct Answer-Should be avoided in the
first trimester of pregnancy. ✔️✔️
Methimazole Toxicity - Correct Answer-Agranulocytosis is the most dangerous
toxicity. ✔️✔️
PTU High Risk Warning - Correct Answer-Carries a risk for liver toxicity. Although
rare, the FDA recommends against using as a first-line treatment due to
potential for hepatic toxicity. ✔️✔️
Effects of maternal hypothyroidism on offspring and appropriate patient teaching
related to need for treatment. - Correct Answer-Can cause delay in mental
development and derangement of growth. In the absence of thyroid hormones,
the child develops a large and protruding tongue, potbelly, and dwarfish stature.
Development of the nervous system, bones, teeth, and muscles is impaired. ✔️✔️
Congenital Hypothyroidism Treatment - Correct Answer-requires replacement
therapy with thyroid hormones. If treatment is initiated within a few days of
birth, physical and mental development will be normal. Replacement therapy
should continue for 3 years, after which it should be stopped for 4 weeks to
determine whether thyroid deficiency is permanent or transient. ✔️✔️
Patient Teaching for Methimazole - Correct Answer-Tell your healthcare providers
that you are taking this drug. ✔️✔️
Check blood work as directed. ✔️✔️
Taking this drug may cause harm to the unborn baby if you are pregnant,
especially in the first trimester. ✔️✔️
If you are pregnant or become pregnant while taking this drug, call your
healthcare provider right away. ✔️✔️
Tell your healthcare provider if you are breast-feeding to discuss risks to the
baby. ✔️✔️
Have your baby's thyroid checked if you are using this drug and breast-feeding.
✔️✔️
, Agranulocytosis is the most dangerous toxicity risk for this medication but is very
rare. Sore throat and fever should be reported immediately. ✔️✔️
Patient Teaching for Levothyroxine - Correct Answer-works best if you take it on
an empty stomach, 30 to 60 minutes before breakfast. ✔️✔️
Take the medicine at the same time each day. ✔️✔️
Ideal HbA1C goal for diabetic, non-pregnant adults - Correct Answer-less than
7%. ✔️✔️
HbA1C 8% - Correct Answer-history of severe hypoglycemia, limited life
expectancy, or advanced microvascular or macrovascular complications ✔️✔️
HBA1C Value considered diagnostic of diabetes. - Correct Answer-a value of 6.5%
or greater ✔️✔️
HbA1C Measuring Interval - Correct Answer-every 3 months until value is <7%;
every 6 months thereafter ✔️✔️
HbA1C Goal for Older Adults - Correct Answer-<7.5% [58 mmol/mol]), while
those with multiple coexisting chronic illnesses, cognitive impairment, or
functional dependence should have less stringent glycemic goals (such as A1C
<8.0-8.5% [64-69 mmol/mol]). ✔️✔️
Criteria for the Diagnosis of Diabetes Mellitus –
Correct Answer--Fasting plasma glucose ≥126 mg/dL ✔️✔️
-Random plasma glucose ≥ 200 mg/dL plus symptoms of diabetes ✔️✔️
-Oral glucose tolerance test (OGTT): 2-h plasma glucose ≥200 mg/dL ✔️✔️
-Hemoglobin A1c 6.5% or higher ✔️✔️
T1DM Etiology and MOA - Correct Answer-Autoimmune process; Loss of
pancreatic β cells; ✔️✔️
T2DM Etiology and MOA - Correct Answer-Unknown—but there is a strong familial
association, suggesting that heredity is a risk factor; Insulin resistance and
inappropriate insulin secretion ✔️✔️
the total daily dose (TDD) of insulin calculation - Correct Answer-total weight of
the patient in kilograms (kg), multiplied by 0.6 units ✔️✔️
Basal insulin replacement - Correct Answer-50% of the total daily insulin dose
which replaces insulin from fasting (overnight) and between meals. ✔️✔️
Bolus insulin replacement - Correct Answer-50% of the total daily insulin dose
and provides carbohydrate coverage and high blood sugar correction. ✔️✔️
Biguanides Drug Class - Correct Answer-Metformin ✔️✔️
Metformin - Correct Answer-Decreases glucose production by the liver
(glucogenesis), increases tissue response to insulin; ✔️✔️
