NR 565 Final Exam – Adv Pharmacology
Fundamentals – (2026) Actual Questions &
Answers (Chamberlain) 100% Guarantee Pass
SECTION 1: THYROID DISORDERS
1. A 35-year-old female presents with fatigue, anxiety, palpitations, weight loss,
trouble sleeping, and intolerance to cold temperatures. Physical exam reveals
tachycardia at 104 bpm and a slightly enlarged thyroid. Thyroid testing reveals
hyperthyroidism. Which agent is the first-line treatment?
A. Methimazole
B. Metoprolol
C. Allopurinol
D. Levothyroxine
Answer: A. Methimazole
Rationale: Methimazole is the first-line thioamide for hyperthyroidism and Graves'
disease, inhibiting thyroid peroxidase and reducing thyroid hormone synthesis.
Propylthiouracil (PTU) is preferred in the first trimester of pregnancy .
2. Which symptoms are most expected of a patient diagnosed with
hypothyroidism?
A. Shortness of breath, wheezing, fatigue
B. Tachycardia, insomnia, weight loss, goiter
C. Irritability, anxiety, dizziness, increased sweating
D. Dry pale skin, brittle hair, fatigue, myxedema
Answer: D. Dry pale skin, brittle hair, fatigue, myxedema
,Rationale: Classic hypothyroidism symptoms result from decreased metabolic rate:
pale, puffy face; cold, dry skin; brittle hair; lethargy; fatigue; cold intolerance; and
weight gain. Options A, B, and C describe hyperthyroid or respiratory conditions .
3. Which medication reduces the absorption of levothyroxine?
A. Warfarin
B. Rifampin
C. Insulin
D. Omeprazole
Answer: D. Omeprazole
Rationale: Proton pump inhibitors like omeprazole reduce gastric acid, decreasing
levothyroxine absorption. Calcium and iron supplements also reduce absorption.
Patients should separate levothyroxine from these medications by at least 4
hours .
4. Which medication accelerates the absorption of levothyroxine?
A. Iron supplements
B. Pantoprazole
C. Sertraline
D. Digoxin
Answer: C. Sertraline
Rationale: SSRIs like sertraline are not typically associated with altered
levothyroxine absorption. Iron, PPIs, and calcium decrease absorption.
Levothyroxine should be taken on an empty stomach 30-60 minutes before
breakfast .
5. When should a TSH level be drawn after adjusting the dose of levothyroxine?
, A. After 24 months
B. Within 6-8 weeks
C. At least once a year
D. The following week
Answer: B. Within 6-8 weeks
Rationale: After initiating or adjusting levothyroxine, TSH should be rechecked in 6-
8 weeks to allow steady-state levels to be achieved. Once stable, TSH may be
checked annually .
6. During pregnancy, untreated hypothyroidism can result in:
A. Gestational diabetes
B. Developmental problems such as decreased IQ
C. Preeclampsia only
D. No adverse effects
Answer: B. Developmental problems such as decreased IQ
Rationale: Untreated maternal hypothyroidism is associated with
neurodevelopmental delays and decreased IQ in offspring. Thyroid hormone is
critical for fetal brain development, especially in the first trimester .
7. A patient reports difficulty falling asleep, increased weight loss despite
increased appetite, feeling increasingly anxious, and noticing their eyes bulging.
Which diagnosis should the NP consider?
A. Hashimoto's Disease
B. Hypothyroidism
C. Hyperthyroidism
D. Depression
Answer: C. Hyperthyroidism
Fundamentals – (2026) Actual Questions &
Answers (Chamberlain) 100% Guarantee Pass
SECTION 1: THYROID DISORDERS
1. A 35-year-old female presents with fatigue, anxiety, palpitations, weight loss,
trouble sleeping, and intolerance to cold temperatures. Physical exam reveals
tachycardia at 104 bpm and a slightly enlarged thyroid. Thyroid testing reveals
hyperthyroidism. Which agent is the first-line treatment?
A. Methimazole
B. Metoprolol
C. Allopurinol
D. Levothyroxine
Answer: A. Methimazole
Rationale: Methimazole is the first-line thioamide for hyperthyroidism and Graves'
disease, inhibiting thyroid peroxidase and reducing thyroid hormone synthesis.
Propylthiouracil (PTU) is preferred in the first trimester of pregnancy .
2. Which symptoms are most expected of a patient diagnosed with
hypothyroidism?
A. Shortness of breath, wheezing, fatigue
B. Tachycardia, insomnia, weight loss, goiter
C. Irritability, anxiety, dizziness, increased sweating
D. Dry pale skin, brittle hair, fatigue, myxedema
Answer: D. Dry pale skin, brittle hair, fatigue, myxedema
,Rationale: Classic hypothyroidism symptoms result from decreased metabolic rate:
pale, puffy face; cold, dry skin; brittle hair; lethargy; fatigue; cold intolerance; and
weight gain. Options A, B, and C describe hyperthyroid or respiratory conditions .
3. Which medication reduces the absorption of levothyroxine?
A. Warfarin
B. Rifampin
C. Insulin
D. Omeprazole
Answer: D. Omeprazole
Rationale: Proton pump inhibitors like omeprazole reduce gastric acid, decreasing
levothyroxine absorption. Calcium and iron supplements also reduce absorption.
Patients should separate levothyroxine from these medications by at least 4
hours .
4. Which medication accelerates the absorption of levothyroxine?
A. Iron supplements
B. Pantoprazole
C. Sertraline
D. Digoxin
Answer: C. Sertraline
Rationale: SSRIs like sertraline are not typically associated with altered
levothyroxine absorption. Iron, PPIs, and calcium decrease absorption.
Levothyroxine should be taken on an empty stomach 30-60 minutes before
breakfast .
5. When should a TSH level be drawn after adjusting the dose of levothyroxine?
, A. After 24 months
B. Within 6-8 weeks
C. At least once a year
D. The following week
Answer: B. Within 6-8 weeks
Rationale: After initiating or adjusting levothyroxine, TSH should be rechecked in 6-
8 weeks to allow steady-state levels to be achieved. Once stable, TSH may be
checked annually .
6. During pregnancy, untreated hypothyroidism can result in:
A. Gestational diabetes
B. Developmental problems such as decreased IQ
C. Preeclampsia only
D. No adverse effects
Answer: B. Developmental problems such as decreased IQ
Rationale: Untreated maternal hypothyroidism is associated with
neurodevelopmental delays and decreased IQ in offspring. Thyroid hormone is
critical for fetal brain development, especially in the first trimester .
7. A patient reports difficulty falling asleep, increased weight loss despite
increased appetite, feeling increasingly anxious, and noticing their eyes bulging.
Which diagnosis should the NP consider?
A. Hashimoto's Disease
B. Hypothyroidism
C. Hyperthyroidism
D. Depression
Answer: C. Hyperthyroidism
