NR565 WEEK 5 | ADVANCED PHARMACOLOGY PRACTICE QUESTIONS & ANSWERS |
COMPREHENSIVE NURSING STUDY GUIDE 2026/2027
Signs and symptoms of hypothyroidism and hyperthyroidism - correct answer
✔✔Hypothyroidism:
Thick, coarse, dry Hyporeflexia, "hung up" patella reflex Slow thought process, Weight gain (5-
10 lbs./2.25-4.5 kg) Constipation, Menorrhagia, Cold intolerance: Cold all the time
Hyperthyroidism (aka graves disease):
Smooth, silky Hyperreflexia, Mind racing, Weight loss (10 lbs./4.5 kg) Diarrhea, loose, frequent
stools, Oligomenorrhea, Heat intolerance: Hot all the time
pg. 418-419
What adjunctive therapy is good to prescribe to control symptoms of hyperthyroidism other
than thyroid specific medications?
Know drug classes and examples of those drug classes. - 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.
pg. 419
Monitoring needs and intervals for thyroid medications. - correct answer ✔✔levothyroxine-
Monitoring: 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.
Methimazole-Monitoring: Check CBC with differential if signs or symptoms of infection. Check
LFTs if signs or symptoms of liver dysfunction.
Propylthiouracil (PTU)- Treatment continues for 1-2 years
,PTU has caused rare cases of liver injury. Onset is sudden and progression is rapid.
- Propylthiouracil (PTU) carries a risk for liver toxicity. Although rare, the FDA recommends
against using PTU as a first-line treatment due to potential for hepatic toxicity. - correct answer
✔✔Treatment continues for 1-2 years
PTU has caused rare cases of liver injury. Onset is sudden and progression is rapid. pg 421
- Effects of maternal hypothyroidism on offspring and appropriate patient teaching related to
need for treatment. - correct answer ✔✔Maternal hypothyroidism can result in permanent
neuropsychological deficits in the child.
can decrease IQ and other aspects of neuropsychological function in the child.
teaching:
to help ensure healthy fetal development, maternal hypothyroidism must be diagnosed and
treated very early.
some authorities currently recommend routine screening for hypothyroidism as soon as
pregnancy is confirmed. If hypothyroidism is diagnosed, replacement therapy should begin
immediately.
the signs and symptoms of pregnancy mimics those of hypothyroidism
When women taking thyroid supplements become pregnant, dosage requirements usually
increase—often by as much as 50%. The need for increased dosage begins between weeks 4
and 8 of gestation, levels off at approximately week 16, and then remains steady until
parturition.
pg. 418
, - Patient teaching for thyroid medications. - correct answer ✔✔:levothyroxine:
should be taken on an empty stomach in the morning, at least 30 to 60 minutes before
breakfast.
Inform patients about the symptoms of thyrotoxicosis and instruct them to notify the prescriber
if these develop (Sweating, irritability, weight loss, tachycardia)Instruct patients to separate
administration of levothyroxine and these drugs by 4 hours
Overdose may cause thyrotoxicosis. Symptoms include tachycardia, angina, tremor,
nervousness, insomnia, sweating, and heat intolerance.
methamizole:
Agranulocytosis: Inform patients about early signs of agranulocytosis, including fever or sore
throat. If follow-up blood tests reveal leukopenia, methimazole should be stopped.
Hypothyroidism: Methimazole may cause excessive reductions in thyroid hormone synthesis. If
signs of hypothyroidism develop or if plasma levels of T3 and T4 become subnormal, dosage
should be reduced.
Radioactive Iodine:
Inform patients about symptoms of iodism, including brassy taste, burning sensations in the
mouth, and soreness of gums and teeth. Iodine can also cause corrosive injury to the GI tract.
Instruct patients to notify the prescriber if severe abdominal distress develops.
PTU:
can cause rare cases of liver injury
What drug class can interfere with the assessment and monitoring of diabetes and why?
COMPREHENSIVE NURSING STUDY GUIDE 2026/2027
Signs and symptoms of hypothyroidism and hyperthyroidism - correct answer
✔✔Hypothyroidism:
Thick, coarse, dry Hyporeflexia, "hung up" patella reflex Slow thought process, Weight gain (5-
10 lbs./2.25-4.5 kg) Constipation, Menorrhagia, Cold intolerance: Cold all the time
Hyperthyroidism (aka graves disease):
Smooth, silky Hyperreflexia, Mind racing, Weight loss (10 lbs./4.5 kg) Diarrhea, loose, frequent
stools, Oligomenorrhea, Heat intolerance: Hot all the time
pg. 418-419
What adjunctive therapy is good to prescribe to control symptoms of hyperthyroidism other
than thyroid specific medications?
Know drug classes and examples of those drug classes. - 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.
pg. 419
Monitoring needs and intervals for thyroid medications. - correct answer ✔✔levothyroxine-
Monitoring: 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.
Methimazole-Monitoring: Check CBC with differential if signs or symptoms of infection. Check
LFTs if signs or symptoms of liver dysfunction.
Propylthiouracil (PTU)- Treatment continues for 1-2 years
,PTU has caused rare cases of liver injury. Onset is sudden and progression is rapid.
- Propylthiouracil (PTU) carries a risk for liver toxicity. Although rare, the FDA recommends
against using PTU as a first-line treatment due to potential for hepatic toxicity. - correct answer
✔✔Treatment continues for 1-2 years
PTU has caused rare cases of liver injury. Onset is sudden and progression is rapid. pg 421
- Effects of maternal hypothyroidism on offspring and appropriate patient teaching related to
need for treatment. - correct answer ✔✔Maternal hypothyroidism can result in permanent
neuropsychological deficits in the child.
can decrease IQ and other aspects of neuropsychological function in the child.
teaching:
to help ensure healthy fetal development, maternal hypothyroidism must be diagnosed and
treated very early.
some authorities currently recommend routine screening for hypothyroidism as soon as
pregnancy is confirmed. If hypothyroidism is diagnosed, replacement therapy should begin
immediately.
the signs and symptoms of pregnancy mimics those of hypothyroidism
When women taking thyroid supplements become pregnant, dosage requirements usually
increase—often by as much as 50%. The need for increased dosage begins between weeks 4
and 8 of gestation, levels off at approximately week 16, and then remains steady until
parturition.
pg. 418
, - Patient teaching for thyroid medications. - correct answer ✔✔:levothyroxine:
should be taken on an empty stomach in the morning, at least 30 to 60 minutes before
breakfast.
Inform patients about the symptoms of thyrotoxicosis and instruct them to notify the prescriber
if these develop (Sweating, irritability, weight loss, tachycardia)Instruct patients to separate
administration of levothyroxine and these drugs by 4 hours
Overdose may cause thyrotoxicosis. Symptoms include tachycardia, angina, tremor,
nervousness, insomnia, sweating, and heat intolerance.
methamizole:
Agranulocytosis: Inform patients about early signs of agranulocytosis, including fever or sore
throat. If follow-up blood tests reveal leukopenia, methimazole should be stopped.
Hypothyroidism: Methimazole may cause excessive reductions in thyroid hormone synthesis. If
signs of hypothyroidism develop or if plasma levels of T3 and T4 become subnormal, dosage
should be reduced.
Radioactive Iodine:
Inform patients about symptoms of iodism, including brassy taste, burning sensations in the
mouth, and soreness of gums and teeth. Iodine can also cause corrosive injury to the GI tract.
Instruct patients to notify the prescriber if severe abdominal distress develops.
PTU:
can cause rare cases of liver injury
What drug class can interfere with the assessment and monitoring of diabetes and why?
