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NR565 / NR 565 Advanced Pharmacology
Care of the Fundamentals Final Exam |
Chamberlain University | Verified
Questions & Answers with Rationales |
Multiple Choice & Open-Ended Q&A
Exam Structure:
Subject: Advanced Pharmacology (NR565) – Final Exam
Source: NR565 / NR 565 Advanced Pharmacology Care of the Fundamentals – Final
Exam (Chamberlain)
Format: Multiple Choice & Open-Ended Q&A
1. What labs are used to diagnose thyroid disorders?
Correct Answer: TSH, total T4 and T3, free T4 and T3.
Rationale:
1. TSH is the primary screening test for thyroid dysfunction.
2. Free T4 and T3 measure the active (unbound) hormone levels.
3. Total T4 and T3 include bound and unbound fractions.
4. Diagnosis requires correlation of labs with clinical symptoms.
2. What is the timeframe for re-checking labs after starting
levothyroxine?
Correct Answer: 6-8 weeks after starting therapy.
Rationale:
1. Levothyroxine has a long half-life (approximately 7 days).
2. Steady state is reached in 6-8 weeks.
3. TSH is the most sensitive marker for dose adjustment.
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4. Re-check sooner if patient is symptomatic or dose was changed
significantly.
3. What are the signs and symptoms of hypothyroidism?
Correct Answer: Face: pale, puffy, expressionless. Skin: cold and dry. Hair:
brittle and hair loss. Heart rate and temperature are lowered. Complaints:
lethargy, fatigue, intolerance to cold. Mentation may be impaired. Thyroid
enlargement if low levels of T3 and T4 promote excessive release of TSH.
Rationale:
1. Hypothyroidism slows metabolic rate.
2. Myxedema (puffy face, non-pitting edema) is characteristic.
3. Bradycardia, hypothermia, and weight gain are common.
4. TSH is elevated in primary hypothyroidism.
4. What is the treatment for thyroid storm?
Correct Answer: High-dose potassium iodide or strong iodine solution to
suppress thyroid hormone release; methimazole to suppress thyroid
hormone synthesis; beta-blocker to reduce heart rate; sedation; cooling;
glucocorticoids; and IV fluids.
Rationale:
1. Thyroid storm is a life-threatening emergency (fever, tachycardia,
delirium).
2. Methimazole (or propylthiouracil) blocks new hormone synthesis.
3. Iodide blocks hormone release (given after methimazole).
4. Beta-blockers (propranolol) control sympathetic symptoms.
5. Glucocorticoids (hydrocortisone) inhibit T4 to T3 conversion and treat
relative adrenal insufficiency.
5. What is the result of not treating hypothyroidism during
pregnancy?
Correct Answer: Permanent neurological defects, decreased IQ, large
protruding tongue, potbelly, dwarfish stature, impaired development of
nervous system, bones, teeth, and muscles.
Rationale:
1. Maternal hypothyroidism impairs fetal brain development (first trimester).
2. Thyroid hormone is critical for neuronal migration and myelination.
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3. Cretinism includes intellectual disability and growth retardation.
4. Levothyroxine dose increases by 30-50% during pregnancy.
6. What medication is used to treat symptoms of hyperthyroidism (not
the hyperthyroidism itself)?
Correct Answer: Metoprolol (beta-blocker) can be used to treat
tachycardia experienced with hyperthyroidism, but it does not treat
hyperthyroidism itself.
Rationale:
1. Beta-blockers control sympathetic symptoms (tachycardia, tremor,
anxiety).
2. They do not reduce thyroid hormone levels.
3. Methimazole, propylthiouracil, radioactive iodine, or surgery treat the
underlying hyperthyroidism.
4. Propranolol also inhibits T4 to T3 conversion (added benefit).
7. What drugs, foods, or supplements reduce levothyroxine
absorption?
Correct Answer: H2 receptor blockers (cimetidine), proton pump
inhibitors (lansoprazole), sucralfate, cholestyramine, colestipol, aluminum-
containing antacids, calcium supplements, iron supplements, magnesium
salts, orlistat.
Rationale:
1. These agents bind levothyroxine in the GI tract or alter gastric pH.
2. Separate administration by at least 4 hours.
3. Food also reduces absorption (take on empty stomach, 30-60 minutes
before breakfast).
4. Consistency in timing is key to stable levels.
8. How is a diagnosis of diabetes mellitus confirmed before beginning
treatment?
Correct Answer: Hemoglobin A1C >6.5%; fasting plasma glucose ≥126
mg/dL; random plasma glucose ≥200 mg/dL plus symptoms of diabetes; or
oral glucose tolerance test (OGTT) with 2-hour plasma glucose ≥200
mg/dL.
Rationale:
1. Any single abnormal test requires confirmation on a second day (except
NR565 / NR 565 Advanced Pharmacology
Care of the Fundamentals Final Exam |
Chamberlain University | Verified
Questions & Answers with Rationales |
Multiple Choice & Open-Ended Q&A
Exam Structure:
Subject: Advanced Pharmacology (NR565) – Final Exam
Source: NR565 / NR 565 Advanced Pharmacology Care of the Fundamentals – Final
Exam (Chamberlain)
Format: Multiple Choice & Open-Ended Q&A
1. What labs are used to diagnose thyroid disorders?
Correct Answer: TSH, total T4 and T3, free T4 and T3.
Rationale:
1. TSH is the primary screening test for thyroid dysfunction.
2. Free T4 and T3 measure the active (unbound) hormone levels.
3. Total T4 and T3 include bound and unbound fractions.
4. Diagnosis requires correlation of labs with clinical symptoms.
2. What is the timeframe for re-checking labs after starting
levothyroxine?
Correct Answer: 6-8 weeks after starting therapy.
Rationale:
1. Levothyroxine has a long half-life (approximately 7 days).
2. Steady state is reached in 6-8 weeks.
3. TSH is the most sensitive marker for dose adjustment.
, 2|Page
4. Re-check sooner if patient is symptomatic or dose was changed
significantly.
3. What are the signs and symptoms of hypothyroidism?
Correct Answer: Face: pale, puffy, expressionless. Skin: cold and dry. Hair:
brittle and hair loss. Heart rate and temperature are lowered. Complaints:
lethargy, fatigue, intolerance to cold. Mentation may be impaired. Thyroid
enlargement if low levels of T3 and T4 promote excessive release of TSH.
Rationale:
1. Hypothyroidism slows metabolic rate.
2. Myxedema (puffy face, non-pitting edema) is characteristic.
3. Bradycardia, hypothermia, and weight gain are common.
4. TSH is elevated in primary hypothyroidism.
4. What is the treatment for thyroid storm?
Correct Answer: High-dose potassium iodide or strong iodine solution to
suppress thyroid hormone release; methimazole to suppress thyroid
hormone synthesis; beta-blocker to reduce heart rate; sedation; cooling;
glucocorticoids; and IV fluids.
Rationale:
1. Thyroid storm is a life-threatening emergency (fever, tachycardia,
delirium).
2. Methimazole (or propylthiouracil) blocks new hormone synthesis.
3. Iodide blocks hormone release (given after methimazole).
4. Beta-blockers (propranolol) control sympathetic symptoms.
5. Glucocorticoids (hydrocortisone) inhibit T4 to T3 conversion and treat
relative adrenal insufficiency.
5. What is the result of not treating hypothyroidism during
pregnancy?
Correct Answer: Permanent neurological defects, decreased IQ, large
protruding tongue, potbelly, dwarfish stature, impaired development of
nervous system, bones, teeth, and muscles.
Rationale:
1. Maternal hypothyroidism impairs fetal brain development (first trimester).
2. Thyroid hormone is critical for neuronal migration and myelination.
, 3|Page
3. Cretinism includes intellectual disability and growth retardation.
4. Levothyroxine dose increases by 30-50% during pregnancy.
6. What medication is used to treat symptoms of hyperthyroidism (not
the hyperthyroidism itself)?
Correct Answer: Metoprolol (beta-blocker) can be used to treat
tachycardia experienced with hyperthyroidism, but it does not treat
hyperthyroidism itself.
Rationale:
1. Beta-blockers control sympathetic symptoms (tachycardia, tremor,
anxiety).
2. They do not reduce thyroid hormone levels.
3. Methimazole, propylthiouracil, radioactive iodine, or surgery treat the
underlying hyperthyroidism.
4. Propranolol also inhibits T4 to T3 conversion (added benefit).
7. What drugs, foods, or supplements reduce levothyroxine
absorption?
Correct Answer: H2 receptor blockers (cimetidine), proton pump
inhibitors (lansoprazole), sucralfate, cholestyramine, colestipol, aluminum-
containing antacids, calcium supplements, iron supplements, magnesium
salts, orlistat.
Rationale:
1. These agents bind levothyroxine in the GI tract or alter gastric pH.
2. Separate administration by at least 4 hours.
3. Food also reduces absorption (take on empty stomach, 30-60 minutes
before breakfast).
4. Consistency in timing is key to stable levels.
8. How is a diagnosis of diabetes mellitus confirmed before beginning
treatment?
Correct Answer: Hemoglobin A1C >6.5%; fasting plasma glucose ≥126
mg/dL; random plasma glucose ≥200 mg/dL plus symptoms of diabetes; or
oral glucose tolerance test (OGTT) with 2-hour plasma glucose ≥200
mg/dL.
Rationale:
1. Any single abnormal test requires confirmation on a second day (except
