NR 565 Advanced Pharmacology Final Study Guide: (Latest 2025/2026 Update)
Comprehensive Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: Advanced Pharmacology (NR 565) – Final Exam Study Guide: Thyroid Disorders, Diabetes
Management, Asthma/COPD, Smoking Cessation, GI Disorders, Infectious Disease, Vaccinations
Source: Final Study Guide Blueprint – Laboratory Monitoring, Drug Mechanisms, Step Therapy,
Contraindications, Patient Education
Format: Q&A Study Guide with Rationale – 100% Verified Answers
Verified: Latest 2025/2026 Update | Grade A Guaranteed
1: What labs are used to diagnose thyroid disorders?
Correct Answer: TSH (screening/hypothyroid monitoring), T4 (monitoring replacement therapy), T3
(diagnosis of hyperthyroidism). Pattern: TSH low, T4 normal, T3 high = hyperthyroidism.
1. TSH is the most sensitive marker for thyroid dysfunction.
2. Overt hyperthyroidism: suppressed TSH, elevated T4 and/or T3.
3. Overt hypothyroidism: elevated TSH, low T4.
2: When should TSH be rechecked after starting levothyroxine?
Correct Answer: 6-8 weeks after initiating therapy and after any dosage change; then at least once a
year after TSH stabilized
1. TSH response takes 6-8 weeks due to levothyroxine's long half-life.
2. More frequent monitoring during pregnancy (every 4-6 weeks).
3. Dose adjustments based on TSH in hypothyroid patients.
3: What are signs and symptoms of hypothyroidism?
Correct Answer: Pale, puffy, expressionless face; cold/dry skin; brittle hair with loss; slowed heart
rate; lethargy, fatigue, cold intolerance; thyroid enlargement; impaired mentation.
1. Hypothyroidism causes decreased metabolic rate.
2. Severe untreated hypothyroidism = myxedema coma (medical emergency).
3. Lab findings: elevated TSH, low free T4.
4: What are signs and symptoms of hyperthyroidism?
Correct Answer: Elevated/strong HR, dysrhythmias, angina; nervousness, insomnia, rapid speech,
hyperreflexia, tremors; muscle weakness; increased metabolic rate → warm/moist skin, heat
intolerance, weight loss; exophthalmos.
1. Thyrotoxicosis refers to the clinical manifestations of excess thyroid hormone.
2. Graves disease is most common cause (autoimmune).
3. Thyroid storm is life-threatening exacerbation.
, 5: How is thyroid storm treated?
Correct Answer: High-dose potassium iodide or strong iodine solution (suppress hormone release);
methimazole (suppress synthesis); beta-blocker (reduce HR); sedation, cooling, glucocorticoids, IV
fluids.
1. Characterized by hyperthermia (≥105°F), severe tachycardia, agitation, tremor, coma,
hypotension.
2. PTU preferred over methimazole in thyroid storm.
3. Supportive care essential.
6: What is the result of not treating hypothyroidism during pregnancy?
Correct Answer: Permanent neuropsychological deficits in the child (decreased IQ); effect limited
largely to first trimester when fetus cannot produce its own thyroid hormone.
1. Levothyroxine dose typically increases by 50% between weeks 4-8 of gestation.
2. Some recommend routine TSH screening as soon as pregnancy confirmed.
3. Monitor TSH every 4-6 weeks in pregnancy.
7: What drugs/supplements interact with levothyroxine?
Correct Answer: Reduce absorption: H2 blockers, PPIs, Carafate, Questran, iron, calcium, magnesium,
antacids. Accelerate metabolism: phenytoin, carbamazepine, rifampin. Adjust warfarin, catecholamines,
insulin, digoxin.
1. Take levothyroxine on empty stomach 30-60 minutes before breakfast.
2. Separate from interacting drugs/supplements by 4 hours.
3. Monitor INR closely when starting/stopping levothyroxine.
8: What is the first-line drug for hyperthyroidism and which is preferred in pregnancy/thyroid
storm?
Correct Answer: Methimazole is first-line (not in pregnancy/breastfeeding). PTU preferred in first
trimester pregnancy and thyroid storm.
1. PTU carries risk of hepatotoxicity, FDA recommends against first-line use except in
pregnancy/storm.
2. Methimazole teratogenic risk (aplasia cutis).
3. Beta-blockers for symptom management.
9: How is diabetes diagnosed?
Correct Answer: FPG ≥126 mg/dL; random plasma glucose ≥200 mg/dL with symptoms; OGTT 2-
hour ≥200 mg/dL; HbA1c ≥6.5% (standard test).
1. Confirmation requires repeat testing unless symptomatic with random glucose ≥200.
2. HbA1c provides estimate of glycemic control over prior 2-3 months.
3. Prediabetes: A1c 5.7-6.4%.
Comprehensive Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: Advanced Pharmacology (NR 565) – Final Exam Study Guide: Thyroid Disorders, Diabetes
Management, Asthma/COPD, Smoking Cessation, GI Disorders, Infectious Disease, Vaccinations
Source: Final Study Guide Blueprint – Laboratory Monitoring, Drug Mechanisms, Step Therapy,
Contraindications, Patient Education
Format: Q&A Study Guide with Rationale – 100% Verified Answers
Verified: Latest 2025/2026 Update | Grade A Guaranteed
1: What labs are used to diagnose thyroid disorders?
Correct Answer: TSH (screening/hypothyroid monitoring), T4 (monitoring replacement therapy), T3
(diagnosis of hyperthyroidism). Pattern: TSH low, T4 normal, T3 high = hyperthyroidism.
1. TSH is the most sensitive marker for thyroid dysfunction.
2. Overt hyperthyroidism: suppressed TSH, elevated T4 and/or T3.
3. Overt hypothyroidism: elevated TSH, low T4.
2: When should TSH be rechecked after starting levothyroxine?
Correct Answer: 6-8 weeks after initiating therapy and after any dosage change; then at least once a
year after TSH stabilized
1. TSH response takes 6-8 weeks due to levothyroxine's long half-life.
2. More frequent monitoring during pregnancy (every 4-6 weeks).
3. Dose adjustments based on TSH in hypothyroid patients.
3: What are signs and symptoms of hypothyroidism?
Correct Answer: Pale, puffy, expressionless face; cold/dry skin; brittle hair with loss; slowed heart
rate; lethargy, fatigue, cold intolerance; thyroid enlargement; impaired mentation.
1. Hypothyroidism causes decreased metabolic rate.
2. Severe untreated hypothyroidism = myxedema coma (medical emergency).
3. Lab findings: elevated TSH, low free T4.
4: What are signs and symptoms of hyperthyroidism?
Correct Answer: Elevated/strong HR, dysrhythmias, angina; nervousness, insomnia, rapid speech,
hyperreflexia, tremors; muscle weakness; increased metabolic rate → warm/moist skin, heat
intolerance, weight loss; exophthalmos.
1. Thyrotoxicosis refers to the clinical manifestations of excess thyroid hormone.
2. Graves disease is most common cause (autoimmune).
3. Thyroid storm is life-threatening exacerbation.
, 5: How is thyroid storm treated?
Correct Answer: High-dose potassium iodide or strong iodine solution (suppress hormone release);
methimazole (suppress synthesis); beta-blocker (reduce HR); sedation, cooling, glucocorticoids, IV
fluids.
1. Characterized by hyperthermia (≥105°F), severe tachycardia, agitation, tremor, coma,
hypotension.
2. PTU preferred over methimazole in thyroid storm.
3. Supportive care essential.
6: What is the result of not treating hypothyroidism during pregnancy?
Correct Answer: Permanent neuropsychological deficits in the child (decreased IQ); effect limited
largely to first trimester when fetus cannot produce its own thyroid hormone.
1. Levothyroxine dose typically increases by 50% between weeks 4-8 of gestation.
2. Some recommend routine TSH screening as soon as pregnancy confirmed.
3. Monitor TSH every 4-6 weeks in pregnancy.
7: What drugs/supplements interact with levothyroxine?
Correct Answer: Reduce absorption: H2 blockers, PPIs, Carafate, Questran, iron, calcium, magnesium,
antacids. Accelerate metabolism: phenytoin, carbamazepine, rifampin. Adjust warfarin, catecholamines,
insulin, digoxin.
1. Take levothyroxine on empty stomach 30-60 minutes before breakfast.
2. Separate from interacting drugs/supplements by 4 hours.
3. Monitor INR closely when starting/stopping levothyroxine.
8: What is the first-line drug for hyperthyroidism and which is preferred in pregnancy/thyroid
storm?
Correct Answer: Methimazole is first-line (not in pregnancy/breastfeeding). PTU preferred in first
trimester pregnancy and thyroid storm.
1. PTU carries risk of hepatotoxicity, FDA recommends against first-line use except in
pregnancy/storm.
2. Methimazole teratogenic risk (aplasia cutis).
3. Beta-blockers for symptom management.
9: How is diabetes diagnosed?
Correct Answer: FPG ≥126 mg/dL; random plasma glucose ≥200 mg/dL with symptoms; OGTT 2-
hour ≥200 mg/dL; HbA1c ≥6.5% (standard test).
1. Confirmation requires repeat testing unless symptomatic with random glucose ≥200.
2. HbA1c provides estimate of glycemic control over prior 2-3 months.
3. Prediabetes: A1c 5.7-6.4%.
