NURS222 EXAM 4 2026 MULTISYSTEM
DISORDERS MODULE QUESTIONS
SOLUTIONS STRUCTURED SCRIPT
◉ Advances Hypothyroidism S/S
Answer: Myxedema: advanced hypothyroidism in adults; swelling,
thickened skin
Thyroid Crisis/Storm: life threatening condition associated with
hyperthyroidism
HR, BP, and Temp soar to dangerously high levels
◉ Hyperthyroidism (Graves Disease) S/S
Answer: CNS: Nervousness, irritability
CV: Tachycardia, palpitations
GI: Weight loss, diarrhea
Temperature: Heat intolerance
Skin: Hyperhidrosis (excess sweating)
Eyes: Exophthalmos (bulging eyes)
◉ Levothyroxine (Hypothyroidism) - MOA, use, and key teaching
,Answer: Drug of choice for hypothyroidism
Synthetic T4 → converts to T3
Take on empty stomach, same time daily Monitor TSH
Recheck labs in ~6 weeks
Do NOT switch brands
◉ Levothyroxine (Hypothyroidism) - side effects & adverse effects
Answer: HYPERthyroid symptoms (too much drug)
Tremors, insomnia, weight loss, diarrhea, sweating
Serious: tachycardia, HTN, palpitations, atrial fibrillation, angina,
osteoporosis, seizures
Risk of thyroid storm
◉ Levothyroxine (Hypothyroidism) - special considerations
Answer: Safe in pregnancy (Category A)
May need ↑ dose in pregnancy
Monitor growth & development in kids
◉ Methimazole (Hyperthyroidism) - MOA, use, key teaching
Answer: Drug of choice for hyperthyroidism
Blocks thyroid hormone synthesis (does NOT destroy existing
hormone)
,Takes time to work (must wait for stored hormone to be used)
Avoid in 1st trimester pregnancy
◉ Methimazole (Hyperthyroidism) - side effects & adverse effect
Answer: CNS: headache, dizziness
GI: nausea, vomiting, loss of taste
**Agranulocytosis (↓ WBCs → infection risk)
Teach: report sore throat or fever immediately
◉ Propylthiouracil (PTU) (Hyperthyroidism) - MOA, Uses, Side
Effects, Downsides
Answer: MOA: Blocks thyroid hormone production; also blocks T4 →
T3 conversion
Uses: Thyroid storm (preferred) & safer in 1st trimester pregnancy
Side Effects
CNS: dizziness, tingling
CV: chest pain, SOB, edema
GI: vomiting, heartburn, stomach pain
Downsides
Liver toxicity
Short half-life → multiple doses/day
Not first-line except for key uses
, ◉ Radioactive Iodine (Hyperthyroidism) - Uses & Contraindications
Answer: Radioactive iodine I-131
High dose → thyroid cancer
Low dose → hyperthyroidism
Radioactive iodine I-123
Diagnostic only
Contraindications: pregnancy, lactation, pediatric
◉ What are glucocorticoids used for?
Answer: Used to replace cortisol in Addison's disease
Short-acting: Hydrocortisone, Cortisone
Intermediate-acting: Prednisone, Prednisolone, Methylprednisolone
Long-acting: Dexamethasone, Betamethasone
◉ Prednisone (Glucocorticoid) - MOA & main effects
Answer: Glucocorticoid causes ↓ inflammation (stabilizes leukocyte
lysosomal membranes)
Suppresses immune system and affects metabolism (protein, fat,
carbs)
◉ Prednisone (Glucocorticoid) - Side Effects
DISORDERS MODULE QUESTIONS
SOLUTIONS STRUCTURED SCRIPT
◉ Advances Hypothyroidism S/S
Answer: Myxedema: advanced hypothyroidism in adults; swelling,
thickened skin
Thyroid Crisis/Storm: life threatening condition associated with
hyperthyroidism
HR, BP, and Temp soar to dangerously high levels
◉ Hyperthyroidism (Graves Disease) S/S
Answer: CNS: Nervousness, irritability
CV: Tachycardia, palpitations
GI: Weight loss, diarrhea
Temperature: Heat intolerance
Skin: Hyperhidrosis (excess sweating)
Eyes: Exophthalmos (bulging eyes)
◉ Levothyroxine (Hypothyroidism) - MOA, use, and key teaching
,Answer: Drug of choice for hypothyroidism
Synthetic T4 → converts to T3
Take on empty stomach, same time daily Monitor TSH
Recheck labs in ~6 weeks
Do NOT switch brands
◉ Levothyroxine (Hypothyroidism) - side effects & adverse effects
Answer: HYPERthyroid symptoms (too much drug)
Tremors, insomnia, weight loss, diarrhea, sweating
Serious: tachycardia, HTN, palpitations, atrial fibrillation, angina,
osteoporosis, seizures
Risk of thyroid storm
◉ Levothyroxine (Hypothyroidism) - special considerations
Answer: Safe in pregnancy (Category A)
May need ↑ dose in pregnancy
Monitor growth & development in kids
◉ Methimazole (Hyperthyroidism) - MOA, use, key teaching
Answer: Drug of choice for hyperthyroidism
Blocks thyroid hormone synthesis (does NOT destroy existing
hormone)
,Takes time to work (must wait for stored hormone to be used)
Avoid in 1st trimester pregnancy
◉ Methimazole (Hyperthyroidism) - side effects & adverse effect
Answer: CNS: headache, dizziness
GI: nausea, vomiting, loss of taste
**Agranulocytosis (↓ WBCs → infection risk)
Teach: report sore throat or fever immediately
◉ Propylthiouracil (PTU) (Hyperthyroidism) - MOA, Uses, Side
Effects, Downsides
Answer: MOA: Blocks thyroid hormone production; also blocks T4 →
T3 conversion
Uses: Thyroid storm (preferred) & safer in 1st trimester pregnancy
Side Effects
CNS: dizziness, tingling
CV: chest pain, SOB, edema
GI: vomiting, heartburn, stomach pain
Downsides
Liver toxicity
Short half-life → multiple doses/day
Not first-line except for key uses
, ◉ Radioactive Iodine (Hyperthyroidism) - Uses & Contraindications
Answer: Radioactive iodine I-131
High dose → thyroid cancer
Low dose → hyperthyroidism
Radioactive iodine I-123
Diagnostic only
Contraindications: pregnancy, lactation, pediatric
◉ What are glucocorticoids used for?
Answer: Used to replace cortisol in Addison's disease
Short-acting: Hydrocortisone, Cortisone
Intermediate-acting: Prednisone, Prednisolone, Methylprednisolone
Long-acting: Dexamethasone, Betamethasone
◉ Prednisone (Glucocorticoid) - MOA & main effects
Answer: Glucocorticoid causes ↓ inflammation (stabilizes leukocyte
lysosomal membranes)
Suppresses immune system and affects metabolism (protein, fat,
carbs)
◉ Prednisone (Glucocorticoid) - Side Effects
