NR 566 WEEK 5 QUIZ BANK 2026/2027 | Advanced
Pharmacology Care of the Family | Chapters 18, 19, 27 |
Questions & Verified Answers | Chamberlain | Pass
Guaranteed - A+ Graded
Chapter 18 – Drugs Affecting the Endocrine System: Thyroid &
Adrenal Disorders (18 Questions)
Q1: A 58-year-old female is newly diagnosed with hypothyroidism and started on
levothyroxine 50 mcg daily. She also takes calcium carbonate 1200 mg daily for
osteoporosis. Which instruction is most important regarding administration?
A. Take both medications together with breakfast
B. Take levothyroxine 30-60 minutes before breakfast, separate calcium by at least 4
hours [CORRECT]
C. Take levothyroxine at bedtime with calcium
D. Take calcium in the morning and levothyroxine at bedtime
Correct Answer: B
Rationale: For Week 5, remember that levothyroxine absorption is significantly reduced
by calcium, iron, and antacids. The correct answer is taking levothyroxine on an empty
stomach 30-60 minutes before breakfast, with calcium separated by at least 4 hours.
This matches what you'll see in clinical practice because timing matters for therapeutic
effectiveness.
,Q2: A 32-year-old female at 8 weeks gestation is diagnosed with hyperthyroidism.
Which antithyroid medication is preferred in the first trimester?
A. Methimazole
B. Propylthiouracil (PTU) [CORRECT]
C. Radioactive iodine
D. Propranolol alone
Correct Answer: B
Rationale: Based on Chapter 18, PTU is preferred in the first trimester because
methimazole has been associated with embryopathy (aplasia cutis, choanal atresia).
The correct answer is PTU, though we switch to methimazole in the second trimester
due to PTU's risk of hepatotoxicity.
Q3: A patient on levothyroxine 100 mcg daily has a TSH of 0.3 mIU/L (low) and free T4
of 1.8 ng/dL (high-normal). The patient reports palpitations and anxiety. Which
adjustment is most appropriate?
A. Increase levothyroxine to 125 mcg
B. Decrease levothyroxine dose [CORRECT]
C. Add liothyronine (T3)
D. Continue current dose and recheck in 6 months
Correct Answer: B
, Rationale: The correct answer is decreasing the levothyroxine dose. For Week 5,
remember that TSH is suppressed (0.3) with symptoms of hyperthyroidism, indicating
overtreatment. We adjust the dose based on TSH primarily, aiming for the target range,
not just the free T4.
Q4: A 45-year-old male with primary adrenal insufficiency (Addison's disease) is on
hydrocortisone replacement. He develops a fever of 101.5°F and flu-like symptoms.
Which instruction should have been given during patient education?
A. Continue current hydrocortisone dose
B. Triple the hydrocortisone dose during illness and contact provider [CORRECT]
C. Stop hydrocortisone until fever resolves
D. Switch to prednisone temporarily
Correct Answer: B
Rationale: The correct answer is stress-dose steroids during illness. This matches what
you'll see in clinical practice because patients with adrenal insufficiency cannot mount a
cortisol response to stress. They need to double or triple their dose during moderate
illness and seek medical care for severe illness or vomiting.
Q5: A patient on long-term prednisone 20 mg daily for polymyalgia rheumatica is being
tapered. Which symptom indicates possible adrenal insufficiency during the taper?
A. Weight gain and moon face
B. Fatigue, weakness, and hypotension [CORRECT]
C. Hyperglycemia and insomnia
Pharmacology Care of the Family | Chapters 18, 19, 27 |
Questions & Verified Answers | Chamberlain | Pass
Guaranteed - A+ Graded
Chapter 18 – Drugs Affecting the Endocrine System: Thyroid &
Adrenal Disorders (18 Questions)
Q1: A 58-year-old female is newly diagnosed with hypothyroidism and started on
levothyroxine 50 mcg daily. She also takes calcium carbonate 1200 mg daily for
osteoporosis. Which instruction is most important regarding administration?
A. Take both medications together with breakfast
B. Take levothyroxine 30-60 minutes before breakfast, separate calcium by at least 4
hours [CORRECT]
C. Take levothyroxine at bedtime with calcium
D. Take calcium in the morning and levothyroxine at bedtime
Correct Answer: B
Rationale: For Week 5, remember that levothyroxine absorption is significantly reduced
by calcium, iron, and antacids. The correct answer is taking levothyroxine on an empty
stomach 30-60 minutes before breakfast, with calcium separated by at least 4 hours.
This matches what you'll see in clinical practice because timing matters for therapeutic
effectiveness.
,Q2: A 32-year-old female at 8 weeks gestation is diagnosed with hyperthyroidism.
Which antithyroid medication is preferred in the first trimester?
A. Methimazole
B. Propylthiouracil (PTU) [CORRECT]
C. Radioactive iodine
D. Propranolol alone
Correct Answer: B
Rationale: Based on Chapter 18, PTU is preferred in the first trimester because
methimazole has been associated with embryopathy (aplasia cutis, choanal atresia).
The correct answer is PTU, though we switch to methimazole in the second trimester
due to PTU's risk of hepatotoxicity.
Q3: A patient on levothyroxine 100 mcg daily has a TSH of 0.3 mIU/L (low) and free T4
of 1.8 ng/dL (high-normal). The patient reports palpitations and anxiety. Which
adjustment is most appropriate?
A. Increase levothyroxine to 125 mcg
B. Decrease levothyroxine dose [CORRECT]
C. Add liothyronine (T3)
D. Continue current dose and recheck in 6 months
Correct Answer: B
, Rationale: The correct answer is decreasing the levothyroxine dose. For Week 5,
remember that TSH is suppressed (0.3) with symptoms of hyperthyroidism, indicating
overtreatment. We adjust the dose based on TSH primarily, aiming for the target range,
not just the free T4.
Q4: A 45-year-old male with primary adrenal insufficiency (Addison's disease) is on
hydrocortisone replacement. He develops a fever of 101.5°F and flu-like symptoms.
Which instruction should have been given during patient education?
A. Continue current hydrocortisone dose
B. Triple the hydrocortisone dose during illness and contact provider [CORRECT]
C. Stop hydrocortisone until fever resolves
D. Switch to prednisone temporarily
Correct Answer: B
Rationale: The correct answer is stress-dose steroids during illness. This matches what
you'll see in clinical practice because patients with adrenal insufficiency cannot mount a
cortisol response to stress. They need to double or triple their dose during moderate
illness and seek medical care for severe illness or vomiting.
Q5: A patient on long-term prednisone 20 mg daily for polymyalgia rheumatica is being
tapered. Which symptom indicates possible adrenal insufficiency during the taper?
A. Weight gain and moon face
B. Fatigue, weakness, and hypotension [CORRECT]
C. Hyperglycemia and insomnia
