NR565 / NR 565 Advanced Pharmacology Care of the Fundamentals Final Exam (Weeks 5-8) | Chamberlain University (2026/2027) | Verified Questions and Answers with Rationales | Get HighScore | Instant Download

GET HIGHSCORE on the NR565 Advanced Pharmacology Care of the Fundamentals Final Exam (Weeks 5-8) at Chamberlain University with this comprehensive test bank featuring verified questions and answers with detailed rationales. The NR565 final exam is non-cumulative, consisting of 100 multiple-choice questions with a 120-minute time allotment (1.2 minutes per question), covering content from Weeks 5 through 8 of the course . This resource covers the four key content areas: Week 5 (Endocrine Disorders), Week 6 (Respiratory Conditions), Week 7 (Gastrointestinal Conditions), and Week 8 (Complementary and Alternative Therapies) . MASTER ENDOCRINOLOGY (WEEK 5 - CHAPTERS 48-49) Levothyroxine Management: Used for hypothyroidism, congenital hypothyroidism, myxedema coma, simple goiter, and primary hypothyroidism . TSH should be rechecked 6-8 weeks after initiating therapy or after any dosage change, then at least once a year after stabilization. The medication should be taken on an empty stomach 30-60 minutes before breakfast . Drug interactions include H2 receptor blockers, PPIs, Carafate, iron supplements, and calcium supplements which reduce absorption. Drugs that accelerate metabolism include phenytoin, carbamazepine, rifampin, and phenobarbital . Levothyroxine and Calcium Supplementation: For a patient on levothyroxine taking a daily calcium supplement, the best instruction is to take calcium at bedtime and levothyroxine in the morning, as calcium salts significantly reduce levothyroxine absorption and doses should be separated by several hours . Levothyroxine in Pregnancy: A pregnant patient with hypothyroidism in the first trimester typically requires an increase in levothyroxine dose and more frequent TSH monitoring, as pregnancy increases thyroid hormone requirements . Hyperthyroidism Treatment: A patient with TSH of 0.28, free T4 of 3.0, and free T3 over 650 has hyperthyroidism and should be started on methimazole, PTU (propylthiouracil), or radioactive iodine . Methimazole is first-line for hyperthyroidism, inhibiting thyroid hormone synthesis, and is preferred in pregnant/breastfeeding patients and those with thyrotoxic crisis. PTU is preferred for thyroid storm . Radioactive Iodine Adverse Effects (Iodism) : Can lead to corrosive injury to the GI tract, brassy taste, burning sensation in mouth, soreness in gums/teeth, and severe abdominal distress . Type 2 Diabetes Diagnosis: A fasting plasma glucose of 130 mg/dL and a repeat value of 128 mg/dL meets the criteria for diabetes mellitus, as fasting plasma glucose ≥126 mg/dL on two separate occasions is diagnostic in the absence of acute stress . Initial Pharmacologic Approach for Type 2 Diabetes: For a patient with newly diagnosed type 2 diabetes with A1C of 7.4% and no significant comorbidities, metformin monotherapy is most appropriate as first-line therapy in combination with diet and exercise . GLP-1 Receptor Agonists: For a patient with type 2 diabetes and obesity already on metformin, a GLP-1 receptor agonist (e.g., exenatide, liraglutide) is best for promoting weight loss and improving glycemic control without hypoglycemia. GLP-1 agonists improve glycemic control, slow gastric emptying, decrease appetite, and are associated with weight loss rather than weight gain . They are subcutaneous injections that cause increased insulin production, inhibit postprandial glucagon release, and increase satiety; they can be helpful in obese patients and stimulate weight loss and suppression of appetite . Sulfonylurea Adverse Effects: When starting a sulfonylurea (e.g., glipizide), the most important adverse effect to emphasize during patient education is hypoglycemia, as sulfonylureas increase insulin secretion independent of glucose levels, carrying substantial risk of hypoglycemia especially with missed meals or renal impairment . SGLT2 Inhibitors (Canagliflozin) : For a patient on canagliflozin reporting increased urination and mild genital itching, the most appropriate counseling point is to report signs of infection and maintain good perineal hygiene, as these medications increase glucose excretion in urine, putting patients at higher risk for UTIs and vulvovaginal infections . SGLT2 inhibitors limit reabsorption of glucose in renal tubules, block glucose reabsorption in the proximal nephron, and increase release of glucose in urine . Insulin Addition to Oral Regimen: When a patient with type 2 diabetes on metformin and a sulfonylurea has an A1C of 8.9% after 6 months, the most appropriate next step is to add basal insulin to the regimen. Guidelines recommend adding basal insulin when A1C remains markedly elevated despite maximized oral agents . Post-Prandial Hyperglycemia Management: For a patient on basal insulin with fasting glucose values within target but elevated pre-dinner readings, the most appropriate adjustment is to add a rapid-acting insulin dose before lunch. Post-prandial hyperglycemia despite controlled fasting values is best addressed by adding or adjusting mealtime rapid-acting insulin rather than simply increasing basal insulin . Hypoglycemia Prevention in Insulin-Treated Patients: For a patient with frequent hypoglycemic episodes on prandial insulin who admits to skipping meals, the best intervention is reinforcing consistent carbohydrate intake with scheduled insulin doses, as recurrent hypoglycemia in the context of skipped meals reflects a mismatch between insulin and carbohydrate intake . Pioglitazone (TZD) : Decreases insulin resistance, increases glucose uptake by muscle/adipose tissue, and decreases glucose production by the liver. Black box warning for severe heart failure; contraindicated in DKA, history of bladder cancer, Type 1 DM, hematuria, and hepatic impairment . GLP-1 Receptor Agonist Adverse Effects: Patients should be educated on signs/symptoms of hypoglycemia. Contraindications include pancreatitis, renal dysfunction, pregnancy, and personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 . Hypoglycemia Unawareness from Beta Blockers: For a patient using basal-bolus insulin prescribed a nonselective beta blocker for migraine prophylaxis, shakiness and palpitations may be blunted during hypoglycemia, but sweating can still occur with low blood glucose. Beta blockade can impair hepatic glucose release, and more frequent glucose monitoring is advisable . De-intensifying Therapy: For a patient with long-standing type 2 diabetes with A1C of 6.1% but frequent symptomatic hypoglycemia, the most appropriate adjustment is to de-intensify therapy to reduce hypoglycemia episodes, as very tight control with recurrent hypoglycemia is not desirable and treatment should be adjusted to prioritize safety . DPP-4 Inhibitors: Inhibit DPP-4 activity and increase active incretin concentrations, resulting in increased insulin secretion and decreased glucagon. May cause severe and disabling joint pain that can occur at any point during treatment; may also cause angioedema and acute pancreatitis . MASTER RESPIRATORY PHARMACOLOGY (WEEK 6) Asthma Classification: A 33-year-old asthmatic with daily symptoms and night-time exacerbations 4-5 times weekly is classified as moderate-persistent asthma. Step 3 (Moderate Persistent) is defined as symptoms daily with nighttime awakenings 3-4 times per month . Asthma Step Classification: Step 1 (Intermittent): symptoms ≤2 days/week, SABA use ≤2 days/week. Step 2 (Mild Persistent): symptoms 2 days/week but less than daily, SABA use 2 days/week but less than daily. Step 3 (Moderate Persistent): symptoms daily, nighttime awakenings 3-4 times/month. Step 4 (Severe Persistent): symptoms several times daily, nighttime awakenings once/week . ICS/LABA Combination Benefits: For a patient with moderate persistent asthma well-controlled on low-dose ICS/LABA combination but forgetting mid-day dosing, the most relevant advantage of combination inhalers is that they provide both bronchodilation and anti-inflammatory effects in one device, which can improve adherence . Bronchodilators: Provide symptomatic relief in patients with asthma and COPD but do not alter the underlying inflammation. They activate beta-2 receptors causing bronchodilation and relieving bronchospasm . MASTER GASTROENTEROLOGY (WEEK 7) Bisacodyl Laxative Discontinuation: For a patient who has taken an oral bisacodyl laxative for years, the correct instruction is to stop taking the laxative immediately and expect no stool for several days . Constipation Management in Pregnancy: For a pregnant woman on bed rest with mild constipation, the most appropriate drug is docusate (stool softener). Docusate is safe in pregnancy . Promethazine Safety: Promethazine is known to potentially cause severe respiratory depression and is contraindicated in children below 2 years of age (FDA boxed warning) . Ondansetron Adverse Effects: The most common adverse effect of ondansetron is constipation. Other side effects include headache and dizziness, but constipation is particularly frequent . Scopolamine Administration: For a patient with nausea and vomiting related to motion sickness, scopolamine is administered via transdermal patch, applied behind the ear several hours before travel