NR 601
Week 5 Quiz: Thyroid Management & Diabetes Care
Solutions, Complete Questions with Verified Answers and
Rationales | Chamberlain University | Latest Updated Version
| Already Graded A+
THIS DOCUMENT CONTAINS:
❖NR601 Week 5 Quiz
❖Thyroid Management & Diabetes Care Solutions
❖Complete Questions with Verified Answers and Rationales
❖Chamberlain University
❖Latest Updated Version
❖Already Graded A+
,Question 1
A 70-year-old patient has a TSH of 7.8 mIU/L and normal free T4. She has no
significant symptoms. What is the most appropriate management approach?
A) Begin levothyroxine 75mcg daily
B) Monitor TSH levels and reassess symptoms periodically
C) Start desiccated thyroid extract due to age-related risk
D) Refer to endocrinology for combination therapy
● Correct Answer: B) Monitor TSH levels and reassess symptoms periodically
● Rationale: This patient presents with subclinical hypothyroidism (elevated
TSH with normal free T4). In older adults (especially those over age 65 or 70)
who are asymptomatic and have a TSH below 10 mIU/L, routine treatment
with thyroid hormone replacement is generally not recommended due to the
risks of over-treatment (e.g., atrial fibrillation, bone loss). The standard of
care is to monitor thyroid function and symptoms every 6 to 12 months.
Question 2
A patient continues to report hypothyroid symptoms despite a normal TSH
level on levothyroxine. What is the next best step?
A) Add liothyronine (T3) or consider combination therapy
B) Increase the levothyroxine dose
C) Discontinue levothyroxine and monitor labs
D) Switch to desiccated thyroid extract immediately
1 | 16
, ● Correct Answer: A) Add liothyronine (T3) or consider combination therapy
● Rationale: When a patient is biochemically euthyroid (normal TSH) on
levothyroxine therapy but continues to have persistent hypothyroid-like
symptoms, clinicians should evaluate for other causes (such as anemia,
vitamin D deficiency, or depression). However, if no other causes are
identified, some guidelines and clinical expert consensus suggest a trial of
adding liothyronine (T3) or utilizing combination T3/T4 therapy to see if
symptomatic relief is achieved. Increasing the levothyroxine dose when TSH
is already normal could induce subclinical or overt hyperthyroidism.
Question 3
A 49-year-old patient is newly diagnosed with T2DM. Which of the following
referrals should the outpatient nurse practitioner prioritize at diagnosis to
support comprehensive diabetes management?
A) Cardiology, nephrology, podiatry
B) Psychology, nephrology, endocrinology
C) Dietitian, ophthalmology, certified diabetes care and education specialist
(CDES)
D) Endocrinology, psychology, ophthalmology
● Correct Answer: C) Dietitian, ophthalmology, certified diabetes care and
education specialist (CDES)
● Rationale: At the time of initial diagnosis of Type 2 Diabetes Mellitus
(T2DM), the American Diabetes Association (ADA) recommends a
comprehensive multi-disciplinary approach. Priority referrals include a
registered dietitian for medical nutrition therapy (MNT), a Certified Diabetes
Care and Education Specialist (CDES) for self-management education, and an
2 | 16
Week 5 Quiz: Thyroid Management & Diabetes Care
Solutions, Complete Questions with Verified Answers and
Rationales | Chamberlain University | Latest Updated Version
| Already Graded A+
THIS DOCUMENT CONTAINS:
❖NR601 Week 5 Quiz
❖Thyroid Management & Diabetes Care Solutions
❖Complete Questions with Verified Answers and Rationales
❖Chamberlain University
❖Latest Updated Version
❖Already Graded A+
,Question 1
A 70-year-old patient has a TSH of 7.8 mIU/L and normal free T4. She has no
significant symptoms. What is the most appropriate management approach?
A) Begin levothyroxine 75mcg daily
B) Monitor TSH levels and reassess symptoms periodically
C) Start desiccated thyroid extract due to age-related risk
D) Refer to endocrinology for combination therapy
● Correct Answer: B) Monitor TSH levels and reassess symptoms periodically
● Rationale: This patient presents with subclinical hypothyroidism (elevated
TSH with normal free T4). In older adults (especially those over age 65 or 70)
who are asymptomatic and have a TSH below 10 mIU/L, routine treatment
with thyroid hormone replacement is generally not recommended due to the
risks of over-treatment (e.g., atrial fibrillation, bone loss). The standard of
care is to monitor thyroid function and symptoms every 6 to 12 months.
Question 2
A patient continues to report hypothyroid symptoms despite a normal TSH
level on levothyroxine. What is the next best step?
A) Add liothyronine (T3) or consider combination therapy
B) Increase the levothyroxine dose
C) Discontinue levothyroxine and monitor labs
D) Switch to desiccated thyroid extract immediately
1 | 16
, ● Correct Answer: A) Add liothyronine (T3) or consider combination therapy
● Rationale: When a patient is biochemically euthyroid (normal TSH) on
levothyroxine therapy but continues to have persistent hypothyroid-like
symptoms, clinicians should evaluate for other causes (such as anemia,
vitamin D deficiency, or depression). However, if no other causes are
identified, some guidelines and clinical expert consensus suggest a trial of
adding liothyronine (T3) or utilizing combination T3/T4 therapy to see if
symptomatic relief is achieved. Increasing the levothyroxine dose when TSH
is already normal could induce subclinical or overt hyperthyroidism.
Question 3
A 49-year-old patient is newly diagnosed with T2DM. Which of the following
referrals should the outpatient nurse practitioner prioritize at diagnosis to
support comprehensive diabetes management?
A) Cardiology, nephrology, podiatry
B) Psychology, nephrology, endocrinology
C) Dietitian, ophthalmology, certified diabetes care and education specialist
(CDES)
D) Endocrinology, psychology, ophthalmology
● Correct Answer: C) Dietitian, ophthalmology, certified diabetes care and
education specialist (CDES)
● Rationale: At the time of initial diagnosis of Type 2 Diabetes Mellitus
(T2DM), the American Diabetes Association (ADA) recommends a
comprehensive multi-disciplinary approach. Priority referrals include a
registered dietitian for medical nutrition therapy (MNT), a Certified Diabetes
Care and Education Specialist (CDES) for self-management education, and an
2 | 16
