NR 565 advanced pharmacology FNP EXAM A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFIED ANSWERS

PHARMACOLOGY EXAM zm




Exam Solution zm




NR 565 Final 2026 A+ GRADE ASSURED COMPLETE SOL
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UTIONS AND VERIFIED ANSWERS (E340A) zm zm zm zm




QUESTION 1 zm




WEEK 5 zm




ANSWER

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QUESTION 2 zm




Thyroid o Diagnosis & Evaluation What labs are used to diagnose?
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ANSWER

-TSH - zm



used primarily for screening and diagnosing hypothyroid and for monitoring replacement therapy i
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n hypothyroid patients -T4 -
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Used to monitor thyroid hormone replacement therapy and to screen for thyroid dysfunction -T3 -
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Useful in the diagnosis of hyperthyroidism; can also be used to monitor hormone replacement ther
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apy -TSH low -T4 normal -T3 is high = hyperthyroidism
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QUESTION 3 zm




Thyroid o Diagnosis & Evaluation Timeframe for re-
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check of labs after starting levothyroxine?
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ANSWER

Recheck TSH 6- zm zm



8 weeks after initiating therapy and after any dosage change; Check TSH at least once a year after s
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erum TSH is stabilized
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QUESTION 4 zm




Thyroid o Diagnosis & Evaluation Signs and symptoms of hypothyroidism?
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,ANSWER

Hypothyroidism: Depend on severity. o Mild: subtle and may go unrecognized o Moderate to severe:
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m-Face is pale, puffy, and expressionless. -Skin cold and dry. -Hair is brittle and hair loss occurs. -
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Slowed Heart rate. -Patient may complain of lethargy, fatigue, and -
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Temperature is lowered & intolerant to cold. - zm zm zm zm zm zm zm



Thyroid Enlargement may occur if reduced levels of T3 and T4 Mentation may be impaired.
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QUESTION 5 zm




Thyroid o Treatment Treatment of thyroid storm?
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ANSWER

Characterized by profound hyperthermia (105 degrees F or higher), severe tachycardia, restlessness,
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agitation, and tremor. Unconsciousness, coma, hypotension, and heart failure may ensure. These sym
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ptoms are produced by excessive levels of thyroid hormone Thyroid crisis can be life threatening an
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d requires immediate treatment. o High doses of potassium iodide or strong iodine solution are give
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n to suppress thyroid hormone release. o Methimazole is given to suppress thyroid hormone synthe
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sis o A beta blocker is given to reduce heart rate o Additional measures include sedation, cooling, a
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nd giving glucocorticoids and IVF
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QUESTION 6 zm




Thyroid o Treatment Result of not treating hypothyroidism during pregnancy?
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ANSWER

Can result in permanent neuropsychological deficits in the child -
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decrease child's IQ The effect of hypothyroidism is limited largely to the first trimester, a time duri
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ng which the fetus is unable to produce thyroid hormone of its own Some authorities currently reco
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mmend routine screening for hypothyroidism as soon as pregnancy is confirmed Women already tak
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ing thyroid hormone replacement will need to increase dose by 50% max between weeks 4-
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8 of gestation and the levels will level out by week 16
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QUESTION 7 zm




Thyroid o Treatment Medication to treat symptoms of hyperthyroidism (notice this is
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treating symptoms and not the hyperthyroidism itself)
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ANSWER

Methimazole - zm



first line drug of choice (not given to women who are pregnant or breastfeeding) o Methimazole bl
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ocks synthesis of thyroid hormone. 1) Prevents the oxidation of iodine, therefore inhibiting incorpor
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ation of iodine into tyrosine. 2) prevents iodinated tyrosine from coupling Propylthiouracil -
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preferred treatment for thyroid storm Beta blockers -
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help with tachycardia experienced with hyperthyroidism
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,QUESTION 8 zm




Thyroid o Treatment Drug/Food/Supplement interactions with levothyroxine
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ANSWER

Absorption of levothyroxine is reduced by food -
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it should be taken on an empty stomach in the morning, at least 30-
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60 minutes before breakfast Drugs that reduce absorption include: H2 receptor blockers, PPIs, Caraf
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ate, Questran, Colestid, Maalox/Mylanta, Tums, iron, Mag salts, Xenical Drugs that accelerate levothyr
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oxine: Phenytoin, Carbamazepine, rifampin, Sertraline, and phenobarbital Patients taking the followin
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g drugs may need to increase their dose of levothyroxine: Warfarin and catecholamines Levothyroxi
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ne can also increase requirements for insulin and digoxin
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QUESTION 9 zm




Diabetes o How to confirm a diagnosis prior to beginning treatment
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ANSWER

Fasting plasma glucose >/= 125mg/dl OR Random plasma glucose >/= 200mg/dl plus symptoms of
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diabetes (polyuria, polydipsia, unexplained weight loss) OR Oral glucose tolerance test (OGTT): 2-
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hour plasma glucose >/= 200mg/dl OR HgbA1C pf 6.5% or greater -
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(a test that provides an estimate of glycemic control over the previous 2-
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3 months) is now considered a standard test as well
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QUESTION 10 zm




Diabetes o A1C General goals zm zm zm zm




ANSWER

To keep A1C below 7% o <8% is less stringent for those with hx. Of severe hypoglycemia, limited li
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fe expectancy, pr advanced microvascular or macrovascular complications
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QUESTION 11 zm




Diabetes o A1C Older Adult goal zm zm zm zm zm




ANSWER

Recommended goal for A1C in the geriatric population is 7.5- zm zm zm zm zm zm zm zm zm



8% in older patients with moderate comorbidities and life expectancy less than 10 years o 8-
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8.5% for older patients with complex medical issues
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QUESTION 12 zm




Diabetes o A1C When should insulin be considered?
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ANSWER

, Recommendation: A GLP- zm zm



1 should be considered before starting insulin Insulin is introduced in Step 3 which includes a 3-
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drug combination which includes insulin. A1C of 9% of greater would start at Step 2 with dual med
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therapy A1C of 10% or greater or fasting glucose of 300 or greater and is symptomatic would start
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on combination injectable therapy immediately (Step 4)
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QUESTION 13 zm




Diabetes o A1C At what time interval should it be re-checked?
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ANSWER

Should be monitored every 3 months until value drops to 7% and at least every 6 months thereafte
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QUESTION 14 zm




Diabetes o Action of Insulin zm zm zm zm




ANSWER

Metabolic actions of insulin are primarily anabolic -
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Insulin promotes conservation of energy and buildup of energy stores, such as glycogen and the ho
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rmone also promotes cell growth and division Stimulates cellular transport (uptake) of glucose, amin
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o acids, nucleotides, and potassium Insulin promotes synthesis of complex organic molecules In all:
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Under the influence of insulin -
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glucose is converted into glycogen, amino acids are assembled into proteins, and fatty acids are inc
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orporated into triglycerides zm zm




QUESTION 15 zm




Diabetes o Pioglitazone contraindications
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ANSWER

Associated with heart failure secondary to renal retention of fluid. If heart failure is diagnosed, piogl
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itazone should be discontinued or used in reduced dosage
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QUESTION 16 zm




Diabetes o Be familiar with abbreviations of diabetic drug classifications (GLP-
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1, TZD, DPP4-I, SGLT2i)
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ANSWER

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QUESTION 17 zm