NR565 Final Exam 2024 | NR 565 Exam Latest
2024/2025 Real Questions and Correct
Answers Rated A+ For NR 565 Exam
Medication to treat symptoms of hyperthyroidism (notice this is treating symptoms and
not the hyperthyroidism itself):
Beta blockers (tachycardia) - propranolol/atenolol most popular.Non-radioactive iodine.
ADJUNCTIVE THERAPY.
Drug/Food/Supplement interactions with levothyroxine:
Do not take antacids, Calcium or Iron, how to take it (morning 30-60 min b4 eat.
How to confirm a diagnosis of DM prior to beginning treatment:
Fasting plasma glucose above 126. A random plasma glucose of over 200 plus symptoms of
diabetes, an oral glucose tolerance test of two hours, plasma glucose of over 200, or a A1C
higher than 6.5.
A1c general goals
<7, patients that experience severe hypoglycemia/have a limited life expectancy may have
an A1C goal of <8.
A1c older adults
<8, those with multiple coexisting chronic illnesses, cognitive impairment, or functional
dependence should have less stringent glycemic goals such as <8.0-8.5.
When should insulin be considered?
For treatment of persistent hyperglycemia starting at a threshold of >180.
Early introduction of insulin should be considered if there is evidence of ongoing weight
loss, if symptoms of hyperglycemia are present, or whenA1C levels >10% or BGS >300
At what time interval should A1c be re-checked?
How often should an A1C be monitored when stable or when unstable?
,Every 2-3 months and max of 4 times a year. If <7, every 6 months.
At least two times a year if meeting goals and quarterly if meds have changed or not
meeting goals.
Action of Insulin
Anabolic, energy conservation, promotes cellular growth and division.
Pioglitazone contraindications:
Heart failure (severe = no, mild = caution) and bladder cancer. Causes fluid retention.
GLP-1 (abbreviation and examples)
Glucagonlike Peptide - Subcutaneous injections - Dulaglutide (Trulicity), Semaglutide
(Ozempic), Liraglutide (Victoza).
SGLT2i (abbreviation and examples)
Sodium Glucose Cotransporter 2 Inhibitors - Canagliflozin (Invokana), Dapagliflozin (Farxiga),
Empagliflozin (Jardiance).
DPP4-I (abbreviation and examples)
Dipeptidyl Peptidase-4 Inhibitors - Sitagliptin, Saxagliptin, Linagliptin, Alogliptin.
TZD (abbreviation and examples)
Thiazolidinediones - Rosiglitazone & Pioglitazone
Which drug class should be considered for diabetes prior to insulin?
It is recommended that a GLP-1 be considered before starting insulin. Metformin first
always unless contraindicated.
Ratio of basal insulin to rapid-acting insulin in total daily dose (TDD) of insulin
Basal and bolus insulin replacement encompasses approximately 50% of the total daily
insulin dose (TDD)
, Example: TDD = patient's weight in kg (80kg) x 0.6 units = 48 units. That means 24 units of
the TDD is the basal insulin dose and the other 24 units is rapid-acting.
How is total daily dose (TDD) of insulin calculated
TDD is calculated by taking the total weight in kg and multiply by 0.6 units.
Know the carbohydrate-to insulin ratio when calculating basal insulin
Mealtime dose is calculated using the 450 rule for regular insulin and 500 rule for rapid
acting insulin then divide by TDD. The answer (rounded) = the ratio of 1:the # answer. That
means that if the meal is 60g of carbs, 60 divided by the # in answer = # of units of rapid-
acting insulin.
GLP-1 MOA
slows gastric emptying, stimulates glucose dependent insulin release, and suppresses
glucagon release and reduces appetite
DPP-4i MOA
Enhance the activity of incretins and thereby increase insulin release, reduce glucagon
TZD MOA
Decreases insulin resistance and increase glucose uptake by muscle and adipose tissue
Sulfonylureas MOA
promote insulin secretion by the pancreas.
HYPOGLYCEMIA
SGLT2i MOA
Kidney tubules.
Which diabetic medication(s) come with a concern of hypoglycemia?
Insulin, meglitinides, sulfonylureas, amylin analogues
2024/2025 Real Questions and Correct
Answers Rated A+ For NR 565 Exam
Medication to treat symptoms of hyperthyroidism (notice this is treating symptoms and
not the hyperthyroidism itself):
Beta blockers (tachycardia) - propranolol/atenolol most popular.Non-radioactive iodine.
ADJUNCTIVE THERAPY.
Drug/Food/Supplement interactions with levothyroxine:
Do not take antacids, Calcium or Iron, how to take it (morning 30-60 min b4 eat.
How to confirm a diagnosis of DM prior to beginning treatment:
Fasting plasma glucose above 126. A random plasma glucose of over 200 plus symptoms of
diabetes, an oral glucose tolerance test of two hours, plasma glucose of over 200, or a A1C
higher than 6.5.
A1c general goals
<7, patients that experience severe hypoglycemia/have a limited life expectancy may have
an A1C goal of <8.
A1c older adults
<8, those with multiple coexisting chronic illnesses, cognitive impairment, or functional
dependence should have less stringent glycemic goals such as <8.0-8.5.
When should insulin be considered?
For treatment of persistent hyperglycemia starting at a threshold of >180.
Early introduction of insulin should be considered if there is evidence of ongoing weight
loss, if symptoms of hyperglycemia are present, or whenA1C levels >10% or BGS >300
At what time interval should A1c be re-checked?
How often should an A1C be monitored when stable or when unstable?
,Every 2-3 months and max of 4 times a year. If <7, every 6 months.
At least two times a year if meeting goals and quarterly if meds have changed or not
meeting goals.
Action of Insulin
Anabolic, energy conservation, promotes cellular growth and division.
Pioglitazone contraindications:
Heart failure (severe = no, mild = caution) and bladder cancer. Causes fluid retention.
GLP-1 (abbreviation and examples)
Glucagonlike Peptide - Subcutaneous injections - Dulaglutide (Trulicity), Semaglutide
(Ozempic), Liraglutide (Victoza).
SGLT2i (abbreviation and examples)
Sodium Glucose Cotransporter 2 Inhibitors - Canagliflozin (Invokana), Dapagliflozin (Farxiga),
Empagliflozin (Jardiance).
DPP4-I (abbreviation and examples)
Dipeptidyl Peptidase-4 Inhibitors - Sitagliptin, Saxagliptin, Linagliptin, Alogliptin.
TZD (abbreviation and examples)
Thiazolidinediones - Rosiglitazone & Pioglitazone
Which drug class should be considered for diabetes prior to insulin?
It is recommended that a GLP-1 be considered before starting insulin. Metformin first
always unless contraindicated.
Ratio of basal insulin to rapid-acting insulin in total daily dose (TDD) of insulin
Basal and bolus insulin replacement encompasses approximately 50% of the total daily
insulin dose (TDD)
, Example: TDD = patient's weight in kg (80kg) x 0.6 units = 48 units. That means 24 units of
the TDD is the basal insulin dose and the other 24 units is rapid-acting.
How is total daily dose (TDD) of insulin calculated
TDD is calculated by taking the total weight in kg and multiply by 0.6 units.
Know the carbohydrate-to insulin ratio when calculating basal insulin
Mealtime dose is calculated using the 450 rule for regular insulin and 500 rule for rapid
acting insulin then divide by TDD. The answer (rounded) = the ratio of 1:the # answer. That
means that if the meal is 60g of carbs, 60 divided by the # in answer = # of units of rapid-
acting insulin.
GLP-1 MOA
slows gastric emptying, stimulates glucose dependent insulin release, and suppresses
glucagon release and reduces appetite
DPP-4i MOA
Enhance the activity of incretins and thereby increase insulin release, reduce glucagon
TZD MOA
Decreases insulin resistance and increase glucose uptake by muscle and adipose tissue
Sulfonylureas MOA
promote insulin secretion by the pancreas.
HYPOGLYCEMIA
SGLT2i MOA
Kidney tubules.
Which diabetic medication(s) come with a concern of hypoglycemia?
Insulin, meglitinides, sulfonylureas, amylin analogues
