NR565 Pharmacology Final Exam 2026
Questions and Answers
Signs and symptoms of hypothyroidism - Correct answer-Face is pale, puffy, and
expressionless.
Skin is cold and dry.
hair is brittle, and hair loss occurs.
Heart rate and temperature are lowered. The patient lethargy, fatigue, and
intolerance to cold.
Mentation may be impaired.
Signs and symptoms of hyperthyroidism - Correct answer-Heart Rate is Rapid;
Possible arrhythmia/angina
Nervousness, insomnia, rapid thought flow, and rapid speech
Skeletal muscles may weaken and atrophy
Metabolic rate is raised, resulting in increased heat production, increased body
temperature, intolerance to heat, and skin that is warm and moist
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,Weight loss occurs if caloric intake fails to match the increase in metabolic rate
Severe hypothyroidism - Correct answer-Myxedema
Hypothyroid Treatment - Correct answer-Levothyroxine is the drug of choice for
most patients who require thyroid hormone replacement.
Levothyroxine (Synthroid) Therapeutic Goal - Correct answer-Resolution of signs
and symptoms of hypothyroidism and restoration of normal laboratory values for
serum thyroid-stimulating hormone (TSH) and free thyroxine (T4).
Major forms of hyperthyroidism - Correct answer-Graves disease and toxic nodular
goiter (also known as Plummer disease).
Graves Disease - Correct answer-Most common cause of excessive thyroid
hormone secretion
What adjunctive therapy is good to prescribe to control symptoms of
hyperthyroidism other than thyroid specific medications? - Correct answer-β-
Blockers and nonradioactive iodine may be used as adjunctive therapy.
β-Blockers suppress tachycardia by blocking β-receptors on the heart.
Nonradioactive iodine inhibits synthesis and release of thyroid hormones.
Monitoring needs and intervals for Levothyroxine - Correct answer-Check TSH 6-
8 weeks after initiating therapy and after any dosage change.
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,Check TSH at least once a year after serum TSH is stabilized.
Hyperthyroid Treatment - Correct answer-thionamide drugs—methimazole and
propylthiouracil (PTU)—suppress synthesis of thyroid hormones.
Methimazole Therapeutic Goal - Correct answer-(1) reduction of thyroid hormone
production in Graves' disease, (2) control of hyperthyroidism until the effects of
radiation on the thyroid become manifest, (3) suppression of thyroid hormone
production before subtotal thyroidectomy, (4) treatment of thyrotoxic crisis.
Monitoring needs and intervals for Methimazole - Correct answer-Check CBC
with differential if signs or symptoms of infection. Check LFTs if signs or
symptoms of liver dysfunction.
High Risk Patients for Methimazole - Correct answer-Should be avoided in the
first trimester of pregnancy.
Methimazole Toxicity - Correct answer-Agranulocytosis is the most dangerous
toxicity.
PTU High Risk Warning - Correct answer-Carries a risk for liver toxicity. Although
rare, the FDA recommends against using as a first-line treatment due to potential
for hepatic toxicity.
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, Effects of maternal hypothyroidism on offspring and appropriate patient teaching
related to need for treatment. - Correct answer-Can cause delay in mental
development and derangement of growth. In the absence of thyroid hormones, the
child develops a large and protruding tongue, potbelly, and dwarfish stature.
Development of the nervous system, bones, teeth, and muscles is impaired.
Congenital Hypothyroidism Treatment - Correct answer-requires replacement
therapy with thyroid hormones. If treatment is initiated within a few days of birth,
physical and mental development will be normal.
replacement therapy should continue for 3 years, after which it should be stopped
for 4 weeks to determine whether thyroid deficiency is permanent or transient.
Patient Teaching for Methimazole - Correct answer-Tell your healthcare providers
that you are taking this drug.
Check blood work as directed.
Taking this drug may cause harm to the unborn baby if you are pregnant, especially
in the first trimester.
If you are pregnant or become pregnant while taking this drug, call your healthcare
provider right away.
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Questions and Answers
Signs and symptoms of hypothyroidism - Correct answer-Face is pale, puffy, and
expressionless.
Skin is cold and dry.
hair is brittle, and hair loss occurs.
Heart rate and temperature are lowered. The patient lethargy, fatigue, and
intolerance to cold.
Mentation may be impaired.
Signs and symptoms of hyperthyroidism - Correct answer-Heart Rate is Rapid;
Possible arrhythmia/angina
Nervousness, insomnia, rapid thought flow, and rapid speech
Skeletal muscles may weaken and atrophy
Metabolic rate is raised, resulting in increased heat production, increased body
temperature, intolerance to heat, and skin that is warm and moist
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,Weight loss occurs if caloric intake fails to match the increase in metabolic rate
Severe hypothyroidism - Correct answer-Myxedema
Hypothyroid Treatment - Correct answer-Levothyroxine is the drug of choice for
most patients who require thyroid hormone replacement.
Levothyroxine (Synthroid) Therapeutic Goal - Correct answer-Resolution of signs
and symptoms of hypothyroidism and restoration of normal laboratory values for
serum thyroid-stimulating hormone (TSH) and free thyroxine (T4).
Major forms of hyperthyroidism - Correct answer-Graves disease and toxic nodular
goiter (also known as Plummer disease).
Graves Disease - Correct answer-Most common cause of excessive thyroid
hormone secretion
What adjunctive therapy is good to prescribe to control symptoms of
hyperthyroidism other than thyroid specific medications? - Correct answer-β-
Blockers and nonradioactive iodine may be used as adjunctive therapy.
β-Blockers suppress tachycardia by blocking β-receptors on the heart.
Nonradioactive iodine inhibits synthesis and release of thyroid hormones.
Monitoring needs and intervals for Levothyroxine - Correct answer-Check TSH 6-
8 weeks after initiating therapy and after any dosage change.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,Check TSH at least once a year after serum TSH is stabilized.
Hyperthyroid Treatment - Correct answer-thionamide drugs—methimazole and
propylthiouracil (PTU)—suppress synthesis of thyroid hormones.
Methimazole Therapeutic Goal - Correct answer-(1) reduction of thyroid hormone
production in Graves' disease, (2) control of hyperthyroidism until the effects of
radiation on the thyroid become manifest, (3) suppression of thyroid hormone
production before subtotal thyroidectomy, (4) treatment of thyrotoxic crisis.
Monitoring needs and intervals for Methimazole - Correct answer-Check CBC
with differential if signs or symptoms of infection. Check LFTs if signs or
symptoms of liver dysfunction.
High Risk Patients for Methimazole - Correct answer-Should be avoided in the
first trimester of pregnancy.
Methimazole Toxicity - Correct answer-Agranulocytosis is the most dangerous
toxicity.
PTU High Risk Warning - Correct answer-Carries a risk for liver toxicity. Although
rare, the FDA recommends against using as a first-line treatment due to potential
for hepatic toxicity.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, Effects of maternal hypothyroidism on offspring and appropriate patient teaching
related to need for treatment. - Correct answer-Can cause delay in mental
development and derangement of growth. In the absence of thyroid hormones, the
child develops a large and protruding tongue, potbelly, and dwarfish stature.
Development of the nervous system, bones, teeth, and muscles is impaired.
Congenital Hypothyroidism Treatment - Correct answer-requires replacement
therapy with thyroid hormones. If treatment is initiated within a few days of birth,
physical and mental development will be normal.
replacement therapy should continue for 3 years, after which it should be stopped
for 4 weeks to determine whether thyroid deficiency is permanent or transient.
Patient Teaching for Methimazole - Correct answer-Tell your healthcare providers
that you are taking this drug.
Check blood work as directed.
Taking this drug may cause harm to the unborn baby if you are pregnant, especially
in the first trimester.
If you are pregnant or become pregnant while taking this drug, call your healthcare
provider right away.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
