,NR 601 Week 5 Quiz: Thyroid Management &
Diabetes Care
Chamberlain University – Verified Questions &
Answers
Thyroid Disorders (Questions 1–20)
1. A 72-year-old female presents with fatigue,
weight gain, constipation, and dry skin. TSH is
12 mIU/L (normal 0.4–4.0). Free T4 is low. What
is the most appropriate initial treatment?
A. Levothyroxine 25 mcg daily
B. Liothyronine (T3) 5 mcg daily
C. Levothyroxine 100 mcg daily
D. No treatment; repeat TSH in 3 months
Answer: A. Levothyroxine 25 mcg daily
*Rationale: Older adults with hypothyroidism
should be started on low-dose levothyroxine
(25–50 mcg/day) to avoid cardiac
complications (arrhythmias, angina). Full
,replacement is 1.6 mcg/kg, but start low, go
slow. T3 is not recommended in elderly.*
2. A patient with known hypothyroidism on
levothyroxine 75 mcg daily has a follow-up TSH
of 8.5 mIU/L. She reports taking her medication
“when I remember.” Which intervention is most
appropriate?
A. Increase levothyroxine to 100 mcg daily
B. Assess adherence and timing of medication
C. Switch to liothyronine
D. Order a thyroid ultrasound
Answer: B. Assess adherence and timing of
medication
*Rationale: First rule out non-adherence or
improper administration (with food, calcium,
iron, proton pump inhibitors). Increase dose
only after adherence confirmed. TSH should be
checked 6–8 weeks after dose change.*
, 3. Which medication commonly interferes with
k k k k k
levothyroxine absorption?
k k
A. Metoprolol
k
B. Calcium carbonate
k k
C. Lisinopril
k
D. Atorvastatin
k
Answer: B. Calcium carbonate k k k
Rationale: Calcium, iron, aluminum hydroxide k k k k
antacids, and proton pump inhibitors reduce
k k k k k k
levothyroxine absorption. Separate
k k k
administration by at least 4 hours.
k k k k k k
4. A 68-year-old male has a TSH of 0.1 mIU/L with
k k k k k k k k k k
normal free T4 and T3. He is asymptomatic. What is
k k k k k k k k k k
the most appropriate management?
k k k k
A. Start methimazole
k k
B. Radioactive iodine ablation
k k k
C. Observe and repeat TSH in 6–12 months
k k k k k k k
D. Refer to endocrinology
k k k
Answer: C. Observe and repeat TSH in 6–12 months
k k k k k k k k
*Rationale: Subclinical hyperthyroidism (low k k k
Diabetes Care
Chamberlain University – Verified Questions &
Answers
Thyroid Disorders (Questions 1–20)
1. A 72-year-old female presents with fatigue,
weight gain, constipation, and dry skin. TSH is
12 mIU/L (normal 0.4–4.0). Free T4 is low. What
is the most appropriate initial treatment?
A. Levothyroxine 25 mcg daily
B. Liothyronine (T3) 5 mcg daily
C. Levothyroxine 100 mcg daily
D. No treatment; repeat TSH in 3 months
Answer: A. Levothyroxine 25 mcg daily
*Rationale: Older adults with hypothyroidism
should be started on low-dose levothyroxine
(25–50 mcg/day) to avoid cardiac
complications (arrhythmias, angina). Full
,replacement is 1.6 mcg/kg, but start low, go
slow. T3 is not recommended in elderly.*
2. A patient with known hypothyroidism on
levothyroxine 75 mcg daily has a follow-up TSH
of 8.5 mIU/L. She reports taking her medication
“when I remember.” Which intervention is most
appropriate?
A. Increase levothyroxine to 100 mcg daily
B. Assess adherence and timing of medication
C. Switch to liothyronine
D. Order a thyroid ultrasound
Answer: B. Assess adherence and timing of
medication
*Rationale: First rule out non-adherence or
improper administration (with food, calcium,
iron, proton pump inhibitors). Increase dose
only after adherence confirmed. TSH should be
checked 6–8 weeks after dose change.*
, 3. Which medication commonly interferes with
k k k k k
levothyroxine absorption?
k k
A. Metoprolol
k
B. Calcium carbonate
k k
C. Lisinopril
k
D. Atorvastatin
k
Answer: B. Calcium carbonate k k k
Rationale: Calcium, iron, aluminum hydroxide k k k k
antacids, and proton pump inhibitors reduce
k k k k k k
levothyroxine absorption. Separate
k k k
administration by at least 4 hours.
k k k k k k
4. A 68-year-old male has a TSH of 0.1 mIU/L with
k k k k k k k k k k
normal free T4 and T3. He is asymptomatic. What is
k k k k k k k k k k
the most appropriate management?
k k k k
A. Start methimazole
k k
B. Radioactive iodine ablation
k k k
C. Observe and repeat TSH in 6–12 months
k k k k k k k
D. Refer to endocrinology
k k k
Answer: C. Observe and repeat TSH in 6–12 months
k k k k k k k k
*Rationale: Subclinical hyperthyroidism (low k k k
