NR 565 Final Exam with Accurate
Solutions
What labs are used to diagnose Thyroid dysfunction? - correct Answer-TSH, free T3,
total T3, free T4 and total T4.
Thyroid function in hypothyroidism? - correct Answer-T3 and T4 are lower, TSH is
higher.
Thyroid function in hyperthyroidism? - correct Answer-TSH low, free T4 is normal and
T3 is high.
What is the timeframe for re-check of labs after starting Levothyroxine? - correct
Answer-Check TSH 6-8 weeks after initiating therapy and after dosage changes. Check
TSH annually once TSH is stablizied.
Signs and symptoms of hypothyroidism? - correct Answer-Pale, puffy, expressionless
face, cold, dry skin, brittle hair, hair loss, low temperature/HR, lethargy, fatigue,
constipation, weight gain, intolerance to cold, menstruation impairment, thyroid
enlargement.
Signs and symptoms of hyperthyroidism? - correct Answer-Rapid strong heartbeat,
dysrhythmias, angina, CNS stimulation, nervousness, insomnia, rapid thought process,
rapid speech, skeletal muscles weaken, atrophy, metabolic rate increased, increased
heat production, increased body temperature, increased appetite, weight loss,
exophthalmos.
What is the treatment of thyroid storm? - correct Answer-High doses of potassium
iodide or strong iodine solution, methimazole suppresses hormone synthesis, beta
blockers reduce heart rate, sedation, cooling, and giving glucocorticoids and IV fluids
can also help.
First line treatment for hypothyroidism? - correct Answer-Levothyroxine.
First line treatment for hyperthyroidism? - correct Answer-Methimazole.
Why does the FDA recommend against using PTU as first line treatment of Thyroid
storm? - correct Answer-Hepatic toxicity.
, What can happen if hypothyroidism is not treated during pregnancy? - correct Answer-
Permanent neuropsychological deficits in the child, congenital hypothyroidism,
decreased IQ (mainly occurs during the 1st trimester and increases up to 50%).
What medication is used to treat symptoms associated with hyperthyroidism? - correct
Answer-Beta blockers to suppress tachycardia.
Medications that accelerate metabolism of Levothyroxine (may need to increase their
levothyroxine dosage)? - correct Answer-phenytoin (Dilantin), carbamazepine (Tegretol,
Carbatrol), rifampin (Rifadin), sertraline (Zoloft).
Think about the CYP450 inducers that increase medication metabolism: CRAP GPS
Medications that reduce Levothyroxine absorption? - correct Answer-Histamine 2
receptor blockers (cimetidine [Tagamet], PPIs (lansoprazole [Prevacid], sucralfate
[carafate], colestipol [colestid]), aluminum containing antacids (Maalox, Mylanta),
calcium supplements (Tums, Os-cal), iron supplements (ferrous sulfate), magnesium
salts, Orlistat (Xenical).
What are the benefits of using an ICS? - correct Answer-Effective for long term control
of airway inflammation. Effective for asthma prophylaxis and management of COPD
exacerbations.
How does Nicotine replacement work? - correct Answer-Allows smokers to substitute a
pharmaceutical source of nicotine and gradually withdraw the replacement nicotine.
Patient education needed for Nicotine Patch? - correct Answer-Apply to clean, dry, non-
hairy skin of the upper body. Change daily, rotate sites.
Patient education for Nicotine Gum? - correct Answer-Chew gum slowly and
intermittently for about 30 minutes. Don't eat or drink while chewing or 15 minutes
before chewing.
Patient education for Nicotine Nasal Spray? - correct Answer-Could be addictive.
Contraindications to Wellbutrin? - correct Answer-Hx of seixures, anorexia nervosa,
cocaine use and ETOH withdraw.
What is the recommended length of treatment with Buproprion (Zyban)? - correct
Answer-7-12 weeks.
What is MDR-TB? - correct Answer-Multidrug resistant TB is resistant to isoniazid and
rifampin.
Solutions
What labs are used to diagnose Thyroid dysfunction? - correct Answer-TSH, free T3,
total T3, free T4 and total T4.
Thyroid function in hypothyroidism? - correct Answer-T3 and T4 are lower, TSH is
higher.
Thyroid function in hyperthyroidism? - correct Answer-TSH low, free T4 is normal and
T3 is high.
What is the timeframe for re-check of labs after starting Levothyroxine? - correct
Answer-Check TSH 6-8 weeks after initiating therapy and after dosage changes. Check
TSH annually once TSH is stablizied.
Signs and symptoms of hypothyroidism? - correct Answer-Pale, puffy, expressionless
face, cold, dry skin, brittle hair, hair loss, low temperature/HR, lethargy, fatigue,
constipation, weight gain, intolerance to cold, menstruation impairment, thyroid
enlargement.
Signs and symptoms of hyperthyroidism? - correct Answer-Rapid strong heartbeat,
dysrhythmias, angina, CNS stimulation, nervousness, insomnia, rapid thought process,
rapid speech, skeletal muscles weaken, atrophy, metabolic rate increased, increased
heat production, increased body temperature, increased appetite, weight loss,
exophthalmos.
What is the treatment of thyroid storm? - correct Answer-High doses of potassium
iodide or strong iodine solution, methimazole suppresses hormone synthesis, beta
blockers reduce heart rate, sedation, cooling, and giving glucocorticoids and IV fluids
can also help.
First line treatment for hypothyroidism? - correct Answer-Levothyroxine.
First line treatment for hyperthyroidism? - correct Answer-Methimazole.
Why does the FDA recommend against using PTU as first line treatment of Thyroid
storm? - correct Answer-Hepatic toxicity.
, What can happen if hypothyroidism is not treated during pregnancy? - correct Answer-
Permanent neuropsychological deficits in the child, congenital hypothyroidism,
decreased IQ (mainly occurs during the 1st trimester and increases up to 50%).
What medication is used to treat symptoms associated with hyperthyroidism? - correct
Answer-Beta blockers to suppress tachycardia.
Medications that accelerate metabolism of Levothyroxine (may need to increase their
levothyroxine dosage)? - correct Answer-phenytoin (Dilantin), carbamazepine (Tegretol,
Carbatrol), rifampin (Rifadin), sertraline (Zoloft).
Think about the CYP450 inducers that increase medication metabolism: CRAP GPS
Medications that reduce Levothyroxine absorption? - correct Answer-Histamine 2
receptor blockers (cimetidine [Tagamet], PPIs (lansoprazole [Prevacid], sucralfate
[carafate], colestipol [colestid]), aluminum containing antacids (Maalox, Mylanta),
calcium supplements (Tums, Os-cal), iron supplements (ferrous sulfate), magnesium
salts, Orlistat (Xenical).
What are the benefits of using an ICS? - correct Answer-Effective for long term control
of airway inflammation. Effective for asthma prophylaxis and management of COPD
exacerbations.
How does Nicotine replacement work? - correct Answer-Allows smokers to substitute a
pharmaceutical source of nicotine and gradually withdraw the replacement nicotine.
Patient education needed for Nicotine Patch? - correct Answer-Apply to clean, dry, non-
hairy skin of the upper body. Change daily, rotate sites.
Patient education for Nicotine Gum? - correct Answer-Chew gum slowly and
intermittently for about 30 minutes. Don't eat or drink while chewing or 15 minutes
before chewing.
Patient education for Nicotine Nasal Spray? - correct Answer-Could be addictive.
Contraindications to Wellbutrin? - correct Answer-Hx of seixures, anorexia nervosa,
cocaine use and ETOH withdraw.
What is the recommended length of treatment with Buproprion (Zyban)? - correct
Answer-7-12 weeks.
What is MDR-TB? - correct Answer-Multidrug resistant TB is resistant to isoniazid and
rifampin.
