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2024 NR 565 EXAM WITH CORRECT ANSWERS
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2024 NR 565 EXAM WITH CORRECT ANSWERS
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2024 NR 565 EXAM WITHCORRECT ANSWERS
Monitoring for levothyroxine - CORRECT ANSWERS-serum levels of TSH and
free T4
labs for Radioactive Iodine - CORRECT ANSWERS-serum levels of thyroid-
stimulating hormone (TSH), free triiodothyronine (T3), and free thyroxine
(T4)
monitoring for levothyroxine - CORRECT ANSWERS-check TSH 6-8 weeks
after initiating therapy and after any dosage change
check TSH at least once a year after serum TSH is stabilized
monitoring for methimazole - CORRECT ANSWERS-check CBC with diff if s/s
of infection. check LFTs if signs or symptoms of liver dysfunction
monitoring for Radioactive Iodine - CORRECT ANSWERS-NONE
Levothyroxine - CORRECT ANSWERS-with caution in those with
cardiovascular disease and start with lower doses in older adults
lifetime considerations with methimazole - CORRECT ANSWERS-avoid in first
trimester of pregnancy. If thionamide is needed during first trimester of
pregnancy, PTU is preferred
lifetime considerations for Radioactive Iodine - CORRECT ANSWERS-
contraindicated in pregnancy and lactation. avoid is very young children
Therapeutic effects of levothyroxine - CORRECT ANSWERS-reversal of signs
of thyroid deficiency and an absence of s/s of thyroid excess, normalization
of intellectual function, growth, and development should occur. IN children,
monthly height measurements demonstrate thyroid sufficiency, laboratory
tests indicate normal plasma levels of TSH and T4
therapeutic effect of Methimazole - CORRECT ANSWERS-weight gain,
decreased heart rate, and other indications that thyroid levels have declined,
laboratory test indicate a decrease in serum free T3 and free T4
,education for levothyroxine - CORRECT ANSWERS-symptoms of
thyrotoxicosis include tachycardia, angina, tremor, nervousness, insomnia,
sweating, and heat intolerance
pt education for methimazole - CORRECT ANSWERS-early signs of
agranulocytosis include fever or sore throat. If follow-up blood tests reveal
leukopenia, methimazole should be stopped. May cause excessive reductions
in thyroid hormone synthesis. If signs of hypothyroidism develop or if plasma
levels of T3 and T4 become subnormal, dosage should be reduced
pt education for radioactive iodine - CORRECT ANSWERS-symptoms of drug
toxicity, include brassy taste, burning sensation in the mouth, and soreness
of gums and teeth. Drug can also cause corrosive injury to GI tract. Notify
the prescriber if severe abdominal distress develops
Emphysema - CORRECT ANSWERS-affects alveoli
alveolar walls are broken down causing alveolar air spaces to becocme
permanently and abnormally enlarged
less alveolar space leads to less surface area for gas exchange to occur,
limiting airflow
Chronic Bronchitis - CORRECT ANSWERS-affects bronchi and bronchioles
airways become narrowed and blocked with mucus, limiting airflow
Hypothyroidism - CORRECT ANSWERS-underproduction of the hormone
thyroxine (T4) (yellow)
Too little thyroxine=slower metabolism
fatigue, depressed mood, slow heart rate, constipation, weight gain, and
irregular menstrual periods.
MC in >60 women
Hyperthyroidism - CORRECT ANSWERS-overproduction of thyroid hormones:
triiodothyronine (T3) (green), and thyroxine (T4) (yellow)
What active hormones are produced by the thyroid? - CORRECT ANSWERS-
triiodothyronine (T3) and thyroxine (T4, tetraiodothyronine)
4 steps to synthesis of thyroid hormoness - CORRECT ANSWERS-1. Uptake
2. Activation (Oxidation by peroxidase)
3. Iodination of Tyrosine
4. Coupling of Iodinated Tyrosine
, 3 Principle Actions of Thyroid Hormones - CORRECT ANSWERS-(1) stimulation
of energy use
(2) stimulation of the heart
(3) promotion of growth and development
Most sensitive method for diagnosing hypothyroidism - CORRECT ANSWERS-
Serum TSH
Levothyroxine Dosage in adults - CORRECT ANSWERS-100-125ug for 70kg
adult
ORAL
Older adults- start at 25-50ug daily
Levothyroxine dose in Myxedema Coma - CORRECT ANSWERS-200-500 ug
once
INJECTION
Addition dose of 100-300 ug can be given a day later
Levothyroxine dose for Congenital Hypothyroidism - CORRECT ANSWERS-
<3mo: 10-15mg/kg
3-5mo: 8-10mg/kg
6-11mo: 6-8mg/kg
1-5yrs: 5-6mg/kg
6-12 yrs: 4-5mg/kg
ORAL
Dose DECREASES with age.
Dose adjusted to normalize TSH and free T4
Levothyroxine dose for simple goiter - CORRECT ANSWERS-100-200ug
ORAL
Baseline data for levothyroxine - CORRECT ANSWERS-Serum levels of TSH
and free T4
What are thionamide drugs - CORRECT ANSWERS-For hyperthyroidism
ex. methimazole and propylthiouracil (PTU)
Suppresses synthesis of thyroid hormones
long term-hyperthyroidism
short-term- subtotal thyroidectomy or tx with radioactive iodine
Frequency of therapy for Methimazole and Propylthiouracil - CORRECT
ANSWERS-Methimazole: Initial therapy-3 times a day
Maintenance therapy- Once a day
Propyltiouracil:
Initial therapy- 3 or 4 times a day
Maintenance therapy- 2 or 3 times a day
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