QuestionQuestion 1 1 / 1 pointElderly patients who are started on levothyroxine for thyroid replacement should be monitored for:Question options:Excessive sedationTachycardia and anginaWeight gainCold intoleranceQuestion 2 1 / 1 pointPotentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propylthiouracil. Patients should be taught to report:Question options:Tinnitus and decreased salivationFever and sore throatHypocalcemia and osteoporosisLaryngeal edema and difficulty swallowing

Question 3 1 / 1 pointMetformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:Question options:Substitutes for insulin usually secreted by the pancreasDecreases glycogenolysis by the liverIncreases the release of insulin from beta cellsDecreases peripheral glucose utilizationQuestion 4 1 / 1 pointHypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include:Question options:“Fruity” breath odor and rapid respirationDiarrhea, abdominal pain, weight loss, and hypertensionDizziness, confusion, diaphoresis, and tachycardiaEasy bruising, palpitations, cardiac dysrhythmias, and comaQuestion 5 1 / 1 pointSulfonylureas may be added to a treatment regimen for type 2 diabetics when lifestyle modifications and metformin are insufficient to achieve target glucose levels. Sulfonylureas have been moved to Step 2 therapy because they:Question options:Increase endogenous insulin secretionHave a significant risk for hypoglycemiaAddress the insulin resistance found in type 2 diabeticsImprove insulin binding to receptors

Question 6 1 / 1 pointTreatment with insulin for type 1 diabetics:Question options:Starts with a total daily dose of 0.2 to 0.4 units per kg of body weightDivides the total doses into three injections based on meal sizeUses a total daily dose of insulin glargine given once daily with no other insulin requiredIs based on the level of blood glucoseQuestion 7 1 / 1 pointThe American Heart Association states that people with diabetes have a 2- to 4-fold increase in the risk of dying from cardiovascular disease.Treatments and targets that do not appear to decrease risk for micro-  and macro-vascular complications include:Question options:Glycemic targets between 7% and 7.5%Use of insulin in type 2 diabeticsControl of hypertension and hyperlipidemiaStopping smokingQuestion 8 1 / 1 pointDrugs used to treat diabetic peripheral neuropathy include:Question options:MetoclopramideCholinergic agonistsCardioselective beta blockersGabapentinQuestion 9 1 / 1 pointThe goals of therapy when prescribing hormone replacement therapy (HRT) include reducing:Question options:Cardiovascular riskRisk of stroke or other thromboembolic eventBreast cancerVasomotor symptomsQuestion 10 1 / 1 pointInadequate vitamin D intake can contribute to the development of osteoporosis by:Question options:Increasing calcitonin productionIncreasing calcium absorption from the intestineAltering calcium metabolismStimulating bone formationQuestion 11 1 / 1 pointThe drug recommended as primary prevention of osteoporosis in men over age 70 years is:Question options:Alendronate (Fosamax)Ibandronate (Boniva)Calcium carbonateRaloxifene (Evista)Question 12 1 / 1 pointIn addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for:Question options:A calcium channel blockerA beta blockerLiothyronineAn alpha blockerQuestion 13 1 / 1 pointWhen starting a patient on levothyroxine for hypothyroidism the patient will need follow-up measurement of thyroid function in:Question options:2 weeks4 weeks2 months6 monthsQuestion 14 1 / 1 pointTreatment of a patient with hypothyroidism and cardiovascular disease consists of:Question options:LevothyroxineLiothyronineLiotrixMethimazoleQuestion 15 1 / 1 pointMen who use transdermal testosterone gel (AndroGel) should be advised to avoid:Question options:Washing their hands after applying the gelWearing occlusive clothing while using the gelExposure to estrogens while using the gelSkin-to-skin contact with pregnant women while using the gelQuestion 16 1 / 1 pointA 22-year-old woman receives a prescription for oral contraceptives. Education for this patient includes:Question options:Counseling regarding decreasing or not smoking while taking oral contraceptivesAdvising a monthly pregnancy test for the first 3 months she is taking the contraceptiveAdvising that she may miss two pills in a row and not be concerned about pregnancyRecommending that her next follow-up visit is in 1 year for a refill and annual examQuestion 17 1 / 1 pointA 56-year-old woman is complaining of vaginal dryness and dyspareunia. To treat her symptoms with the lowest adverse effects she should be prescribed:Question options:Low-dose oral estrogenA low-dose estrogen/progesterone combinationA vaginal estradiol ringVaginal progesterone creamQuestion 18 1 / 1 pointAshley comes to the clinic with a request for oral contraceptives. She has successfully used oral contraceptives before and has recently started dating a new boyfriend so would like to restart contraception. She denies recent intercourse and has a negative urine pregnancy test in the clinic. An appropriate plan of care would be:Question options:Recommend she return to the clinic at the start of her next menses to get a Depo Provera shot.Prescribe oral combined contraceptives and recommend she start them at the beginning of her next period and use a back-up method for the first 7 days.Prescribe oral contraceptives and have her start them the same day as the visit with a back-up method used for the first 7 days.Discuss the advantages of using the topical birth control patch and recommend she consider using the patch.Question 19 1 / 1 pointWomen who are prescribed progestin-only contraception need education regarding which common adverse drug effects?Question options:Increased migraine headachesIncreased risk of developing blood clotsIrregular vaginal bleeding for the first few monthsIncreased risk for hypercalcemiaQuestion 20 1 / 1 pointOral emergency contraception (Plan B) is contraindicated in women who:Question options:Had intercourse within the past 72 hoursMay be pregnantAre taking combined oral contraceptivesAre using a diaphragm