Chapter 31: Thyroid and Antithyroid Drugs

Question 1

Referring to normal thyroid function.

Answer 1

euthyroid

Question 2

A condition characterized by excessive production of the thyroid hormones. A severe form of this disorder is called thyrotoxicosis.

Answer 2

hyperthyroidism

Question 3

A condition characterized by diminished production of the thyroid hormones.

Answer 3

hypothyroidism

Question 4

An endogenous substance secreted by the pituitary gland that controls the release of thyroid gland hormones and which is necessary for the growth and function of the thyroid gland (also called thyrotropin).

Answer 4

thyroid-stimulating hormone (TSH)

Question 5

The principle thyroid hormone that influences the metabolic rate.

Answer 5

thyroxine (T4)

Question 6

A secondary thyroid hormone that also affects body metabolism.

Answer 6

triiodothyronine (T3)

Question 7

When monitoring the laboratory values for a patient who is taking antithyroid drugs, the nurse knows to watch for which of these? (Select all that apply.)

a. Decreased platelet counts
b. Increased white blood cell counts
c. Increased blood urea nitrogen level
d. Increased blood glucose levels
e. Decreased creatinine levels

Answer 7

a. Decreased platelet counts

c. Increased blood urea nitrogen level

Question 8

When monitoring the laboratory values for a patient who is taking antithyroid drugs, the nurse knows to watch for which of these? (Select all that apply.)

a. Decreased platelet counts
b. Increased white blood cell counts
c. Increased blood urea nitrogen level
d. Increased blood glucose levels
e. Decreased creatinine levels

Answer 8

a. Decreased platelet counts

c. Increased blood urea nitrogen level

Question 9

The pharmacy has called a patient to notify her that the current brand of thyroid replacement hormone is on back order. The patient calls the clinic to ask what to do. Which is the best response by the nurse?

a. “Go ahead and take the other brand that the pharmacy has available for now.”
b. “You can stop the medication until your current brand is available.”
c. “You can split the thyroid pills that you have left so that they will last longer.”
d. “Let me ask your prescriber what needs to be done; we will need to watch how you do if you switch brands.”

Answer 9

d. “Let me ask your prescriber what needs to be done; we will need to watch how you do if you switch brands.”

Question 10

The nurse is assessing a 72-year-old patient who will be starting thyroid replacement therapy. Which statement is true regarding the dosage of thyroid replacement hormones for the older adult?

a. Thyroid hormone replacement requirements are approximately 25% lower for this age group.
b. Older adults require higher dosages of thyroid replacement hormone for therapeutic effects.
c. There is no difference in the dosage of thyroid replacement hormone in older adults versus younger adults.
d. The dosage of thyroid hormone will depend on the amount of iodine in the patient’s diet.

Answer 10

a. Thyroid hormone replacement requirements are approximately 25% lower for this age group.

Question 11

To help with the insomnia associated with thyroid hormone replacement therapy, the nurse will include which statement in the teaching session?

a. “Take half the dose at lunchtime and the other half 2 hours later.”
b. “You will need to use a sedative to help you fall asleep.”
c. “Take the dose on awakening in the morning.”
d. “The dose may need to be reduced if you can’t sleep.”

Answer 11

c. “Take the dose on awakening in the morning.”

Question 12

antithyroid drug propylthiouracil. Which statement by the nurse is correct?

a. “There are no food restrictions while on this drug.”
b. “You need to avoid foods high in iodine, such as iodized salt, seafood, and soy products.”
c. “This drug is given to raise the thyroid hormone levels in your blood.”
d. “Take this drug in the morning on an empty stomach.”

Answer 12

b. “You need to avoid foods high in iodine, such as iodized salt, seafood, and soy products.”

Question 13

When teaching a patient who has a new prescription for thyroid hormone, the nurse will instruct the patient to notify the prescriber if which adverse effects are noted? (Select all that apply.)

a. Palpitations
b. Weight gain
c. Angina
d. Fatigue
e. Cold intolerance

Answer 13

a. Palpitations

c. Angina

Question 14

Which laboratory tests does the nurse know are used to monitor thyroid hormone replacement therapy? (Select all that apply.)

a. Serum TSH
b. BUN
c. CBC
d. Free thyroid hormone levels
e. Serum iodine levels

Answer 14

a. Serum TSH

d. Free thyroid hormone levels

Question 15

A patient who is beginning therapy with levothyr-oxine asks the nurse when the medication will start working. What is the nurse’s best answer?

a. Immediately
b. Within a few days
c. Within a few weeks
d. Within a few months

Answer 15

c. Within a few weeks

Question 16

A patient wants to switch brands of levothyroxine. What is the nurse’s best response?

a. “If you do this, you should reduce the dosage of your current brand before starting the new one.”

b. “Levothyroxine has been standardized, so there is only one brand.”

c. “It shouldn’t matter if you switch brands; they are all very much the same.”

d. “You should check with your provider before switching brands.”

Answer 16

d. “You should check with your provider before switching brands.”

Question 17

Patient teaching for a patient taking antithyroid medication will include the need to avoid which foods?

a. Soy products and seafood
b. Bananas and oranges
c. Dairy products
d. Processed meats and cheese

Answer 17

a. Soy products and seafood

Question 18

Which information needs to be included in the nurse’s teaching of patients taking thyroid medications? (Select all that apply.)

a. Keeping a log or journal of individual responses and a graph of pulse rate, weight, and mood would be helpful.

b. The medication will be discontinued if the adverse effects become too strong.

c. The medication needs to be taken at the same time every day.

d. Nervousness, irritability, and insomnia may be a result of a dosage that is too high.

e. Take thyroid replacement drugs after meals.

Answer 18

a. Keeping a log or journal of individual responses and a graph of pulse rate, weight, and mood would be helpful.

c. The medication needs to be taken at the same time every day.

d. Nervousness, irritability, and insomnia may be a result of a dosage that is too high.

Question 19

A patient is scheduled for a radioactive isotope study. The scheduling nurse notes that he takes levothyr-oxine daily. Which medication order needs to be made before the radioactive isotope study is scheduled?

a. Continue to take the levothyroxine as ordered. b. Do not take the levothyroxine on the morning of the test.
c. Stop the levothyroxine about 4 weeks before the test.
d. Reduce the levothyroxine dosage by one-half 1 week before the test.

Answer 19

c. Stop the levothyroxine about 4 weeks before the test.

Question 20

Which statement is accurate regarding the method of action of I-131?

a. Radioactive iodine works by decreasing the synthesis of thyroid hormone.

b. Radioactive iodine works by decreasing the production of thyroid-stimulating hormone.

c. Radioactive iodine works by inhibiting the negative feedback mechanism.

d. Radioactive iodine works by destroying the thyroid gland.

Answer 20

d. Radioactive iodine works by destroying the thyroid gland.

Question 21

Which statement is accurate regarding the method of action of methimazole?

a. It works by decreasing the synthesis of thyroid hormone.

b. It works by decreasing the production of thyroid-stimulating hormone.

c. It works by inhibiting the negative feedback mechanism.

d. It works by destroying the thyroid gland.

Answer 21

a. It works by decreasing the synthesis of thyroid hormone.

Question 22

The nurse has been providing patient education regarding thyroid hormone replacement therapy. Which statement by the patient reflects a need for further teaching?

a. “I will take this pill in the mornings.”

b. “Sometimes this medicine can make my heart skip beats, but that’s a normal side effect.”

c. “I need to take this pill on an empty stomach and wait about 30 to 60 minutes before eating.”

d. “I will be sure to go to the clinic to have my thyroid levels tested regularly.”

Answer 22

b. “Sometimes this medicine can make my heart skip beats, but that’s a normal side effect.”

Question 23

A patient who is beginning therapy with pro-pylthiouracil (PTU) asks the nurse when the medi-cation will start working. What is the nurse’s best answer?

a. Immediately
b. Within a few days
c. Within 2 weeks
d. Within a few months

Answer 23

c. Within 2 weeks