Thyroid Questions

Question 1

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 1

a. Decreased platelet counts

Question 2

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 2

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

Question 3

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 3

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

Question 4

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 4

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

Question 5

The nurse is teaching a patient who has a new prescription for the antithyroid drug propylthiouracil (PTU). 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 5

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

Question 6

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 6

a. Palpitations
c. Angina

Question 7

The nurse is giving an intravenous dose of levothyroxine (Synthroid). The order reads: “Give 0.1 mg IV push now.” What is the ordered dose in micrograms?

Answer 7

100 mcg

Question 8

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. T3 & T4

e. Serum iodine levels

Answer 8

a. Serum TSH
d. T3 & T4

Question 9

A patient, newly diagnosed with hypothyroidism, receives a prescription for a thyroid hormone replacement drug. The nurse assesses for which potential contraindication to this drug?
a. Infection
b. Diabetes mellitus
c. Liver disease
d. Recent myocardial infarction

Answer 9

d. Recent myocardial infarction

Question 10

A patient with hypothyroidism is given a prescription for levothyroxine. When the nurse explains that this is a synthetic form of the thyroid hormone, he states that he prefers to receive more natural forms of drugs. What will the nurse explain to him about the advantages of levothyroxine?
a. It has a stronger effect than the natural forms.
b. Levothyroxine is less expensive than the natural forms.
c. The synthetic form has fewer adverse effects on the gastrointestinal tract.
d. The half-life of levothyroxine is long enough to permit once-daily dosing.

Answer 10

d. The half-life of levothyroxine is long enough to permit once-daily dosing.

Question 11

The order reads, ―Give levothyroxine,
200mg, PO once every morning. Which action by the nurse is correct?
a. Give the medication as ordered.
b. Change the dose to 200 mcg because that is what the prescriber meant.
c. Hold the drug until the prescriber returns to see the patient.
d. Question the order because the dose is higher than 200 mcg.

Answer 11

d. Question the order because the dose is higher than 200 mcg.

Question 12

A patient who is taking propylthiouracil for hyperthyroidism wants to know how this medicine works. Which explanation by the nurse is accurate?
a. It promotes the formation of thyroid hormone.
b. It slows down the formation of thyroid hormone.
c. It destroys overactive cells in the thyroid gland.
d. It inactivates already existing thyroid hormone in the bloodstream.

Answer 12

b. It slows down the formation of thyroid hormone.

Question 13

A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse will instruct the patient to take this medication at which time of day?
a. In the morning
b. With the noon meal
c. With the evening meal
d. At bedtime

Answer 13

a. In the morning

Question 14

A 19-year-old student was diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine. After 1 week, she called the clinic to report that she does not feel better. Which response from the nurse is correct?
a. It will probably require surgery for a cure to happen.
b. The full therapeutic effects may not occur for several weeks.
c. Is it possible that you did not take your medication as instructed?
d. Let‘s review your diet; it may be causing absorption problems.

Answer 14

b. The full therapeutic effects may not occur for several weeks.

Question 15

When reviewing the laboratory values of a patient who is taking antithyroid drugs, the nurse will monitor for which adverse effect?
a. Decreased glucose levels
b. Decreased white blood cell count
c. Increased red blood cell count
d. Increased platelet count

Answer 15

b. Decreased white blood cell count

Question 16

A patient has been taking levothyroxine for more than one decade for primary hypothyroidism. Today she calls because she has a cousin who can get her the same medication in a generic form from a pharmaceutical supply company. Which is the nurse‘s best advice?
a. This would be a great way to save money.
b. There‘s no difference in brands of this medication.
c. This should never be done; once you start with a certain brand, you must stay with it.
d. It‘s better not to switch brands unless we check with your doctor.

Answer 16

d. It‘s better not to switch brands unless we check with your doctor.

Question 17

A patient has a diagnosis of primary hypothyroidism. Which statement accurately describes this problem?
a. The hypothalamus is not secreting thyrotropin-releasing hormone (TRH);therefore, thyroid-stimulating hormone (TSH) is not released from the pituitary gland.
b. The pituitary gland is dysfunctional and is not secreting TSH.
c. The abnormality is in the thyroid gland itself.
d. The abnormality is caused by an insufficient intake of iodine.

Answer 17

c. The abnormality is in the thyroid gland itself.

Question 18

A 19-year-old woman has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine. After 6 months, she calls the nurse to say that she feels better and wants to stop the medication. Which response by the nurse is correct?
a. You can stop the medication if your symptoms have improved.
b. You need to stay on the medication for at least 1 year before a decision about stopping it can be made.
c. You need to stay on this medication until you become pregnant.
d. Medication therapy for hypothyroidism is usually lifelong, and you should not stop taking the medication.

Answer 18

d. Medication therapy for hypothyroidism is usually lifelong, and you should not stop taking the medication.

Question 19

Levothyroxine has been prescribed for a patient with hypothyroidism. The nurse reviews the patient‘s current medications for potential interactions. Which of these drugs or drug classes interact with levothyroxine? (Select all that apply.)
a. Phenytoin
b. Estrogens
c. Beta blockers
d. Warfarin
e. Penicillins
f. Iron supplements

Answer 19

a. Phenytoin
b. Estrogens
d. Warfarin
f. Iron supplements

Question 20

The nurse is giving morning medications. The Medication Administration Record has an order for levothyroxine, 88 mcg PO. The drug-dispensing cabinet contains levothyroxine tablets in milligram strengths instead of micrograms. Calculate the milligram equivalent dose of 88 mcg.

Answer 20

0.088 mg