Deck 67: Pharmacotherapy of Thyroid Disorders

Question 1

The nurse would monitor carefully the client concurrently taking levothyroxine (Synthroid)and:

A)aspirin.
B)vitamin B₁₂ supplementation.
C)warfarin.
D)penicillin.

Answer 1

warfarin.

Question 2

The nurse would anticipate elevated levels of circulating T3 and T4 in the client with:

A)leukopenia.
B)thrombocytopenia.
C)hypoalbuminemia.
D)hemolytic anemia.

Answer 2

hypoalbuminemia.

Question 3

In which instance would the nurse hold the dose of levothyroxine (Synthroid)?

A)The client complains of palpitations.
B)The client's blood pressure 118/78 mmHg.
C)The client's respiratory rate is 10.
D)The client is fatigued.

Answer 3

The client complains of palpitations.

Question 4

The nurse is concerned that a client is developing myxedema coma after assessing which symptoms? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Puffy face and eyes
B)Tachycardia
C)Hypoglycemia
D)Hyperthermia
E)Hypoventilation

Question 5

To detect malignancy of a thyroid nodule,the nurse would prepare the client for:

A)thyroid scanning.
B)ultrasound.
C)needle biopsy.
D)x-ray.

Question 6

The nurse knows the most visible signs of Graves disease are goiter and exophthalmos.Exophthalmos is:

A)excessive heat production.
B)skin thickening with plaques.
C)hypertrophy of the thyroid gland.
D)outward bulging of the eyes.

Question 7

The nurse,learning that a client's thyroid hormone is elevated,recognizes that one of the strongest stimuli for an increase in thyroid hormone production is:

A)hunger.
B)exposure to cold.
C)ongoing infection.
D)hypocalcemia.

Question 8

The nurse is instructing a client taking levothyroxine (Synthroid)that full therapeutic benefits will be seen:

A)immediately.
B)within 3-5 days.
C)in 1-3 weeks.
D)within 24 hours.

Question 9

The nurse instructs a client with hypothyroidism about medications that accelerate the metabolism of levothyroxine,including:

A)warfarin.
B)phenytoin.
C)digoxin.
D)calcium.

Question 10

For which client would the nurse use of levothyroxine (Synthroid)?

A)A child under 2
B)A pregnant client
C)A client allergic to shellfish
D)A client allergic to aspirin

Question 11

A client is diagnosed with primary hypothyroidism.Which laboratory tests were used to aid in this diagnosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Serum T4 level
B)TSH level
C)Serum calcium
D)Serum potassium
E)Serum iodine level

Question 12

Which laboratory value will the nurse monitor to determine the progression of a thyroid disease in a client?

A)TSH
B)T3
C)Iodine
D)T4

Question 13

How would the nurse explain the pathophysiologic etiology of cretinism to a client's family?

A)Lack of iodine replacement
B)Hypercalcemia from thyroid hyperplasia
C)Congenital hypofunction of the thyroid gland
D)Hypersecretion of the thyroid in the first six months of life

Question 14

The nurse would anticipate the client with hypothyroidism to exhibit which symptom?

A)Constipation
B)Heat intolerance
C)Weight loss
D)Hypertension

Question 15

A client is diagnosed with a thyroid hormone imbalance.The nurse recognizes that the body tissues that do not depend on thyroid hormones to stimulate the metabolic rate include the: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)anterior pituitary.
B)lungs.
C)brain.
D)kidneys.
E)testes.

Question 16

The nurse is reviewing the results of a client's laboratory studies to find the level of an important chemical that must be available to assist in the synthesis of thyroid hormones,or:

A)cortisol.
B)iodide.
C)calcitonin.
D)iodine.

Question 17

The nurse should instruct the parents of a client with cretinism that the duration of thyroid replacement is expected to be:

A)3 years.
B)The first year of life.
C)Until puberty.
D)Until symptoms disappear.

Question 18

A client is receiving thyroid hormone replacement therapy which increases the number of beta₁- and beta₂-adrenergic receptors.The nurse knows that this increase in receptors will make the receptors more responsive to which neurotransmitters? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Norepinephrine
B)Epinephrine
C)Dopamine
D)Serotonin
E)Melatonin

Question 19

A client has low levels of T3 and T . The nurse realizes that in response to these levels,the anterior pituitary will secrete:

A)thyroid-stimulating hormone.
B)tri-iodothyronine.
C)thyrotropin-releasing hormone.
D)thyroxine.

Question 20

The nurse would anticipate the client with hyperthyroidism to exhibit which symptom?

A)Hypothermia
B)Bradycardia
C)Weight gain
D)Hypertension

Question 21

A client is diagnosed with hyperthyroidism.The nurse will prepare to administer which medications as routine treatment of this disorder.Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Propylthiouracil (PTU)
B)Methimazole (Tapazole)
C)Propranolol (Inderal)
D)Esmolol (Brevibloc)
E)Metoprolol (Toprol)

Question 22

What should the nurse instruct a client who is prescribed propylthiouracil (PTU)? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"A rash can occur when taking this medication."
B)"Contact your health care provider with any changes in urine output at home."
C)"You might experience a headache."
D)"You might experience vertigo when taking this medication."
E)"Nausea and vomiting are side effects of this medication."

Question 23

Why is a client prescribed intravenous hydrocortisone (Solu-Cortef)as part of the treatment for thyroid storm? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Steroids block the conversion of T4 to T3 in peripheral tissues.
B)IV corticosteroids serve as replacement for corticosteroids in the body.
C)Steroids reduce the TSH level.
D)Steroids help maintain the blood pressure.
E)Steroids are used to stabilize the heart rate.

Question 24

A client is being treated with radioactive iodine.What should the nurse instruct the client about this treatment? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Tell family to visit for only 1 hour per day per person.
B)Ask pregnant family members not to visit.
C)Increase fluid intake up to 2 liters per day.
D)Limit the intake of all protein products.
E)Keep a wastebasket at the bedside to dispose of used tissues.

Question 25

What foods should the nurse instruct a client to avoid when taking thyroid replacement medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Soy sauce
B)Yogurt
C)Milk
D)Strawberries
E)Red meat