Deck 31: Thyroid and Antithyroid Drugs

Question 1

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 1

Decreased white blood cell count

Question 2

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 2

The abnormality is in the thyroid gland itself.

Question 3

A patient with hypothyroidism is given a prescription for levothyroxine ( Synthroid ). 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 3

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

Question 4

A patient who is taking propylthiouracil (PTU) for hyperthyroidism wants to know how this medicine works. Which explanation by the nurse is accurate?

A) It blocks the action 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.

Question 5

A patient has been taking levothyroxine ( Synthroid ) for more than 1 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."

Question 6

Levothyroxine ( Synthroid ) has been prescribed for a patient with hypothyroidism. The nurse provides information to the patient about the medication and tells the patient to contact the prescriber if which potential adverse effect occurs? (Select all that apply.)

A) Fatigue
B) Chest pains
C) Palpitations
D) Drowsiness
E) Rapid heart rate
F) Constipation

Question 7

A 19-year-old woman has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine ( Synthroid ). 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."

Question 8

A 19-year-old student was diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine ( Synthroid ). 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 3 to 4 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."

Question 9

The nurse is giving morning medications. The Medication Administration Record has an order for levothyroxine, 75 mcg PO. The drug-dispensing cabinet contains levothyroxine tablets in milligram strengths instead of micrograms. Calculate the milligram equivalent dose of 75 mcg.

Question 10

When reviewing the drugs taken by a patient who will be starting thyroid replacement preparations, the nurse notes that an interaction may occur with which of these drugs?

A) Vitamin supplements
B) Antibiotics
C) Oral antidiabetic drugs
D) Beta blockers

Question 11

The order reads, "Give levothyroxine ( Synthroid ), 200 mg, 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.

Question 12

During a teaching session for a patient on antithyroid drugs, the nurse will discuss which dietary instructions?

A) Using iodized salt when cooking
B) Avoiding foods containing iodine
C) Restricting fluid intake to 2500 mL per day
D) Increasing intake of sodium- and potassium-containing foods

Question 13

When monitoring a patient who is taking a thyroid replacement hormone, which adverse effect needs to be reported to the prescriber?

A) Weakness
B) Palpitations
C) Constipation
D) Drowsiness

Question 14

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

Question 15

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