Question 1

A patient has a diagnosis of primary hypothyroidism.Which statement accurately describes this problem?&#10;A) The hypothalamus is not secreting thyrotropin-releasing hormone (TRH); therefore,thyroid-stimulating hormone (TSH)is not released from the pituitary gland.&#10;B) The pituitary gland is dysfunctional and is not secreting TSH.&#10;C) The abnormality is in the thyroid gland itself.&#10;D) The abnormality is caused by an insufficient intake of iodine.

Accepted Answer

Primary hypothyroidism refers to a problem with the thyroid gland itself, usually resulting in decreased production of thyroid hormones. Option A describes secondary hypothyroidism, where the problem lies with the pituitary gland or hypothalamus. Option B describes tertiary hypothyroidism, where the issue is with the hypothalamus. Option D refers to iodine deficiency, which can cause hypothyroidism but is not specifically related to primary hypothyroidism.

Question 2

When reviewing the laboratory values of a patient who is taking antithyroid drugs,the nurse will monitor for which adverse effect?&#10;A) Decreased glucose levels&#10;B) Decreased white blood cell count&#10;C) Increased red blood cell count&#10;D) Increased platelet count

Accepted Answer

Antithyroid drugs can cause agranulocytosis, a potentially life-threatening condition characterized by a severe decrease in white blood cell count, which increases the risk of infections. Therefore, the nurse should monitor the patient's white blood cell count closely and report any signs of infection promptly. Decreased glucose levels are not a common adverse effect of antithyroid drugs, and increased red blood cell count and platelet count are not typically associated with these medications.

Question 3

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?&#10;A) In the morning&#10;B) With the noon meal&#10;C) With the evening meal&#10;D) At bedtime

Accepted Answer

Thyroid replacement therapy should be taken in the morning on an empty stomach to ensure maximal absorption and efficacy of the medication. It should be taken at least 30 minutes before breakfast or any other medications or supplements.

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?&#10;A) It blocks the action of thyroid hormone.&#10;B) It slows down the formation of thyroid hormone.&#10;C) It destroys overactive cells in the thyroid gland.&#10;D) It inactivates already existing thyroid hormone in the bloodstream.

Accepted Answer

PTU slows down the formation of thyroid hormone by inhibiting the enzyme that converts iodine into thyroid hormone in the thyroid gland.

Question 5

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."

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Accepted Answer

Medication therapy for hypothyroidism is usually lifelong, and stopping the medication can result in recurrence of symptoms and long-term health complications. Therefore, the nurse should inform the patient that she should not stop taking the medication and that it is important to continue treatment as prescribed by the healthcare provider.

Question 6

During a teaching session for a patient on antithyroid drugs,the nurse will discuss which dietary instructions?&#10;A) Using iodized salt when cooking&#10;B) Avoiding foods containing iodine&#10;C) Restricting fluid intake to 2500 mL/day&#10;D) Increasing intake of sodium- and potassium-containing foods

Accepted Answer

Antithyroid drugs work by decreasing the production of thyroid hormones. Since iodine is necessary for the production of thyroid hormones, it is important to avoid foods containing high levels of iodine while taking antithyroid drugs. Iodized salt should also be avoided or used in very limited amounts. Restricting fluid intake to 2500 mL/day and increasing intake of sodium- and potassium-containing foods are not necessary dietary instructions specifically related to antithyroid drugs.

Question 7

A patient has been taking levothyroxine (Synthroid)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."

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Accepted Answer

It's important to not switch brands of medication without first consulting with the prescribing healthcare provider. Even though the generic form of levothyroxine may contain the same active ingredient as the brand name Synthroid, the dose and absorption rate could be different, which could potentially cause harm to the patient. The healthcare provider will be able to determine if a switch to a different form or brand of medication is appropriate for the patient's individual situation.

Question 8

The order reads,&#34;Give levothyroxine (Synthroid),200 mg,PO once every morning.&#34; Which action by the nurse is correct?&#10;A) Give the medication as ordered.&#10;B) Change the dose to 200 mcg because that is what the prescriber meant.&#10;C) Hold the drug until the prescriber returns to see the patient.&#10;D) Question the order because the dose is higher than 200 mcg.

Accepted Answer

Levothyroxine is dosed in micrograms. A common medication error is to write the intended dose in milligrams instead of micrograms. If not caught, this error would result in a thousandfold overdose. Doses higher than 200 mcg need to be questioned in case this error has occurred. The other options are incorrect.

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?&#10;A) Infection&#10;B) Diabetes mellitus&#10;C) Liver disease&#10;D) Recent myocardial infarction

Accepted Answer

Thyroid hormone replacement drugs can increase the heart rate and cardiac output, which can be dangerous for patients with recent myocardial infarction or unstable angina. Patients with these conditions may need to have their thyroid hormone dosages adjusted carefully. Infections, diabetes mellitus, and liver disease are not contraindications to thyroid hormone replacement therapy, although these conditions may affect the patient's thyroid hormone requirement.

Question 10

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.

Accepted Answer

The half-life of levothyroxine is long enough to permit once-daily dosing, which can be more convenient for the patient. While the other options may be true to some extent, they do not directly address the advantages of levothyroxine over "natural" forms of thyroid hormone.

Question 11

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."

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Accepted Answer

The answer of A 19-year-old student was diagnosed with hypothyroidism...

Question 12

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._______

Accepted Answer

The answer of The nurse is giving morning medications.The Medication...

Deck 31: Thyroid and Antithyroid Drugs