Chapter 52: Thyroid Medications

Chapter 52: Thyroid Medications

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient reports fatigue, weight loss, and dry skin. The primary care nurse practitioner (NP) orders thyroid function tests. The patient’s thyroid stimulating hormone (TSH) is 40 microunits/mL, and T₄ is 0.1 ng/mL. The NP should refer the patient to an endocrinologist and prescribe:

ANS:  C

This patient has hypothyroidism and should be treated with levothyroxine. Methimazole is a thyroid suppressant. Liothyronine is synthetic T₃. Propylthiouracil is a thyroid suppressant.

DIF:    Cognitive Level: Applying (Application)                           REF:   582

2. A patient who has hypothyroidism has been taking levothyroxine 50 mcg daily for 2 weeks. The patient reports continued fatigue. The primary care NP should:

ANS:  C

Full therapeutic effectiveness may not be achieved for 3 to 6 weeks. Measuring the TSH level is indicated to evaluate drug effectiveness. The dose should not be increased without first evaluating the patient’s TSH level.

DIF:    Cognitive Level: Applying (Application)                           REF:   582

3. A primary care NP orders thyroid function tests. The patient’s TSH is 1.2 microunits/mL, and T₄ is 1.7 ng/mL. The NP should:

ANS:  C

Primary hypothyroidism is the most common form of hypothyroidism. Use of certain drugs, such as lithium, and diseases such as Hashimoto’s thyroiditis can cause hypothyroidism but are less likely. The patient does not have signs of hyperthyroidism.

DIF:    Cognitive Level: Applying (Application)                           REF:   585

4. An 80-year-old female patient with a history of angina has increased TSH and decreased T₄. The primary care NP should prescribe _____ mcg of _____.

ANS:  C

Elderly individuals may experience exacerbation of cardiovascular disease and angina with thyroid hormone replacement. It is advisable to start low at 25 mcg and work up as tolerated. Liothyronine is a synthetic T₃.

DIF:    Cognitive Level: Applying (Application)                           REF:   587