Pharmacology for Nursing Care, 7th Edition by Richard A. Lehne
Pharmacology for Nursing Care, 7th Edition by Richard A. Lehne
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Chapter 57: Drugs for Thyroid Disorders
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| a. | “Hypothyroidism causes a decrease in TSH.” |
| b. | “The test probably is erroneous, because you don’t have a goiter.” |
| c. | “TSH is not a good screening test for thyroid disease.” |
| d. | “The low TSH is consistent with hyperthyroidism.” |
ANS: D
The nurse should explain that a low TSH level indicates hyperthyroidism, because the thyroid hormones, T3 and T4, are high, and this causes the pituitary-hypothalamus-thyroid feedback system to reduce TSH in an attempt to avoid stimulating the thyroid to release further T3 and T4.
Hypothyroidism does not cause a decrease in the TSH level; hyperthyroidism does.
A goiter is not always present with hyperthyroidism.
TSH is an acceptable screening test for thyroid disease.
DIF: Cognitive Level: Analysis REF: p. 691
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation
| a. | Therapy should continue until all symptoms have resolved. |
| b. | Medication should be taken as directed for 3 to 6 months. |
| c. | Most patients require therapy for at least 1 year. |
| d. | In most cases, treatment is likely to be lifelong. |
ANS: D
In most cases, treatment is lifelong. Symptoms never just go away; they must be managed for the rest of the patient’s life. With hypothyroidism, the thyroid must be supplemented with T4 daily.
Symptoms never just go away; they must be managed for the rest of the patient’s life.
Medication should be taken as directed for life, not just for 3 to 6 months or 1 year.
DIF: Cognitive Level: Application REF: p. 692
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation
| a. | neuropsychologic deficits in the fetus may result if the condition is not treated. |
| b. | no danger to the fetus exists until the third trimester, therefore the patient has time to make the decision. |
| c. | treatment is required only if the mother is experiencing symptoms. |
| d. | hypothyroidism is a normal effect of pregnancy and usually is of no consequence. |
ANS: A
Maternal hypothyroidism can result in permanent neuropsychologic deficits in the child.
The greatest danger to the fetus occurs in the first trimester, because the fetus is entirely dependent on the mother; the thyroid does not fully develop until the second trimester. Early identification is essential.
Symptoms often are vague. Treatment should begin as soon as possible, or mental retardation and other developmental problems may occur.
Hypothyroidism is not a normal effect of pregnancy and is a serious condition that can affect both mother and fetus.
DIF: Cognitive Level: Analysis REF: p. 692
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential
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