Chapter 36 Drugs Used to Treat Thyroid Disease

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Chapter 36  Drugs Used to Treat Thyroid Disease

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. Which medication is used to treat hyperthyroidism?
a.
Levothyroxine (Synthroid)
b.
Liotrix (Thyrolar)
c.
Propylthiouracil (Propacil)
d.
Liothyronine (Cytomel)

ANS: C
Propylthiouracil is an antithyroid agent used in the treatment of hyperthyroidism. Levothyroxine, liotrix, and liothyronine are used to treat hypothyroidism.

DIF: Cognitive Level: Knowledge REF: Page 577 OBJ: 2
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Hormonal Regulation

2. A patient with a history of heart failure has been diagnosed with hypothyroidism. The drug interaction with glycosides and thyroid replacement therapy will most likely require which change in therapy?
a.
Decrease in the daily digoxin dosage
b.
Gradual increase in the daily glycoside dosage
c.
Inability to begin thyroid replacement therapy because of the underlying heart condition
d.
Increased thyroid replacement dosage

ANS: B
If thyroid replacement therapy is started while receiving digoxin, a gradual increase in the glycoside will also be necessary to maintain adequate therapeutic activity. Decreasing the digoxin would put the patient at risk for cardiovascular complications. The two treatments can be coordinated. The thyroid medication does not need to be increased.

DIF: Cognitive Level: Comprehension REF: Page 576 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety

3. Which nursing diagnosis may be identified for a patient with hyperthyroidism?
a.
Imbalanced nutrition: more than body requirements
b.
Constipation
c.
Disturbed sleep pattern
d.
Ineffective airway clearance

ANS: C
Hyperthyroidism is caused by an excess amount of thyroid hormones. Patients typically exhibit the following symptoms: rapid, bounding pulse (even during sleep); cardiac enlargement; palpitations; and dysrhythmias. Patients are nervous and easily agitated. Reflexes are hyperactive and the patient typically experiences insomnia. A nursing diagnosis of “Disturbed sleep pattern” would be a common problem. The patient with hyperthyroidism is likely to consume less than body requirements and is not likely to be constipated as a result of the disease. Ineffective airway clearance is not a common problem of patients with hyperthyroidism.

DIF: Cognitive Level: Analysis REF: Page 572 OBJ: 4
TOP: Nursing Process Step: Diagnosis
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Sleep; Hormonal Regulation

4. The nurse is providing instruction to a patient recently prescribed a radioactive iodine isotope. Which is the correct action of this medication?
a.
Stimulates the synthesis of T3 and T4 hormones
b.
Increases the storage of thyroxine before thyroid surgery
c.
Destroys hyperactive thyroid tissue
d.
Replaces deficient thyroid hormone

ANS: C
The thyroid gland absorbs high concentrations of radioactive iodine, which destroys the hyperactive thyroid tissue with essentially no damage to other tissues in the body. Radioactive iodine does not stimulate hormone synthesis, increase hormone storage, or replace deficient hormones.

DIF: Cognitive Level: Comprehension REF: Page 576 OBJ: 2 | 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Communication; Patient Education; Hormonal Regulation

5. Which patient would be a candidate for radioactive iodine therapy?
a.
A 17-year-old woman with Graves’ disease
b.
A 64-year-old woman with hypothyroidism
c.
A 46-year-old man with heart disease and thyroid cancer
d.
An 82-year-old man with myxedema crisis

ANS: C
Patients typically treated with radioactive iodine therapy are those who are beyond childbearing years, those with severe complicating diseases (e.g., heart disease), those with recurrent hyperthyroidism after previous thyroid surgery, those who are poor surgical risks, and those who have unusually small thyroid glands. Women of childbearing age should not be treated with radioactive iodine. Hypothyroidism and myxedema are not treated with radioactive iodine.

DIF: Cognitive Level: Application REF: Page 576 OBJ: 2 | 4
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
NOT: CONCEPT(S): Clinical Judgment

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