Chapter 37 Thyroid and Parathyroid Agents

Chapter 37  Thyroid and Parathyroid Agents

Complete Chapter Questions And Answers
 

Sample Questions

1.
The nurse is teaching the patient, newly diagnosed with Graves’s disease, about the normal functioning of the thyroid gland. What hormone will the nurse tell the patient controls production and release of thyroid hormones?
A)
Thyrotropin-releasing hormone (TRH)
B)
Thyroid-stimulating hormone (TSH)
C)
Tetraiodothyronine
D)
Triiodothyronine
Ans:
B

Feedback:

Thyroid hormone production and release are regulated by the anterior pituitary hormone called thyroid-stimulating hormone (TSH). The secretion of TSH is regulated by thyrotropin-releasing hormone (TRH), a hypothalamic regulating factor. Tetraiodothyronine and triiodothyronine are thyroid hormones produced by the thyroid gland because of TSH stimulation.

2.
A child is diagnosed with hypothyroidism. The nurse anticipates an order for the drug of choice when treating children, which is what?
A)
Liothyronine (Cytomel)
B)
Liotrix (Thyrolar)
C)
Levothyroxine (Synthroid)
D)
Methimazole (Tapazole)
Ans:
C

Feedback:

Levothyroxine is the drug of choice in children because of its predictable bioavailability and reliability. Liothyronine and liotrix tend to have more adverse effects and, although they can be used in children, are not the drugs of choice. Methimazole is an antithyroid drug and is used to treat hyperthyroidism.

3.
A patient is at risk for thrombosis formation and is taking an oral anticoagulant. The patient has been newly diagnosed with hypothyroidism and placed on levothyroxine (Synthroid). What will the nurse monitor the patient for?
A)
Tachycardia
B)
Elevated body temperature
C)
Increased time spent sleeping
D)
Increased bruising and bleeding
Ans:
D

Feedback:

The effectiveness of an oral anticoagulant is increased if it is used in combination with a thyroid hormone. This may lead to increased bleeding and the need to decrease the dosage of the oral anticoagulant. Tachycardia would be found with hyperthyroidism and the effect of levothyroxine is not increased with the drug combination. Increased time spent sleeping would indicate lowering of thyroid function and the treatment should increase thyroid function. Increased body temperature is associated with hyperthyroidism.

4.
The nurse is providing patient teaching regarding the administration of levothyroxine (Synthroid). What is the nurse’s priority teaching point?
A)
“Take the medication after breakfast.”
B)
“Take the medication with a full glass of water.”
C)
“Remain in the upright position for 30 minutes after administering.”
D)
“Take the medication before going to bed at night.”
Ans:
B

Feedback:

The patient should be instructed to take the medication with a full glass of water to help prevent difficulty swallowing and esophageal atresia. The medication should be taken on an empty stomach before breakfast. There is no need to maintain an upright position. The medication should be taken as a single daily dose before breakfast each day to ensure consistent therapeutic levels.

5.
The nurse instructs the patient with a new prescription to treat hyperthyroidism and includes the importance of regular lab studies to monitor for bone marrow suppression, which can be an adverse effect of this drug. What drug is the nurse teaching the patient about?
A)
Methimazole (Tapazole)
B)
Propylthiouracil (PTU)
C)
Sodium iodide I131 (Generic)
D)
Potassium iodide (Thyro-Block)
Ans:
A

Feedback:

Methimazole is associated with bone marrow suppression, so the patient using this drug must have frequent blood tests to monitor for this effect. Propylthiouracil is associated with GI effects. The most common adverse effect of sodium iodide I131 and potassium iodide is hypothyroidism. Other effects of these two drugs include metallic taste and burning in the mouth, sore teeth and gums, diarrhea, cold symptoms, stomach upset, stained teeth, rash, and the development of goiter.