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Chapter 52: Thyroid Medications Test Bank

Chapter 52: Thyroid Medications Test Bank

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Chapter 52: Thyroid Medications
Test Bank
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:
a.

methimazole.

b.

liothyronine.

c.

levothyroxine.

d.

propylthiouracil.

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:
a.

order a T4 level today.

b.

increase the dose to 100 mcg.

c.

check the TSH level in 1 week.

d.

reassure the patient that this will improve in several weeks.

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:
a.

assess the patient for symptoms of hyperthyroidism.

b.

ask the patient about the use of medications such as lithium.

c.

tell the patient that the results most likely indicate hypothyroidism.

d.

ask an endocrinologist to evaluate for possible Hashimoto’s thyroiditis.

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 _____.
a.

25; liothyronine

b.

75; liothyronine

c.

25; levothyroxine

d.

75; levothyroxine

5.   A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day. The child weighs 15 kg. The primary care NP sees the child for a 3-year-old check-up. The NP should consult with a pediatric endocrinologist to discuss:
a.

increasing the dose to 90 mcg/day.

b.

decreasing the dose to 30 mcg/day.

c.

stopping the medication and checking TSH and T4 in 4 weeks.

d.

discussing the need for lifetime replacement therapy with the child’s parents.

6.   A primary care NP prescribes levothyroxine for a patient to treat thyroid deficiency. When teaching this patient about the medication, the NP should:
a.

counsel the patient to take the medication with food.

b.

tell the patient that changing brands of the medication should be avoided.

c.

instruct the patient to stop taking the medication if signs of thyrotoxicosis occur.

d.

tell the patient that the drug may be stopped when thyroid function tests stabilize.

7.   A patient has been taking levothyroxine 100 mcg daily for several months. The patient comes to the clinic with complaints of insomnia and irritability. The primary care NP notes a heart rate of 92 beats per minute. The NP should:
a.

change to liothyronine 75 mcg/day.

b.

discontinue levothyroxine indefinitely.

c.

order propylthiouracil to counter the increased thyroid levels.

d.

order TSH and T4 levels and decrease the dose to 75 mcg/day.

8.   A 75-year-old patient who has cardiovascular disease reports insomnia and vomiting for several weeks. The primary care NP orders thyroid function tests. The tests show TSH is decreased and T4 is increased. The NP should consult with an endocrinologist and order:
a.

thyrotropin.

b.

methimazole.

c.

levothyroxine.

d.

propylthiouracil.

9.   A patient with Graves’ disease is taking methimazole. After 6 months of therapy, the primary care NP notes normal T3 and T4 and elevated TSH. The NP should:
a.

order a complete blood count (CBC) with differential.

b.

order aspartate aminotransferase, AGT, and LDH tests.

c.

decrease the dose of the medication.

d.

add levothyroxine to the patient’s regimen.


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