Drugs for Endocrine Problems

Understanding Pharmacology Essentials for Medication Safety

Nursing
21
Questions
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True/False
18
Choices
3
Essay
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Questions

Q1
Free

Which mineral is critical for the thyroid to use in making thyroid hormones?

Multiple Choice
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A) Lithium
B) Sodium
C) Chloride
D) Iodine
Answer:
D) Iodine

Explanation:
Thyroid hormones (TH) are made from the amino acid tyrosine and the mineral iodine. For the thyroid gland to make correct amounts of TH, the diet must contain enough protein and iodine.
Q2
Free

Laboratory blood tests show that a patient has a T3 level of 190 ng/dL. How does the nurse interpret this finding?

Multiple Choice
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A) Hypothyroidism
B) Hyperthyroidism
C) Normal thyroid function
D) Thyroid function totally absent
Answer:
C) Normal thyroid function

Explanation:
The normal level for T3 (triiodothyronine) ranges between 70 and 205 ng/dL.
Q3
Free

A patient with hypothyroidism as a result of Hashimotos thyroiditis asks how long thyroid replacement drugs will need to be taken. What is the nurses best response?

Multiple Choice
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A) You will need to take the thyroid replacement drug until the goiter is completely gone.
B) You will need thyroid replacement drugs for the rest of your life because thyroid function will not return.
C) The thyroiditis will be cured with antibiotics and then you will no longer need the thyroid replacement drugs.
D) When your thyroid function studies indicate a normal blood level of thyroid hormones you will be able to discontinue the drugs.
Answer:
B) You will need thyroid replacement drugs for the rest of your life because thyroid function will not return.

Explanation:
Hashimotos thyroiditis results in a permanent loss of thyroid function. Without continuous thyroid replacement drugs, the patients metabolism would eventually stop and death would occur.
Q4

Which assessment is most important for the nurse to perform before giving a patient who is prescribed levothyroxine (Synthroid) the first dose of the drug?

Multiple Choice
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A) Measuring heart rate and rhythm
B) Determining level of consciousness
C) Asking about an allergy to sulfa drugs
D) Checking intake and output for the last 24 hours
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Q5

A patient is prescribed levothyroxine 25 mcg by IV push. The drug on hand is levothyroxine sodium 100 mcg/mL. How many milliliters does the nurse administer?

Multiple Choice
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A) 2.5
B) 1
C) 0.5
D) 0.25
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Q6

A patient who is prescribed liothyronine (Cytomel) also takes warfarin (Coumadin). Which laboratory blood test result indicates to the nurse a possible drug interaction?

Multiple Choice
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A) Hematocrit 42%
B) Hemoglobin 14.2 g/dL
C) Blood urea nitrogen (BUN) 12 mg/dL
D) International normalized ratio (INR) 4.5
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Q7

A patient who has been taking levothyroxine (Synthroid) for 2 months has all of the following conditions. Which condition indicates to the nurse that the drug therapy is effective?

Multiple Choice
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A) Increased thirst
B) Daily bowel movement for 1 week
C) White blood cell count of 6000/mm3
D) Weight unchanged for the last 3 weeks
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Q8

Which precaution is most important for the nurse to teach a patient who is newly prescribed a thyroid hormone replacement drug?

Multiple Choice
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A) Avoid taking fiber supplements while on this drug.
B) Be sure to take this drug at the same time every day.
C) Weigh yourself daily and keep a record of these weights.
D) Do not increase the dose without your prescribers knowledge.
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Q9

Why should pregnant patients who have hypothyroidism continue to take thyroid replacement drugs throughout pregnancy?

Multiple Choice
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A) These drugs are pregnancy category A and have no side effects.
B) Without continuing thyroid replacement drugs, the pregnancy may not continue.
C) Pregnancy is a high metabolism condition and less drug is needed but should still be taken.
D) The fetus produces thyroid hormones that help supplement the pregnant womans hormone level, but minimal replacement is needed during pregnancy.
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Q10

How do thyroid replacement drugs affect diabetes?

Multiple Choice
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A) Thyroid replacement drugs reduce the effectiveness of all antidiabetic drugs.
B) When thyroid replacement drugs return metabolism to normal, diabetes is gone.
C) Thyroid replacement drugs can allow a patient to switch from insulin to an oral antidiabetic drug.
D) Thyroid replacement drugs require that a patient taking an oral antidiabetic drug be placed on insulin.
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Q11

Which statement made by a patient who is taking a thyroid replacement drug indicates to the nurse that a higher dose may be needed?

Multiple Choice
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A) My goiter seems to be smaller.
B) I seem to feel the heat more than other people.
C) Food just doesnt taste good without a lot of salt.
D) I am always tired, even when I get 10 or 12 hours of sleep.
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Q12

Which symptom of hyperthyroidism occurs only with the Graves disease form of the problem?

Multiple Choice
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A) Goiter
B) Hypertension
C) Exophthalmos
D) Thinning scalp hair
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Q13

A patient with hyperthyroidism is in the hospital waiting for surgery to remove the thyroid gland. This patient has all of the following conditions. For which condition does the nurse notify the prescriber immediately?

Multiple Choice
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A) High level of anxiety about having surgery on the neck
B) Temperature increase of 2 F
C) Pulse pressure decrease of 10 mm Hg
D) Increased bowel sounds and flatulence
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Q14

Why does a patient who is taking drugs for thyroid suppression continue to have symptoms of hyperthyroidism for 3 weeks (or longer) after drug therapy is started?

Multiple Choice
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A) Thyroid hormones are stored and thyroid suppressing drugs only stop the synthesis of new hormones.
B) At first, the patients metabolism is so high that the thyroid cells continue to synthesize thyroid hormones.
C) The activity of the intestinal tract is increased and the drug is eliminated before complete suppression can occur.
D) The side effects of thyroid suppression drugs are so uncomfortable that most patients do not take the full dose of the drug that is needed to prevent further hormone secretion.
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Q15

A patient who has been taking methimazole (Tapazole) for 3 weeks has all of the following laboratory blood test results. Which result does the nurse report immediately to the prescriber?

Multiple Choice
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A) White blood cell count 3500 cells/mm3
B) Lactate dehydrogenase 990 IU/L
C) Sodium 132 mEq/L
D) Hematocrit 32%
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Q16

A patient who is prescribed propylthiouracil (Propacil) also takes warfarin (Coumadin). Which laboratory blood test result indicates to the nurse a possible drug interaction?

Multiple Choice
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A) Hematocrit 42%
B) Hemoglobin 14.2 g/dL
C) Blood urea nitrogen (BUN) 12 mg/dL
D) International normalized ratio (INR) 5.0
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Q17

Which precaution is important for the nurse to teach an older patient who is prescribed methimazole (Tapazole)?

Multiple Choice
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A) If you miss a dose, go to the nearest emergency department and get an injection of methimazole.
B) Be sure to wear sunscreen and a hat whenever you go outside into the sunshine.
C) Drink at least 3 liters of fluid daily while taking this drug.
D) Avoid contact with crowds or anyone who is ill.
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Q18

A patient who has just been prescribed estrogen-based hormone replacement therapy (HRT) also has all of the following health problems. For which problem does the nurse check with the prescriber to determine whether the patient should take HRT?

Multiple Choice
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A) Asthma
B) Hypertension
C) Osteoporosis
D) Diabetes mellitus
Answer:

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Q19

[Multiple Response] Which precautions are important for the nurse to teach a patient who is taking hormone replacement therapy (HRT) to reduce menopausal discomfort? (Select all that apply.)
a. Use oral contraceptives.
b. Avoid cigarette smoking.
c. Avoid drinking alcoholic beverages.
d. Obtain a yearly influenza vaccination.
e. Perform monthly breast self-examinations.
f. Go to the hospital immediately if chest pains or symptoms of a stroke occur.

Essay
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Q20

[Multiple Response] Which precautions are important for the nurse to teach a patient who is taking hormone replacement therapy (HRT) to reduce menopausal discomfort? (Select all that apply.)
a. Use oral contraceptives.
b. Avoid cigarette smoking.
c. Avoid drinking alcoholic beverages.
d. Obtain a yearly influenza vaccination.
e. Perform monthly breast self-examinations.
f. Go to the hospital immediately if chest pains or symptoms of a stroke occur.

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Q21

A patient with hyperthyroidism is prescribed an immediate dose of propylthiouracil (Propacil) 150 mg orally. The available drug is propylthiouracil 50 milligrams per tablet. How many tablets does the nurse administer? _____ tablets

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