Regular exposure to NCLEX RN Practice Questions prepares students to think critically and make sound clinical judgments in a time-sensitive environment.
NCLEX Anti-thyroid Drugs Questions - NCLEX Questions on Anti-thyroid Drugs
Anti-thyroid Drugs NCLEX Questions Test Strategies
NGN case study:
Jane is a 45-year-old female who presents with a chief complaint of fatigue and weight gain over the past few months. She reports feeling cold all the time and has noticed that her skin has become dry and her hair has become brittle. She denies any significant medical history and is currently not taking any medications.
Nurse's Notes: Upon assessment. Jane appears pale and fatigued. Her vital signs are within normal limits, except for a slightly elevated blood pressure of 138/84 mmHg. She reports a 10-pound weight gain over the past 6 months, despite maintaining a healthy diet and exercise routine. Her skin is dry. and her hair is thin and brittle. She also reports feeling cold all the time. Physical examination of the thyroid gland reveals a diffuse enlargement of the gland with no nodules or tenderness.
Physician's Orders:
Thyroid function tests, including TSH, free T4, and free T3 Thyroid ultrasound to evaluate thyroid gland size and any nodules Referral to an endocrinologist for further evaluation and management.
Lab Values:
TSH: 5.5 uTU/mL (normal range 0.5-5.0 uIU/mL)
Free T4: 0.8 ng/dL (normal range 0.8-1.8 ng/dL)
Free T3: 2.5 pg/mL (normal range 2.3-4.2 pg/mL)
Question 1.
What is the most likely diagnosis for Jane based on her presentation and lab values?
(a) Hyperthyroidism
(b) Hypothyroidism
(c) Subclinical hyperthyroidism
(d) Normal thyroid function
Answer:
(b) Hypothyroidism
Explanation:
Jane's presentation of fatigue, weight gain, cold intolerance, dry skin, and brittle hair, along with a diffuse enlargement of the thyroid gland, are all consistent with a diagnosis of hypothyroidism. Her TSH level is elevated at 5.5 uIU/mL, which indicates decreased thyroid hormone production and is a hallmark finding in hypothyroidism. Additionally, her free T4 level is at the lower end of the normal range, while her free T3 level is slightly decreased, further supporting a diagnosis of hypothyroidism.
Rationale:
Option (a) Hyperthyroidism is incorrect because Jane's presentation is not consistent with an overactive thyroid gland. Hyperthyroidism typically presents with symptoms such as weight loss, heat intolerance, palpitations, and tremors, and lab values show a decreased TSH level and increased levels of free T4 and/or free T3.
Option (c) Subclinical hyperthyroidism is also incorrect because Jane's TSH level is elevated, indicating decreased thyroid hormone production, rather than decreased TSH production. Subclinical hyperthyroidism is characterized by a slightly decreased TSH level with normal levels of free T4 and free T3.
Option (d) Normal thyroid function is incorrect because Jane's TSH level is outside the normal range, indicating abnormal thyroid function. Normal thyroid function is characterized by TSH, free T4, and free T3 levels within the normal range. Therefore, based on Jane's presentation and lab values, the most likely diagnosis is hypothyroidism.
Question 2.
Which of the following is characterized by w eight gain, fatigue, and a diffuse enlargement of the thyroid gland?
(a) Hypothyroidism
(b) Hyperthyroidism
(c) Thyroid storm
(d) Both A and C
Answer:
(b) Hyperthyroidism
Explanation:
Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, resulting in a slowing down of the body's metabolic processes. This is characterized by symptoms such as weight gain, fatigue, constipation, cold intolerance, and dry skin. Additionally, a physical examination may reveal a diffuse enlargement of the thyroid gland, also known as a goiter, which can occur due to increased stimulation of the thyroid gland in an attempt to produce more hormones. Therefore, option (a) Hypothyroidism is the correct answer.
Rationale:
Option (b) Hyperthyroidism is characterized by an overactive thyroid gland, resulting in the body's metabolic processes speeding up. Symptoms may include weight loss, anxiety, tremors, heat intolerance, and palpitations. Physical examination may reveal an enlarged thyroid gland, but it is typically accompanied by nodules and tenderness, rather than a diffuse enlargement.
Option (c) Thyroid storm is a severe complication of hyperthyroidism characterized by fever, tachycardia, hypertension, altered mental status, and possible organ failure. This is a medical emergency and requires immediate treatment in an intensive care setting. It is not characterized by weight gain or a diffuse enlargement of the thyroid gland.
Option (d) Both A and C is incorrect because although hypothyroidism and thyroid storm are both related to thyroid dysfunction, they are opposite ends of the spectrum in terms of severity and presentation. Thyroid storm is a medical emergency characterized by extreme hyperthyroidism, while hypothyroidism is a chronic condition characterized by decreased thyroid hormone production. Therefore, based on the symptoms provided, the correct answer is (a) Hypothyroidism.
Question 3.
If the patient’s conditions worsen, what is the priority nursing intervention for a patient experiencing myxedema coma due to hypothyroidism?
(a) Administer thyroid replacement hormone therapy
(b) Administer vasopressor medications to treat hypotension
(c) Administer corticosteroids to reduce inflammation
(d) Administer oxygen therapy to treat respiratory distress
Answer:
(a) Administer thyroid replacement hormone therapy
Explanation:
Myxedema coma is a rare, life-threatening complication of hypothyroidism characterized by severe hypothyroidism leading to decreased metabolism and altered mental status. The priority nursing intervention for a patient experiencing myxedema coma is to administer thyroid replacement hormone therapy to correct the hypothyroidism and prevent further complications.
Administering vasopressor medications to treat hypotension, corticosteroids to reduce inflammation, or oxygen therapy to treat respiratory distress may be appropriate interventions but are not the priority in this situation. The primary goal is to treat the underlying hypothyroidism to prevent further complications and improve the patient's overall condition.
Question 4.
Which of the following is the most appropriate nursing intervention for a patient experiencing thyrotoxicosis crisis?
(a) Administer a high dose of levothyroxine to rapidly decrease thyroid hormone levels.
(b) Place the patient in a cool environment to decrease metabolic demands.
(c) Administer a beta-blocker to decrease heart rate and blood pressure.
(d) Encourage the patient to consume a high-protein diet to promote healing.
Answer:
(c) Administer a beta-blocker to decrease heart rate and blood pressure.
Explanation:
Thyrotoxicosis crisis, also known as thyroid storm, is a life-threatening complication of hyperthyroidism. Symptoms include fever, tachycardia, hypertension, and altered mental status. Treatment involves managing the symptoms while decreasing thyroid hormone levels. Administering a beta-blocker, such as propranolol, is the most appropriate nursing intervention because it will decrease heart rate and blood pressure, reducing the risk of cardiovascular complications.
Option A is incorrect because levothyroxine would further increase thyroid hormone levels and exacerbate the crisis. Option B is incorrect because although a cool environment may help reduce symptoms, it does not address the underlying cause of the crisis. Option D is incorrect because a high- protein diet would not directly address the symptoms of thyrotoxicosis crisis.
Question 5.
Which of the following is an appropriate nursing intervention for managing constipation, a common complication of hypothyroidism, with diet?
(a) Increasing intake of high-fiber foods
(b) Decreasing fluid intake to avoid further fluid retention
(c) Avoiding foods rich in iron and calcium
(d) Increasing intake of caffeine-containing beverages
Answer:
(a) Increasing intake of high-fiber foods
Explanation:
Constipation is a common complication of hypothyroidism due to the decreased metabolic rate in the body. One of the nursing interventions to manage constipation in hypothyroidism is to increase the intake of high-fiber foods such as fruits, vegetables, and whole grains. This will help to promote bowel movement and prevent constipation.
Option (b) is incorrect because decreasing fluid intake may lead to dehydration and worsen constipation. Option (c) is incorrect because iron and calcium-rich foods are important for patients with hypothyroidism. Option (d) is incorrect because caffeine-containing beverages may cause dehydration and interfere with the absorption of thyroid medications.
Question 6.
Which of the following are good choices for education that should be given by a nurse to a patient who is suffering from hypothyroidism? Select all that apply.
(a) Importance of taking thyroid hormone replacement medication as prescribed
(b) Maintaining a healthy and balanced diet
(c) Avoiding over-the-counter supplements without consulting a healthcare provider
(d) Importance of regular exercise to manage weight
(e) Monitoring thyroid hormone levels regularly
(f) Avoiding exposure to extreme temperatures
(g) Using iodized salt for cooking
Answer:
(a) Importance of taking thyroid hormone replacement medication as prescribed
(b) Maintaining a healthy and balanced diet
(e) Monitoring thyroid hormone levels regularly
Explanation:
Options (a) (b), and (e) are all good choices for education for patients with hypothyroidism. Patients should be educated on the importance of taking their thyroid hormone replacement medication as prescribed, maintaining a healthy and balanced diet, and regularly monitoring their thyroid hormone levels. Options (c), (d), (f), and (g) may not be directly related to hypothyroidism management or may even be harmful, such as using iodized salt excessively.
Anti-thyroid Drugs NCLEX Practice Questions
Question 1.
Mrs. Ranjan is a 45-year-old woman who has been diagnosed with hyperthyroidism. She has been prescribed a thyroid medication to help manage her condition. After starting the medication. Mrs. Ranjan experiences a metallic taste in her mouth, swelling of her gums, and abdominal pain followed by diarrhea and vomiting. She also reports experiencing low energy, hair loss, sweating, and difficulty sleeping.
What is a common side effect of thyroid medications that Mrs. Ranjan may be experiencing?
(a) Thrombocytopenia
(b) Agranulocytosis
(c) Hypothyroidism
(d) Thyroid toxicity
Answer:
(d) Thyroid toxicity
Rationale:
Before solving these terms, let's see these terms:
(a) Thrombocytopenia - a decrease in the number of platelets in the blood, which can cause bleeding and bruising.
(b) Agranulocytosis - a severe decrease in the number of white blood cells, which can lead to infection.
(c) Hypothyroidism - a condition in which the thyroid gland does not produce enough hormones, causing symptoms such as fatigue, weight gain, and cold intolerance.
(d) Thyroid toxicity - a condition in which the thyroid gland produces too much hormone, causing symptoms such as tremors, palpitations, and restlessness.
Question 2.
Mrs. Ranjan's symptoms of metallic taste, swelling of the gums, and abdominal pain followed by diarrhea and vomiting are most consistent with thyroid toxicity, which is a common side effect of thyroid medications. Thrombocytopenia and agranulocytosis are also potential side effects of thyroid medications, but these are not typically accompanied by symptoms such as metallic taste or abdominal pain. Hypothyroidism is a condition that is caused by insufficient production of thyroid hormones, so it is not likely to be the cause of Mrs. Ranjan's symptoms.
Explanation:
Thyroid toxicity is a condition that can occur when a patient is taking thyroid medications for an extended period of time or when the dose of the medication is too high. It is characterized by symptoms such as tremors, palpitations, and restlessness, as well as other symptoms such as metallic taste, swelling of the gums, and abdominal pain.
It is important for healthcare providers to closely monitor patients taking thyroid medications to ensure that they are taking the correct dosage and to watch for any signs of thyroid toxicity. If thyroid toxicity is suspected, the patient's medication regimen may need to be adjusted or the medication may need to be stopped altogether.
Question 3.
A patient with hyperthyroidism is prescribed thyroid hormone therapy with Liothyronine sodium. The patient has been taking the medication for several months and has reported experiencing symptoms of heat intolerance, decreased appetite, hair loss, sweating, and insomnia. The nurse is responsible for monitoring the patient's thyroid hormone levels and ensuring that the patient is taking the medication as prescribed.
What is a potential side effect of taking thyroid hormone therapy for a long period of time?
(a) Thrombocytopenia
(b) Agranulocytosis
(c) Hypothyroidism
(d) Thyroid storm
Answer:
(c) Hypothyroidism
Explanation:
Option (a) Thrombocytopenia is incorrect because this is a side effect of some medications, but it is not specifically taken as a potential side effect of thyroid hormone therapy. Option (b) Agranulocytosis is also incorrect because this is a rare side effect of some medications Option (d) Thyroid storm is incorrect because this is a severe condition that occurs when there is a sudden and severe increase in thyroid hormone levels. It is not specifically taken as a potential side effect of taking thyroid hormone therapy for a long period of time. Therefore, the correct answer is (c) Hypothyroidism.
Rationale:
The correct answer is (c) Hypothyroidism. Taking thyroid hormone therapy for a long period of time without following the doctor's advice can cause hypothyroidism, which is a deficiency of thyroid hormones. The patient in the case study is experiencing symptoms of thyroid hormone deficiency, including heat intolerance, decreased appetite, hair loss, sweating, and insomnia. These symptoms may be a result of hypothyroidism caused by taking the thyroid hormone therapy for a long period of time.