NUR 311 Exam 4 Study Questions and Correct Answers
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Course
NUR 311
Institution
NUR 311
What two hormones does the thyroid produce? Triiodothyronine (T3) Thyroxine (T4)
Which thyroid hormone is converted in the periphery? T4 is converted to T3
Which thyroid hormone is more potent? T3
Describe the steps of thyroid hormone regulation. (TRH, TSH, T3, T4, negative feedback loop) TRH fr...
NUR 311 Exam 4 Study Questions and
Correct Answers
What two hormones does the thyroid produce? ✅Triiodothyronine (T3)
Thyroxine (T4)
Which thyroid hormone is converted in the periphery? ✅T4 is converted to T3
Which thyroid hormone is more potent? ✅T3
Describe the steps of thyroid hormone regulation. (TRH, TSH, T3, T4, negative
feedback loop) ✅TRH from hypothalmus -> TSH from anterior pituitary -> T3 & T4 from
thyroid -> inhibit TSH from anterior pituitary
Describe the relationship of TSH levels to T3 and T4 levels. ✅Low T3 or T4 increases
TSH, high T3 or T4 lowers TSH
Describe common clinical signs and symptoms of hypothyroidism? ✅Goiter: puffy,
expressionless face; cold/dry skin; brittle hair; hair loss from scalp & outer half of
eyebrows; fatigue; irritability; depression; lack of concentration; cold intolerance;
constipation; heavy menses; increased cholesterol
Persons over 50 years of age may need what change in the initial dose of
levothyroxine? ✅Lowered
Discuss the effects on the fetus of maternal hypothyrodism may need to increase the
dose of levothyroxine by how much? ✅Decreased IQ and neuropsychological function
of the child. Increase levothyroxine dose by up to 50%. Increase by 30% as soon as
pregnancy confirmed
Discuss the effects of congenital hypothyroidism in infants. ✅Mental retardation, large
tongue, pot belly, dwarfish stature, derangement of growth - nerves, muscles, bone,
teeth
How long until levothyroxine reaches a plateau? ✅One month
Levothyroxine should be given with or without food? ✅Without food
Discuss the expected change in TSH when a patient is responding to levothyroxine?
✅TSH decreases to normal levels
, Describes the signs and symptoms of throtoxicosis. ✅Tachycardia, angina, tremor,
nervousness, insomnia, hyperthermia, heat intolerance, sweating, weight loss,
increased appetite.
Which drugs can cause decreased absorption of levothyroxine? How many hours after
the administration of levothyroxine may these drugs be given? ✅H2-receptor blockers,
proton pump inhibitors, bile-acid sequestrants such as colestyramine (Questran) and
colestipol (Colestid); sucralfate (Carafate); calcium, iron, magnesium, aluminum.
4 hours.
Why would a nurse administer levothyroxine with caution to a patient on warfarin?
✅Levothyroxine increases the degradation of Vitamin K-dependent clotting factors and
may increase the chance of bleeding. May need to decrease dose of warfarin.
What is the interaction between catecholamines and levothyroxine? ✅Levothyroxine
increases the body's response to epinephrine, norepinephrine, and dopamine.
Why might lithothyronine (Cytomel) be given instead of levothyroxine (Levothyroid)?
✅Rapid onset of action in myxedema coma.
Discuss the nursing care of a patient with hypothyroidism. ✅Life-long replacement;
take on an empty stomach; monitor for hypothyroidism & hyperthyroidism; hold
levothyroxine if pulse >100/min & call primary care provider; monitor TSH, T3 & T4;
minimize adverse drug interactions; monitor warfarin levels.
What are the symptoms of thyrotoxic crisis (thyroid storm)? What usually triggers it?
✅Restlessness, agitation, tremor, severe tachycardia, hypotension, heart failure,
hyperthermia, profound weakness, unconsciousness, coma.
Severe illness or major surgery.
What mimics TSH in patients with Grave's Disease? ✅Thyroid-stimulating
immunoglobins (TSI)
What are some signs and symptoms of Grave's Disease? ✅Rapid, strong heartbeat;
rapid thoughts & speech; trouble concentrating; tremor; insomnia; weakened muscles;
increased body temperature; warm, moist skin; increased appetite with weight loss;
diarrhea; exophthalmos.
What TSH level is expected with hyperthyroidism? ✅Decreased TSH
Give two ways propylthiouracil (PTU) works in hyperthyroidism? ✅Inhibits thyroid
hormone synthesis by inhibiting peroxidase.
Supresses conversion of T4 to T3 in the periphery.
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