NUR 422 Community Health Nursing Exam Prep 2026 |
Gwynedd Mercy University Thyroid Disorders Practice
Questions with 50+ Questions & Detailed Rationales
Thyroid Disorders Nursing Practice Exam
Question 1
Clinical Scenario:
The nurse is caring for a patient in an endocrine clinic who reports increasing fatigue, sensitivity
to cold temperatures, constipation, and difficulty concentrating over the past several months.
The patient states that they have gained weight despite no major changes in diet or activity
level. Laboratory results show an elevated thyroid-stimulating hormone (TSH) level and a
decreased free thyroxine (T4) level.
Question:
Which nursing action is the priority when caring for this patient?
A. Encourage increased dietary iodine intake immediately
B. Assess the patient’s understanding of thyroid hormone replacement therapy
C. Prepare the patient for emergency thyroid surgery
D. Restrict fluid intake to prevent fluid overload
Correct Answer:
B. Assess the patient’s understanding of thyroid hormone replacement therapy
Rationale:
The patient’s symptoms and laboratory findings indicate hypothyroidism, which is commonly
managed with thyroid hormone replacement therapy such as levothyroxine. Assessing the
patient’s understanding of medication administration, timing, interactions, and the importance
of consistent use is a priority nursing intervention because proper medication management is
essential for restoring normal thyroid function. Increasing iodine intake is not the immediate
intervention because most hypothyroidism cases in developed healthcare settings are not
caused by iodine deficiency. Emergency thyroid surgery is not indicated for hypothyroidism, and
,fluid restriction is unrelated to the patient’s condition. Nursing care should focus on education,
medication adherence, symptom monitoring, and prevention of complications.
Question 2
Clinical Scenario:
A patient receiving treatment for hyperthyroidism reports taking prescribed methimazole daily.
During a follow-up visit, the nurse reviews laboratory results and notes a significant decrease in
the patient’s white blood cell count. The patient reports a sore throat and fever that began
yesterday.
Question:
Which action should the nurse take first?
A. Instruct the patient to increase fluid intake and rest at home
B. Notify the healthcare provider about possible medication-related complications
C. Encourage the patient to continue the medication until symptoms improve
D. Schedule routine laboratory testing at the next follow-up appointment
Correct Answer:
B. Notify the healthcare provider about possible medication-related complications
Rationale:
Methimazole can cause agranulocytosis, a potentially serious decrease in white blood cells that
increases the risk of infection. A patient taking antithyroid medication who develops fever and
sore throat requires immediate evaluation and notification of the healthcare provider.
Continuing the medication without evaluation may increase the risk of worsening infection, and
delaying follow-up laboratory testing is unsafe. Rest and hydration may be appropriate
supportive measures for minor symptoms but do not address the potential life-threatening
adverse effect. The nurse must recognize medication complications and prioritize patient safety.
Question 3
Clinical Scenario:
The nurse is caring for a patient admitted to the medical-surgical unit after experiencing
worsening symptoms related to untreated hyperthyroidism. The patient is restless, reports
,feeling extremely anxious, has a temperature of 39.2°C (102.6°F), a heart rate of 148
beats/minute, and irregular cardiac rhythm. The provider suspects thyroid storm.
Question:
Which nursing intervention is the priority?
A. Provide a warm blanket to decrease shivering
B. Monitor cardiac rhythm and administer prescribed medications promptly
C. Encourage ambulation to reduce anxiety
D. Restrict oxygen therapy to prevent respiratory suppression
Correct Answer:
B. Monitor cardiac rhythm and administer prescribed medications promptly
Rationale:
Thyroid storm is a life-threatening complication of severe hyperthyroidism characterized by
extreme thyroid hormone activity, fever, tachycardia, altered mental status, and cardiovascular
instability. The priority nursing action is to closely monitor cardiac status and ensure timely
administration of prescribed treatments to control symptoms and prevent complications such as
heart failure or fatal arrhythmias. Providing warmth may worsen hyperthermia, ambulation
increases metabolic demand and cardiac stress, and restricting oxygen is inappropriate because
patients with severe illness may require oxygen support. Nursing care focuses on rapid
recognition, stabilization, and prevention of deterioration.
Question 4
Clinical Scenario:
During discharge teaching, the nurse reviews medication instructions with a patient who has
recently started levothyroxine therapy for hypothyroidism. The patient states, “I will take my
medication every morning with my calcium supplement because they are both important.”
Question:
Which response by the nurse is most appropriate?
A. “Taking both medications together will improve absorption.”
B. “You should take levothyroxine with meals to prevent stomach irritation.”
C. “Calcium supplements can interfere with levothyroxine absorption, so separate them by
, several hours.”
D. “You should stop taking calcium supplements permanently.”
Correct Answer:
C. “Calcium supplements can interfere with levothyroxine absorption, so separate them by
several hours.”
Rationale:
Levothyroxine absorption can be reduced when taken with calcium supplements, iron
supplements, and certain foods. Patients should take levothyroxine consistently, usually on an
empty stomach, and separate interfering substances by several hours as instructed. Taking the
medications together may result in inadequate thyroid hormone replacement. Taking
levothyroxine with meals can reduce absorption, and patients should not discontinue
prescribed supplements without discussing the change with a healthcare provider. Effective
patient education improves medication effectiveness and prevents persistent hypothyroid
symptoms.
Question 5
Clinical Scenario:
The nurse is caring for a patient in an outpatient thyroid clinic who underwent a thyroidectomy
two days ago. During assessment, the patient reports tingling around the mouth and fingertips.
The nurse observes muscle twitching when assessing facial nerve response.
Question:
Which complication should the nurse suspect?
A. Hyperglycemia caused by surgical stress
B. Hypocalcemia caused by decreased parathyroid function
C. Increased thyroid hormone production
D. Excess potassium retention
Correct Answer:
B. Hypocalcemia caused by decreased parathyroid function
Rationale:
Tingling around the mouth, numbness, and muscle twitching after thyroid surgery are signs of
hypocalcemia, which may occur if the parathyroid glands are damaged or temporarily impaired
Gwynedd Mercy University Thyroid Disorders Practice
Questions with 50+ Questions & Detailed Rationales
Thyroid Disorders Nursing Practice Exam
Question 1
Clinical Scenario:
The nurse is caring for a patient in an endocrine clinic who reports increasing fatigue, sensitivity
to cold temperatures, constipation, and difficulty concentrating over the past several months.
The patient states that they have gained weight despite no major changes in diet or activity
level. Laboratory results show an elevated thyroid-stimulating hormone (TSH) level and a
decreased free thyroxine (T4) level.
Question:
Which nursing action is the priority when caring for this patient?
A. Encourage increased dietary iodine intake immediately
B. Assess the patient’s understanding of thyroid hormone replacement therapy
C. Prepare the patient for emergency thyroid surgery
D. Restrict fluid intake to prevent fluid overload
Correct Answer:
B. Assess the patient’s understanding of thyroid hormone replacement therapy
Rationale:
The patient’s symptoms and laboratory findings indicate hypothyroidism, which is commonly
managed with thyroid hormone replacement therapy such as levothyroxine. Assessing the
patient’s understanding of medication administration, timing, interactions, and the importance
of consistent use is a priority nursing intervention because proper medication management is
essential for restoring normal thyroid function. Increasing iodine intake is not the immediate
intervention because most hypothyroidism cases in developed healthcare settings are not
caused by iodine deficiency. Emergency thyroid surgery is not indicated for hypothyroidism, and
,fluid restriction is unrelated to the patient’s condition. Nursing care should focus on education,
medication adherence, symptom monitoring, and prevention of complications.
Question 2
Clinical Scenario:
A patient receiving treatment for hyperthyroidism reports taking prescribed methimazole daily.
During a follow-up visit, the nurse reviews laboratory results and notes a significant decrease in
the patient’s white blood cell count. The patient reports a sore throat and fever that began
yesterday.
Question:
Which action should the nurse take first?
A. Instruct the patient to increase fluid intake and rest at home
B. Notify the healthcare provider about possible medication-related complications
C. Encourage the patient to continue the medication until symptoms improve
D. Schedule routine laboratory testing at the next follow-up appointment
Correct Answer:
B. Notify the healthcare provider about possible medication-related complications
Rationale:
Methimazole can cause agranulocytosis, a potentially serious decrease in white blood cells that
increases the risk of infection. A patient taking antithyroid medication who develops fever and
sore throat requires immediate evaluation and notification of the healthcare provider.
Continuing the medication without evaluation may increase the risk of worsening infection, and
delaying follow-up laboratory testing is unsafe. Rest and hydration may be appropriate
supportive measures for minor symptoms but do not address the potential life-threatening
adverse effect. The nurse must recognize medication complications and prioritize patient safety.
Question 3
Clinical Scenario:
The nurse is caring for a patient admitted to the medical-surgical unit after experiencing
worsening symptoms related to untreated hyperthyroidism. The patient is restless, reports
,feeling extremely anxious, has a temperature of 39.2°C (102.6°F), a heart rate of 148
beats/minute, and irregular cardiac rhythm. The provider suspects thyroid storm.
Question:
Which nursing intervention is the priority?
A. Provide a warm blanket to decrease shivering
B. Monitor cardiac rhythm and administer prescribed medications promptly
C. Encourage ambulation to reduce anxiety
D. Restrict oxygen therapy to prevent respiratory suppression
Correct Answer:
B. Monitor cardiac rhythm and administer prescribed medications promptly
Rationale:
Thyroid storm is a life-threatening complication of severe hyperthyroidism characterized by
extreme thyroid hormone activity, fever, tachycardia, altered mental status, and cardiovascular
instability. The priority nursing action is to closely monitor cardiac status and ensure timely
administration of prescribed treatments to control symptoms and prevent complications such as
heart failure or fatal arrhythmias. Providing warmth may worsen hyperthermia, ambulation
increases metabolic demand and cardiac stress, and restricting oxygen is inappropriate because
patients with severe illness may require oxygen support. Nursing care focuses on rapid
recognition, stabilization, and prevention of deterioration.
Question 4
Clinical Scenario:
During discharge teaching, the nurse reviews medication instructions with a patient who has
recently started levothyroxine therapy for hypothyroidism. The patient states, “I will take my
medication every morning with my calcium supplement because they are both important.”
Question:
Which response by the nurse is most appropriate?
A. “Taking both medications together will improve absorption.”
B. “You should take levothyroxine with meals to prevent stomach irritation.”
C. “Calcium supplements can interfere with levothyroxine absorption, so separate them by
, several hours.”
D. “You should stop taking calcium supplements permanently.”
Correct Answer:
C. “Calcium supplements can interfere with levothyroxine absorption, so separate them by
several hours.”
Rationale:
Levothyroxine absorption can be reduced when taken with calcium supplements, iron
supplements, and certain foods. Patients should take levothyroxine consistently, usually on an
empty stomach, and separate interfering substances by several hours as instructed. Taking the
medications together may result in inadequate thyroid hormone replacement. Taking
levothyroxine with meals can reduce absorption, and patients should not discontinue
prescribed supplements without discussing the change with a healthcare provider. Effective
patient education improves medication effectiveness and prevents persistent hypothyroid
symptoms.
Question 5
Clinical Scenario:
The nurse is caring for a patient in an outpatient thyroid clinic who underwent a thyroidectomy
two days ago. During assessment, the patient reports tingling around the mouth and fingertips.
The nurse observes muscle twitching when assessing facial nerve response.
Question:
Which complication should the nurse suspect?
A. Hyperglycemia caused by surgical stress
B. Hypocalcemia caused by decreased parathyroid function
C. Increased thyroid hormone production
D. Excess potassium retention
Correct Answer:
B. Hypocalcemia caused by decreased parathyroid function
Rationale:
Tingling around the mouth, numbness, and muscle twitching after thyroid surgery are signs of
hypocalcemia, which may occur if the parathyroid glands are damaged or temporarily impaired
