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NSG 554 Exam 4 Test Bank 2026 – 180 Most
Tested Questions with Accurate Detailed
Answers and Rationales| Latest Update
Question 1: Which age group is most commonly affected by hypothyroidism?
A. Neonates
B. Adolescents
C. Women aged 30-50
D. Men over 60
Answer: C
Rationale: Hypothyroidism is most common in women, particularly those aged
30-50, and 85% of cases occur in women.
Question 2: What is the most common cause of hypothyroidism in the United
States?
A. Iodine deficiency
B. Hashimoto thyroiditis
C. Pituitary failure
D. Thyroidectomy
Answer: B
Rationale: Hashimoto thyroiditis, an autoimmune disorder, is the most
common cause of hypothyroidism in the U.S. Iodine deficiency is more
common worldwide.
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Question 3: A patient has elevated TSH and low T4. What type of
hypothyroidism is this?
A. Primary
B. Secondary
C. Subclinical
D. Tertiary
Answer: A
Rationale: Primary hypothyroidism is characterized by high TSH and low T4
due to failure of the thyroid gland. Secondary hypothyroidism has low TSH
and low T4.
Question 4: In subclinical hypothyroidism, which lab finding is expected?
A. Elevated T4 and elevated TSH
B. Normal T4 and elevated TSH
C. Low T4 and low TSH
D. Normal T4 and normal TSH
Answer: B
Rationale: Subclinical hypothyroidism is defined as normal T4 with increased
TSH. Symptoms may be absent or mild.
Question 5: What is the average starting dose of levothyroxine for
hypothyroidism?
A. 0.5 mcg/kg/day
B. 1.6 mcg/kg/day
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C. 2.5 mcg/kg/day
D. 3.0 mcg/kg/day
Answer: B
Rationale: The average dose of levothyroxine is 1.6 mcg/kg/day. TSH should
be rechecked 4-6 weeks after initiation.
Question 6: After starting levothyroxine, when should TSH be rechecked?
A. 1 week
B. 2 weeks
C. 4-6 weeks
D. 3 months
Answer: C
Rationale: TSH levels should be rechecked 4-6 weeks after starting or
adjusting levothyroxine to allow steady-state.
Question 7: What is the target TSH range for a patient on levothyroxine?
A. 0.1-0.4
B. 0.4-2.0
C. 2.0-4.0
D. 4.0-6.0
Answer: B
Rationale: The target TSH is generally 0.4-2.0 mIU/L for most patients on
thyroid replacement.
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Question 8: Which of the following is a common cause of goiter?
A. Iodine deficiency
B. Lithium use
C. Amiodarone use
D. All of the above
Answer: D
Rationale: Goiter can be caused by iodine deficiency, drug goitrogens such as
lithium and amiodarone, thyroiditis, and genetic enzyme defects.
Question 9: A patient with Graves disease may have an increased risk of which
other autoimmune conditions?
A. Sjogren syndrome
B. Celiac disease
C. Type 1 diabetes
D. All of the aboveAnswer: D
Rationale: Graves disease is associated with other autoimmune diseases
including Sjogren, celiac, pernicious anemia, Addison's, vitiligo, type 1
diabetes, and myasthenia gravis.
Question 10: What is the most common cause of thyrotoxicosis?
A. Toxic multinodular goiter
NSG 554 Exam 4 Test Bank 2026 – 180 Most
Tested Questions with Accurate Detailed
Answers and Rationales| Latest Update
Question 1: Which age group is most commonly affected by hypothyroidism?
A. Neonates
B. Adolescents
C. Women aged 30-50
D. Men over 60
Answer: C
Rationale: Hypothyroidism is most common in women, particularly those aged
30-50, and 85% of cases occur in women.
Question 2: What is the most common cause of hypothyroidism in the United
States?
A. Iodine deficiency
B. Hashimoto thyroiditis
C. Pituitary failure
D. Thyroidectomy
Answer: B
Rationale: Hashimoto thyroiditis, an autoimmune disorder, is the most
common cause of hypothyroidism in the U.S. Iodine deficiency is more
common worldwide.
,2
Question 3: A patient has elevated TSH and low T4. What type of
hypothyroidism is this?
A. Primary
B. Secondary
C. Subclinical
D. Tertiary
Answer: A
Rationale: Primary hypothyroidism is characterized by high TSH and low T4
due to failure of the thyroid gland. Secondary hypothyroidism has low TSH
and low T4.
Question 4: In subclinical hypothyroidism, which lab finding is expected?
A. Elevated T4 and elevated TSH
B. Normal T4 and elevated TSH
C. Low T4 and low TSH
D. Normal T4 and normal TSH
Answer: B
Rationale: Subclinical hypothyroidism is defined as normal T4 with increased
TSH. Symptoms may be absent or mild.
Question 5: What is the average starting dose of levothyroxine for
hypothyroidism?
A. 0.5 mcg/kg/day
B. 1.6 mcg/kg/day
,3
C. 2.5 mcg/kg/day
D. 3.0 mcg/kg/day
Answer: B
Rationale: The average dose of levothyroxine is 1.6 mcg/kg/day. TSH should
be rechecked 4-6 weeks after initiation.
Question 6: After starting levothyroxine, when should TSH be rechecked?
A. 1 week
B. 2 weeks
C. 4-6 weeks
D. 3 months
Answer: C
Rationale: TSH levels should be rechecked 4-6 weeks after starting or
adjusting levothyroxine to allow steady-state.
Question 7: What is the target TSH range for a patient on levothyroxine?
A. 0.1-0.4
B. 0.4-2.0
C. 2.0-4.0
D. 4.0-6.0
Answer: B
Rationale: The target TSH is generally 0.4-2.0 mIU/L for most patients on
thyroid replacement.
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Question 8: Which of the following is a common cause of goiter?
A. Iodine deficiency
B. Lithium use
C. Amiodarone use
D. All of the above
Answer: D
Rationale: Goiter can be caused by iodine deficiency, drug goitrogens such as
lithium and amiodarone, thyroiditis, and genetic enzyme defects.
Question 9: A patient with Graves disease may have an increased risk of which
other autoimmune conditions?
A. Sjogren syndrome
B. Celiac disease
C. Type 1 diabetes
D. All of the aboveAnswer: D
Rationale: Graves disease is associated with other autoimmune diseases
including Sjogren, celiac, pernicious anemia, Addison's, vitiligo, type 1
diabetes, and myasthenia gravis.
Question 10: What is the most common cause of thyrotoxicosis?
A. Toxic multinodular goiter
