, NURS 5461 MODULE 5 QUIZ
Adult Gerontology Management Across the Continuum of
Care University of Texas at Arlington (UTA) 100-Question
Practice Quiz
2026/2027 Edition
1. The hypothalamic hormone that stimulates pituitary TSH release is:
A) T3
B) T4
C) TRH
D) Calcitonin
Correct Answer: TRH
Rationale: Thyrotropin-releasing hormone is secreted by the hypothalamus and stimulates the anterior pituitary to
release TSH. TSH then acts on the thyroid gland to promote synthesis and release of thyroid hormones.
2. The principal pituitary hormone regulating thyroid hormone synthesis is:
A) TSH
B) ACTH
C) FSH
D) Prolactin
Correct Answer: TSH
Rationale: Thyroid-stimulating hormone binds thyroid follicular cells and increases iodide uptake, thyroglobulin
processing, and secretion of T4 and T3. It is the primary pituitary regulator of thyroid function.
3. Most circulating thyroid hormone is secreted by the thyroid as:
A) T3
B) Reverse T3
C) T4
D) Calcitonin
Correct Answer: T4
Rationale: The thyroid secretes mostly thyroxine, or T4. Much of the biologically active T3 is produced in peripheral
tissues by deiodination of T4.
4. The more biologically active thyroid hormone at nuclear receptors is: A)
T3
B) T4
C) TSH
D) TRH
Correct Answer: T3
Rationale: Triiodothyronine has greater receptor affinity and biologic potency than T4. T4 functions partly as a
circulating prohormone that is converted to T3 in peripheral tissues.
NURS 5461 Module 5 Quiz | Practice Quiz | 2026/2027 Edition | Page 1
, 5. A low TSH with elevated free T4 most strongly suggests:
A) Primary hypothyroidism
B) Secondary hypothyroidism
C) Euthyroid state
D) Primary hyperthyroidism
Correct Answer: Primary hyperthyroidism
Rationale: In primary hyperthyroidism, excessive thyroid hormone suppresses pituitary TSH through negative feedback.
Elevated free T4 with a low TSH is therefore a classic biochemical pattern.
6. A high TSH with low free T4 most strongly indicates:
A) Primary hyperthyroidism
B) Central hypothyroidism
C) Subclinical hyperthyroidism
D) Primary hypothyroidism
Correct Answer: Primary hypothyroidism
Rationale: When the thyroid gland fails, circulating thyroid hormone falls and the pituitary compensates by raising TSH.
This produces high TSH with low free T4.
7. A low or inappropriately normal TSH with low free T4 suggests:
A) Primary hypothyroidism
B) Graves disease
C) Toxic adenoma
D) Central hypothyroidism
Correct Answer: Central hypothyroidism
Rationale: Pituitary or hypothalamic disease can produce inadequate TSH stimulation despite low thyroid hormone. The
TSH may be low or inappropriately normal rather than elevated.
8. Subclinical hypothyroidism is typically defined by:
A) Low TSH with normal free T4
B) Elevated TSH with normal free T4
C) Low TSH with high free T4
D) High TSH with high free T4
Correct Answer: Elevated TSH with normal free T4
Rationale: Subclinical hypothyroidism is a biochemical diagnosis in which TSH is elevated but circulating free T4
remains within the reference range.
9. Subclinical hyperthyroidism is usually characterized by:
A) High TSH with normal T4
B) Low TSH with normal free T4 and T3
C) High TSH with low T4
D) Low TSH with low T4
NURS 5461 Module 5 Quiz | Practice Quiz | 2026/2027 Edition | Page 2
Adult Gerontology Management Across the Continuum of
Care University of Texas at Arlington (UTA) 100-Question
Practice Quiz
2026/2027 Edition
1. The hypothalamic hormone that stimulates pituitary TSH release is:
A) T3
B) T4
C) TRH
D) Calcitonin
Correct Answer: TRH
Rationale: Thyrotropin-releasing hormone is secreted by the hypothalamus and stimulates the anterior pituitary to
release TSH. TSH then acts on the thyroid gland to promote synthesis and release of thyroid hormones.
2. The principal pituitary hormone regulating thyroid hormone synthesis is:
A) TSH
B) ACTH
C) FSH
D) Prolactin
Correct Answer: TSH
Rationale: Thyroid-stimulating hormone binds thyroid follicular cells and increases iodide uptake, thyroglobulin
processing, and secretion of T4 and T3. It is the primary pituitary regulator of thyroid function.
3. Most circulating thyroid hormone is secreted by the thyroid as:
A) T3
B) Reverse T3
C) T4
D) Calcitonin
Correct Answer: T4
Rationale: The thyroid secretes mostly thyroxine, or T4. Much of the biologically active T3 is produced in peripheral
tissues by deiodination of T4.
4. The more biologically active thyroid hormone at nuclear receptors is: A)
T3
B) T4
C) TSH
D) TRH
Correct Answer: T3
Rationale: Triiodothyronine has greater receptor affinity and biologic potency than T4. T4 functions partly as a
circulating prohormone that is converted to T3 in peripheral tissues.
NURS 5461 Module 5 Quiz | Practice Quiz | 2026/2027 Edition | Page 1
, 5. A low TSH with elevated free T4 most strongly suggests:
A) Primary hypothyroidism
B) Secondary hypothyroidism
C) Euthyroid state
D) Primary hyperthyroidism
Correct Answer: Primary hyperthyroidism
Rationale: In primary hyperthyroidism, excessive thyroid hormone suppresses pituitary TSH through negative feedback.
Elevated free T4 with a low TSH is therefore a classic biochemical pattern.
6. A high TSH with low free T4 most strongly indicates:
A) Primary hyperthyroidism
B) Central hypothyroidism
C) Subclinical hyperthyroidism
D) Primary hypothyroidism
Correct Answer: Primary hypothyroidism
Rationale: When the thyroid gland fails, circulating thyroid hormone falls and the pituitary compensates by raising TSH.
This produces high TSH with low free T4.
7. A low or inappropriately normal TSH with low free T4 suggests:
A) Primary hypothyroidism
B) Graves disease
C) Toxic adenoma
D) Central hypothyroidism
Correct Answer: Central hypothyroidism
Rationale: Pituitary or hypothalamic disease can produce inadequate TSH stimulation despite low thyroid hormone. The
TSH may be low or inappropriately normal rather than elevated.
8. Subclinical hypothyroidism is typically defined by:
A) Low TSH with normal free T4
B) Elevated TSH with normal free T4
C) Low TSH with high free T4
D) High TSH with high free T4
Correct Answer: Elevated TSH with normal free T4
Rationale: Subclinical hypothyroidism is a biochemical diagnosis in which TSH is elevated but circulating free T4
remains within the reference range.
9. Subclinical hyperthyroidism is usually characterized by:
A) High TSH with normal T4
B) Low TSH with normal free T4 and T3
C) High TSH with low T4
D) Low TSH with low T4
NURS 5461 Module 5 Quiz | Practice Quiz | 2026/2027 Edition | Page 2
