PHARMACOLOGY EXAM 3 PRACTICE
QUESTIONS EXAM WITH COMPLETE
SOLUTIONS
Which of the following is NOT a principal action of thyroid hormones?
a. Stimulation of energy use by increasing basal metabolism rate
b. Delivers oxygen to peripheral tissues
c. Stimulate the heart and increase heart rate and force of contraction
d. Promotion of growth and development -ANSB
Which of the following is the correct order steps for thyroid hormone regulation?
a. The TRH is released from the hypothalamus and stimulates the release of T3 and T4
from the anterior pituitary, which stimulates TSH from the thyroid to produce biologic
effects
b. TSH is released from the hypothalamus and stimulates the release of TRH from the
anterior pituitary which stimulates T3 and T4 from the thyroid to produce biologic effects
c. TRH is released from the hypothalamus and stimulates the release of TSH from the
anterior pituitary, which stimulates T3 and T4 from the thyroid to produce biologic
effects
d. T3 and T4 are released from the hypothalamus to stimulate the release of TRH from
the anterior pituitary, which stimulates TSH from the thyroid to produce biologic effects -
ANSC (TRH from hypothalamus. TSH from anterior pituitary. T3 & T4 from thyroid
inhibit TSH from anterior pituitary)
To test for a thyroid disorder, which of the following tests would MOST likely be
ordered?
a. Serum T3
b. Serum T4
c. TSH
d. Creatinine -ANSC
A TSH test is ordered on your patient to screen for hyperthyroidism. Which of the
following results would you anticipate if the patient did have this condition?
a. High TSH levels
b. Low TSH levels
c. Normal TSH levels
d. High TRH levels -ANSB (Low TSH levels=hyperthyroidism, High=hypothyroidism)
,What is the drug of choice to treat hypothyroidism?
a. Methimazole
b. Levothyroxine
c. Liothyronine
d. Propylthiouracil -ANSB
You are implementing patient education for a client who has just started taking
levothyroxine (Synthroid) for their hypothyroidism. Which of the following statements
made by the client requires further instruction?
a. "I should only use one brand and use the same one every time when taking this
medication because not every brand has the identical effect."
b. "This medication should only take a week for an effect to take place."
c. "I should recheck my thyroid hormone levels one month after beginning
levothyroxine."
d. "I should take this medication 30-60 minutes before breakfast." -ANSB
(Levothyroxine takes 1 month to reach plateau)
Your patient is a 27-year-old female patient with hypothyroidism taking levothyroxine
that is newly married. Which of the following statements would you say to your patient
regarding pregnancy and her medication?
a. "You should be careful about getting pregnant because levothyroxine is toxic to a
fetus."
b. "You should decrease your dosage by 50% once your pregnancy is confirmed."
c. "Once your pregnancy is confirmed, increase your dosage of the medication by 50%
percent."
d. "Because fetuses are unable to produce thyroid hormones during the first trimester,
make sure to increase your dosage by 30% as soon as your pregnancy is confirmed to
reduce the risk of decreased IQ and neuropsychological function in the fetus." -ANSD
One month after your patient started taking levothyroxine for their hypothyroidism, a
TSH test is ordered to test the function of the medication. Which of the following results
would indicate that the thyroid hormone replacement is working?
a. The TSH level is dropping or in normal range.
b. The TSH level is elevating.
c. The TSH level has remained the same.
d. The TRH level is elevating. -ANSA
Your patient's hypothyroidism is being treated with levothyroxine. What laboratory value
would indicate that your patient needs a decreased dose?
a. A TSH which is below the normal range.
,b. A TSH which is above the normal range.
c. A T3 which is below the normal range.
d. A T4 which is below the normal range. -ANSA (TSH that is below the normal range
indicates a decreased dose because the medication is lowering the TSH by too much.)
Which of the following would NOT interact with levothyroxine?
a. H2 receptor blockers and proton pump inhibitors
b. Bile-acid sequetrants
c. Vitamins
d. An empty stomach -ANSD
When educating your patient about taking levothyroxine with drugs that reduce
absorption in the stomach, which of the following statements would you tell them?
a. "You can take levothyroxine and proton pump inhibitors at the same time during
breakfast."
b. "You should wait two hours between taking levothyroxine and drugs that reduce
absorption in the stomach."
c. "You should wait at least four hours between taking levothyroxine and drugs that
reduce absorption in the stomach."
d. "Never take levothyroxine and drugs that reduce absorption in the stomach less than
24 hours apart." -ANSC
Which of the following medications may need to be reduced when taking levothyroxine
due to the increase of the chance of bleeding?
a. Warfarin
b. Omeprazole
c. Cimetidine
d. Questran -ANSA
What is the interaction between catecholamines and levothyroxine?
a. Levothyroxine has no effect on the bodies response to catecholamines.
b. Lexothyroxine decreases the bodies response to catecholamines.
c. Lexothyroxine increases the bodies response to catecholamines. -ANSC
Levothyroxine is synthetic:
a. TRH
b. TSH
c. T3
d. T4 -ANSD
Liothyronine is synthetic:
, a. TRH
b. TSH
c. T3
d. T4 -ANSC
A patient has been admitted to the emergency room with myxedema crisis, or severe
life-threatening hypothyroidism, and is non-responsive. Which of the following
medications would you anticipate the physician to order to treat this condition?
a. Levothyroxine
b. Liothyronine
c. Methimazole
d. Propylthiouracil -ANSB (Liothyronine has a rapid onset of action in myxedema coma.)
A patient is admitted to the ER with a pulse of 180, temperature of 105.7, blood
pressure of 78/40, and is unconscious. Upon assessment, their muscles have atrophied
and the patient looks underweight. Upon reviewing their medical history, you learn that
they have hyperthyroidism and just recently had a major open heart surgery. Which of
the following conditions do you suspect has occurred because of their hyperthyroidism
and symptoms?
a. Hypoglycemia
b. Drug overdose
c. Congestive heart failure
d. Thyrotoxic crisis -ANSD
Your 68-year-old patient is being treated with levothyroxine 50 mcg/day. She states that
the room's thermostat is set too high. She is sweating and has a noticeable fine tremor
as she lifts a glass. You suspect that she is showing signs of:
a. myxedema.
b. Graves' disease.
c. cretinism.
d. thyrotoxicosis. -ANSD
A 37-year old female patient has just been admitted to your clinic for a chief complaint
of diarrhea. Your client states, "I have trouble concentrating, I feel hot and sweaty all the
time, and I'm eating ALL the time but losing weight! Also, for some reason my eyes look
like they're bulging out of my head." Which of the following disease's do you suspect
your patient of having based on these symptoms?
a. Hashimoto's disease
b. Type II diabetes
c. Menopause
d. Grave's disease -ANSD
QUESTIONS EXAM WITH COMPLETE
SOLUTIONS
Which of the following is NOT a principal action of thyroid hormones?
a. Stimulation of energy use by increasing basal metabolism rate
b. Delivers oxygen to peripheral tissues
c. Stimulate the heart and increase heart rate and force of contraction
d. Promotion of growth and development -ANSB
Which of the following is the correct order steps for thyroid hormone regulation?
a. The TRH is released from the hypothalamus and stimulates the release of T3 and T4
from the anterior pituitary, which stimulates TSH from the thyroid to produce biologic
effects
b. TSH is released from the hypothalamus and stimulates the release of TRH from the
anterior pituitary which stimulates T3 and T4 from the thyroid to produce biologic effects
c. TRH is released from the hypothalamus and stimulates the release of TSH from the
anterior pituitary, which stimulates T3 and T4 from the thyroid to produce biologic
effects
d. T3 and T4 are released from the hypothalamus to stimulate the release of TRH from
the anterior pituitary, which stimulates TSH from the thyroid to produce biologic effects -
ANSC (TRH from hypothalamus. TSH from anterior pituitary. T3 & T4 from thyroid
inhibit TSH from anterior pituitary)
To test for a thyroid disorder, which of the following tests would MOST likely be
ordered?
a. Serum T3
b. Serum T4
c. TSH
d. Creatinine -ANSC
A TSH test is ordered on your patient to screen for hyperthyroidism. Which of the
following results would you anticipate if the patient did have this condition?
a. High TSH levels
b. Low TSH levels
c. Normal TSH levels
d. High TRH levels -ANSB (Low TSH levels=hyperthyroidism, High=hypothyroidism)
,What is the drug of choice to treat hypothyroidism?
a. Methimazole
b. Levothyroxine
c. Liothyronine
d. Propylthiouracil -ANSB
You are implementing patient education for a client who has just started taking
levothyroxine (Synthroid) for their hypothyroidism. Which of the following statements
made by the client requires further instruction?
a. "I should only use one brand and use the same one every time when taking this
medication because not every brand has the identical effect."
b. "This medication should only take a week for an effect to take place."
c. "I should recheck my thyroid hormone levels one month after beginning
levothyroxine."
d. "I should take this medication 30-60 minutes before breakfast." -ANSB
(Levothyroxine takes 1 month to reach plateau)
Your patient is a 27-year-old female patient with hypothyroidism taking levothyroxine
that is newly married. Which of the following statements would you say to your patient
regarding pregnancy and her medication?
a. "You should be careful about getting pregnant because levothyroxine is toxic to a
fetus."
b. "You should decrease your dosage by 50% once your pregnancy is confirmed."
c. "Once your pregnancy is confirmed, increase your dosage of the medication by 50%
percent."
d. "Because fetuses are unable to produce thyroid hormones during the first trimester,
make sure to increase your dosage by 30% as soon as your pregnancy is confirmed to
reduce the risk of decreased IQ and neuropsychological function in the fetus." -ANSD
One month after your patient started taking levothyroxine for their hypothyroidism, a
TSH test is ordered to test the function of the medication. Which of the following results
would indicate that the thyroid hormone replacement is working?
a. The TSH level is dropping or in normal range.
b. The TSH level is elevating.
c. The TSH level has remained the same.
d. The TRH level is elevating. -ANSA
Your patient's hypothyroidism is being treated with levothyroxine. What laboratory value
would indicate that your patient needs a decreased dose?
a. A TSH which is below the normal range.
,b. A TSH which is above the normal range.
c. A T3 which is below the normal range.
d. A T4 which is below the normal range. -ANSA (TSH that is below the normal range
indicates a decreased dose because the medication is lowering the TSH by too much.)
Which of the following would NOT interact with levothyroxine?
a. H2 receptor blockers and proton pump inhibitors
b. Bile-acid sequetrants
c. Vitamins
d. An empty stomach -ANSD
When educating your patient about taking levothyroxine with drugs that reduce
absorption in the stomach, which of the following statements would you tell them?
a. "You can take levothyroxine and proton pump inhibitors at the same time during
breakfast."
b. "You should wait two hours between taking levothyroxine and drugs that reduce
absorption in the stomach."
c. "You should wait at least four hours between taking levothyroxine and drugs that
reduce absorption in the stomach."
d. "Never take levothyroxine and drugs that reduce absorption in the stomach less than
24 hours apart." -ANSC
Which of the following medications may need to be reduced when taking levothyroxine
due to the increase of the chance of bleeding?
a. Warfarin
b. Omeprazole
c. Cimetidine
d. Questran -ANSA
What is the interaction between catecholamines and levothyroxine?
a. Levothyroxine has no effect on the bodies response to catecholamines.
b. Lexothyroxine decreases the bodies response to catecholamines.
c. Lexothyroxine increases the bodies response to catecholamines. -ANSC
Levothyroxine is synthetic:
a. TRH
b. TSH
c. T3
d. T4 -ANSD
Liothyronine is synthetic:
, a. TRH
b. TSH
c. T3
d. T4 -ANSC
A patient has been admitted to the emergency room with myxedema crisis, or severe
life-threatening hypothyroidism, and is non-responsive. Which of the following
medications would you anticipate the physician to order to treat this condition?
a. Levothyroxine
b. Liothyronine
c. Methimazole
d. Propylthiouracil -ANSB (Liothyronine has a rapid onset of action in myxedema coma.)
A patient is admitted to the ER with a pulse of 180, temperature of 105.7, blood
pressure of 78/40, and is unconscious. Upon assessment, their muscles have atrophied
and the patient looks underweight. Upon reviewing their medical history, you learn that
they have hyperthyroidism and just recently had a major open heart surgery. Which of
the following conditions do you suspect has occurred because of their hyperthyroidism
and symptoms?
a. Hypoglycemia
b. Drug overdose
c. Congestive heart failure
d. Thyrotoxic crisis -ANSD
Your 68-year-old patient is being treated with levothyroxine 50 mcg/day. She states that
the room's thermostat is set too high. She is sweating and has a noticeable fine tremor
as she lifts a glass. You suspect that she is showing signs of:
a. myxedema.
b. Graves' disease.
c. cretinism.
d. thyrotoxicosis. -ANSD
A 37-year old female patient has just been admitted to your clinic for a chief complaint
of diarrhea. Your client states, "I have trouble concentrating, I feel hot and sweaty all the
time, and I'm eating ALL the time but losing weight! Also, for some reason my eyes look
like they're bulging out of my head." Which of the following disease's do you suspect
your patient of having based on these symptoms?
a. Hashimoto's disease
b. Type II diabetes
c. Menopause
d. Grave's disease -ANSD
