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PTU FINAL EXAM 3 (Practice) NEWEST 2026 ACTUAL EXAM TEST- COMPLETE REAL
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (MOST RECENT!!)
1
A patient with thyroid storm is ordered PTU, iodine solution, propranolol, and hydrocortisone.
Which medication must be given FIRST?
Answer:
PTU
Rationale:
PTU must be administered before iodine to block new thyroid hormone synthesis and T4→T3
conversion.
2
Which lab value is most critical to review before administering PTU?
Answer:
AST and ALT
Rationale:
PTU carries a black box warning for severe hepatotoxicity.
3
Which symptom requires immediate discontinuation of PTU?
Answer:
Sore throat and fever
Rationale:
These indicate possible agranulocytosis.
2026 2027 GRADED A+
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4
PTU lowers thyroid hormone levels by inhibiting which process?
Answer:
Thyroid peroxidase activity
Rationale:
This enzyme is required for iodine binding and hormone synthesis.
5
Which patient is the BEST candidate for PTU therapy?
Answer:
Pregnant patient in the first trimester with Graves’ disease
Rationale:
PTU is preferred early in pregnancy due to lower teratogenic risk.
6
Which adverse effect is unique and most severe with PTU?
Answer:
Acute liver failure
Rationale:
PTU has a higher hepatotoxicity risk than methimazole.
7
Which statement by the patient indicates correct understanding of PTU therapy?
Answer:
“I will call my provider if I develop a fever.”
Rationale:
Early reporting of infection prevents life-threatening agranulocytosis.
2026 2027 GRADED A+
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8
Which lab finding confirms agranulocytosis?
Answer:
Low absolute neutrophil count
Rationale:
Agranulocytosis is defined by severe neutropenia.
9
Why is PTU preferred over methimazole in thyroid storm?
Answer:
It blocks peripheral conversion of T4 to T3
Rationale:
Rapid reduction of active T3 is essential in emergencies.
10
Which symptom suggests PTU overdose?
Answer:
Cold intolerance
Rationale:
This indicates hypothyroidism from excessive hormone suppression.
11
A patient on PTU reports right upper quadrant pain. What is the nurse’s priority?
Answer:
Hold the medication and notify the provider
Rationale:
RUQ pain may indicate liver injury.
2026 2027 GRADED A+
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12
Which medication may have increased effects when taken with PTU?
Answer:
Warfarin
Rationale:
PTU increases anticoagulant effects.
13
Which assessment finding indicates therapeutic effectiveness of PTU?
Answer:
Decreased heart rate
Rationale:
Hyperthyroidism causes tachycardia.
14
Which endocrine hormone will increase as PTU becomes effective?
Answer:
TSH
Rationale:
Lower T3/T4 reduces negative feedback on the pituitary.
15
Which condition would contraindicate PTU use?
Answer:
History of PTU-induced hepatitis
Rationale:
Re-exposure increases risk of fatal liver failure.
2026 2027 GRADED A+
PTU FINAL EXAM 3 (Practice) NEWEST 2026 ACTUAL EXAM TEST- COMPLETE REAL
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (MOST RECENT!!)
1
A patient with thyroid storm is ordered PTU, iodine solution, propranolol, and hydrocortisone.
Which medication must be given FIRST?
Answer:
PTU
Rationale:
PTU must be administered before iodine to block new thyroid hormone synthesis and T4→T3
conversion.
2
Which lab value is most critical to review before administering PTU?
Answer:
AST and ALT
Rationale:
PTU carries a black box warning for severe hepatotoxicity.
3
Which symptom requires immediate discontinuation of PTU?
Answer:
Sore throat and fever
Rationale:
These indicate possible agranulocytosis.
2026 2027 GRADED A+
,2|Page
4
PTU lowers thyroid hormone levels by inhibiting which process?
Answer:
Thyroid peroxidase activity
Rationale:
This enzyme is required for iodine binding and hormone synthesis.
5
Which patient is the BEST candidate for PTU therapy?
Answer:
Pregnant patient in the first trimester with Graves’ disease
Rationale:
PTU is preferred early in pregnancy due to lower teratogenic risk.
6
Which adverse effect is unique and most severe with PTU?
Answer:
Acute liver failure
Rationale:
PTU has a higher hepatotoxicity risk than methimazole.
7
Which statement by the patient indicates correct understanding of PTU therapy?
Answer:
“I will call my provider if I develop a fever.”
Rationale:
Early reporting of infection prevents life-threatening agranulocytosis.
2026 2027 GRADED A+
,3|Page
8
Which lab finding confirms agranulocytosis?
Answer:
Low absolute neutrophil count
Rationale:
Agranulocytosis is defined by severe neutropenia.
9
Why is PTU preferred over methimazole in thyroid storm?
Answer:
It blocks peripheral conversion of T4 to T3
Rationale:
Rapid reduction of active T3 is essential in emergencies.
10
Which symptom suggests PTU overdose?
Answer:
Cold intolerance
Rationale:
This indicates hypothyroidism from excessive hormone suppression.
11
A patient on PTU reports right upper quadrant pain. What is the nurse’s priority?
Answer:
Hold the medication and notify the provider
Rationale:
RUQ pain may indicate liver injury.
2026 2027 GRADED A+
, 4|Page
12
Which medication may have increased effects when taken with PTU?
Answer:
Warfarin
Rationale:
PTU increases anticoagulant effects.
13
Which assessment finding indicates therapeutic effectiveness of PTU?
Answer:
Decreased heart rate
Rationale:
Hyperthyroidism causes tachycardia.
14
Which endocrine hormone will increase as PTU becomes effective?
Answer:
TSH
Rationale:
Lower T3/T4 reduces negative feedback on the pituitary.
15
Which condition would contraindicate PTU use?
Answer:
History of PTU-induced hepatitis
Rationale:
Re-exposure increases risk of fatal liver failure.
2026 2027 GRADED A+
