,UTA NURS 3365 Exam 3 | Pharmacology in
Nursing Practice (2026) Q&A
1. Which statement accurately describes the mechanism of action of
levothyroxine?
A) It increases levels of T3 and T4 by providing synthetic thyroid hormone
B) It blocks thyroid hormone synthesis in the thyroid gland
C) It inhibits thyroid-stimulating hormone release from the pituitary
D) It destroys thyroid tissue through radioactive iodine
Correct Answer: It increases levels of T3 and T4 by providing
synthetic thyroid hormone
Rationale: Levothyroxine is a synthetic form of thyroxine (T4) that is
converted to T3 in the peripheral tissues. It replaces deficient thyroid
hormone in hypothyroidism, increasing T3 and T4 levels to normal.
2. What is the most concerning adverse effect of levothyroxine therapy?
A) Cardiovascular effects such as tachycardia and angina
B) Gastrointestinal effects such as diarrhea
C) Neurological effects such as confusion
D) Dermatological effects such as rash
Correct Answer: Cardiovascular effects such as tachycardia and
angina
Rationale: Excessive levothyroxine dosing causes signs of
hyperthyroidism, including tachycardia, palpitations, angina, and
dysrhythmias. These cardiovascular effects are the most concerning and
may indicate the need for a dose reduction.
,3. When should a patient take levothyroxine?
A) In the morning, 30 minutes before eating breakfast
B) At bedtime with a light snack
C) With lunch to prevent gastrointestinal upset
D) Any time of day as long as it is consistent
Correct Answer: In the morning, 30 minutes before eating breakfast
Rationale: Levothyroxine should be taken on an empty stomach,
typically 30 minutes before breakfast, to ensure consistent absorption.
Food, especially those high in fiber or calcium, can reduce its absorption.
4. Which laboratory findings are expected before initiating levothyroxine
therapy?
A) Low T3 and T4, elevated TSH
B) Elevated T3 and T4, low TSH
C) Elevated T3 and T4, elevated TSH
D) Low T3 and T4, low TSH
Correct Answer: Low T3 and T4, elevated TSH
Rationale: In primary hypothyroidism, the thyroid gland produces
insufficient T3 and T4, leading to elevated TSH as the pituitary attempts to
stimulate the thyroid. This pattern confirms the need for thyroid
replacement therapy.
5. A patient taking levothyroxine reports palpitations and insomnia. What
is the most appropriate nursing action?
A) Notify the prescriber; this may indicate excessive dosing
B) Reassure the patient that these effects are expected
C) Administer the next dose as scheduled
, D) Instruct the patient to increase dietary iodine
Correct Answer: Notify the prescriber; this may indicate excessive
dosing
Rationale: Palpitations and insomnia are signs of hyperthyroidism,
which may occur if the levothyroxine dose is too high. The prescriber
should be notified to evaluate the need for a dose reduction.
6. What is a common medication error with levothyroxine?
A) Writing mg instead of mcg
B) Administering it with food
C) Taking it at bedtime
D) Using the intravenous route
Correct Answer: Writing mg instead of mcg
Rationale: Levothyroxine doses are measured in micrograms (mcg),
but prescribers may accidentally write milligrams (mg), leading to a 1000-
fold overdose. This is a well-documented and dangerous medication error.
7. Which drug interaction requires monitoring when a patient takes
levothyroxine and warfarin concurrently?
A) Levothyroxine enhances the anticoagulant effect of warfarin
B) Levothyroxine reduces the anticoagulant effect of warfarin
C) Warfarin reduces the absorption of levothyroxine
D) There is no significant interaction
Correct Answer: Levothyroxine enhances the anticoagulant effect of
warfarin
Nursing Practice (2026) Q&A
1. Which statement accurately describes the mechanism of action of
levothyroxine?
A) It increases levels of T3 and T4 by providing synthetic thyroid hormone
B) It blocks thyroid hormone synthesis in the thyroid gland
C) It inhibits thyroid-stimulating hormone release from the pituitary
D) It destroys thyroid tissue through radioactive iodine
Correct Answer: It increases levels of T3 and T4 by providing
synthetic thyroid hormone
Rationale: Levothyroxine is a synthetic form of thyroxine (T4) that is
converted to T3 in the peripheral tissues. It replaces deficient thyroid
hormone in hypothyroidism, increasing T3 and T4 levels to normal.
2. What is the most concerning adverse effect of levothyroxine therapy?
A) Cardiovascular effects such as tachycardia and angina
B) Gastrointestinal effects such as diarrhea
C) Neurological effects such as confusion
D) Dermatological effects such as rash
Correct Answer: Cardiovascular effects such as tachycardia and
angina
Rationale: Excessive levothyroxine dosing causes signs of
hyperthyroidism, including tachycardia, palpitations, angina, and
dysrhythmias. These cardiovascular effects are the most concerning and
may indicate the need for a dose reduction.
,3. When should a patient take levothyroxine?
A) In the morning, 30 minutes before eating breakfast
B) At bedtime with a light snack
C) With lunch to prevent gastrointestinal upset
D) Any time of day as long as it is consistent
Correct Answer: In the morning, 30 minutes before eating breakfast
Rationale: Levothyroxine should be taken on an empty stomach,
typically 30 minutes before breakfast, to ensure consistent absorption.
Food, especially those high in fiber or calcium, can reduce its absorption.
4. Which laboratory findings are expected before initiating levothyroxine
therapy?
A) Low T3 and T4, elevated TSH
B) Elevated T3 and T4, low TSH
C) Elevated T3 and T4, elevated TSH
D) Low T3 and T4, low TSH
Correct Answer: Low T3 and T4, elevated TSH
Rationale: In primary hypothyroidism, the thyroid gland produces
insufficient T3 and T4, leading to elevated TSH as the pituitary attempts to
stimulate the thyroid. This pattern confirms the need for thyroid
replacement therapy.
5. A patient taking levothyroxine reports palpitations and insomnia. What
is the most appropriate nursing action?
A) Notify the prescriber; this may indicate excessive dosing
B) Reassure the patient that these effects are expected
C) Administer the next dose as scheduled
, D) Instruct the patient to increase dietary iodine
Correct Answer: Notify the prescriber; this may indicate excessive
dosing
Rationale: Palpitations and insomnia are signs of hyperthyroidism,
which may occur if the levothyroxine dose is too high. The prescriber
should be notified to evaluate the need for a dose reduction.
6. What is a common medication error with levothyroxine?
A) Writing mg instead of mcg
B) Administering it with food
C) Taking it at bedtime
D) Using the intravenous route
Correct Answer: Writing mg instead of mcg
Rationale: Levothyroxine doses are measured in micrograms (mcg),
but prescribers may accidentally write milligrams (mg), leading to a 1000-
fold overdose. This is a well-documented and dangerous medication error.
7. Which drug interaction requires monitoring when a patient takes
levothyroxine and warfarin concurrently?
A) Levothyroxine enhances the anticoagulant effect of warfarin
B) Levothyroxine reduces the anticoagulant effect of warfarin
C) Warfarin reduces the absorption of levothyroxine
D) There is no significant interaction
Correct Answer: Levothyroxine enhances the anticoagulant effect of
warfarin
