,NUR 636 Module 8 Pediatric Primary Care 2026/2027 Questions And
Answers SNHU
Q1. What is the most common cause of acquired hypothyroidism in
older children and adolescents in iodine-sufficient regions?
A) Subacute viral thyroiditis
B) Hashimoto autoimmune thyroiditis
C) Acute bacterial thyroiditis
D) Traumatic thyroiditis
Correct Answer: B) Hashimoto autoimmune thyroiditis
Rationale: Chronic autoimmune thyroiditis, commonly called Hashimoto
thyroiditis, is the leading cause of acquired hypothyroidism in children and
adolescents in iodine-sufficient areas. Autoimmune destruction progressively
reduces thyroid hormone production and may be associated with a goiter.
Q2. A newborn screening result raises concern for congenital
hypothyroidism. What is the most appropriate next step?
A) Wait until the infant develops clinical symptoms
B) Repeat newborn screening at 6 months
C) Obtain thyroid ultrasonography before laboratory testing
D) Promptly obtain serum TSH and free T4 and arrange endocrine evaluation
Correct Answer: D) Promptly obtain serum TSH and free T4 and arrange
endocrine evaluation
Rationale: Congenital hypothyroidism is frequently clinically silent at birth.
An abnormal screen requires rapid confirmatory serum testing because
delayed diagnosis and treatment can impair neurodevelopment.
Endocrinology consultation should not be unnecessarily delayed.
Q3. Which medication is the standard initial treatment for confirmed
congenital hypothyroidism?
A) Levothyroxine
B) Methimazole
C) Propranolol
, D) Radioactive iodine
Correct Answer: A) Levothyroxine
Rationale: Levothyroxine replaces deficient thyroid hormone and should be
started promptly after congenital hypothyroidism is confirmed or strongly
suspected. Early adequate replacement is critical because thyroid hormone
is essential for normal brain growth and development.
Q4. Which clinical pattern most strongly suggests acquired
hypothyroidism in a school-age child?
A) Weight loss, tremor, and heat intolerance
B) Tachycardia, diarrhea, and hyperreflexia
C) Slowed growth, fatigue, constipation, and cold intolerance
D) Polyuria, polydipsia, and weight loss
Correct Answer: C) Slowed growth, fatigue, constipation, and cold
intolerance
Rationale: Reduced thyroid hormone activity can slow linear growth and
metabolism, producing fatigue, constipation, cold intolerance, dry skin, and
other manifestations. Growth deceleration may be an especially important
clue in pediatric patients.
Q5. An 8-year-old has poor concentration, hyperreflexia,
tremulousness, and a goiter. Which disorder should be considered
first?
A) Congenital hypothyroidism
B) Hyperthyroidism
C) Type 2 diabetes
D) Constitutional growth delay
Correct Answer: B) Hyperthyroidism
Rationale: Hyperreflexia, tremor, goiter, restlessness, tachycardia, heat
intolerance, and difficulty concentrating are compatible with excess thyroid
hormone activity. Thyroid function testing helps distinguish hyperthyroidism
from behavioral and other endocrine conditions.
Answers SNHU
Q1. What is the most common cause of acquired hypothyroidism in
older children and adolescents in iodine-sufficient regions?
A) Subacute viral thyroiditis
B) Hashimoto autoimmune thyroiditis
C) Acute bacterial thyroiditis
D) Traumatic thyroiditis
Correct Answer: B) Hashimoto autoimmune thyroiditis
Rationale: Chronic autoimmune thyroiditis, commonly called Hashimoto
thyroiditis, is the leading cause of acquired hypothyroidism in children and
adolescents in iodine-sufficient areas. Autoimmune destruction progressively
reduces thyroid hormone production and may be associated with a goiter.
Q2. A newborn screening result raises concern for congenital
hypothyroidism. What is the most appropriate next step?
A) Wait until the infant develops clinical symptoms
B) Repeat newborn screening at 6 months
C) Obtain thyroid ultrasonography before laboratory testing
D) Promptly obtain serum TSH and free T4 and arrange endocrine evaluation
Correct Answer: D) Promptly obtain serum TSH and free T4 and arrange
endocrine evaluation
Rationale: Congenital hypothyroidism is frequently clinically silent at birth.
An abnormal screen requires rapid confirmatory serum testing because
delayed diagnosis and treatment can impair neurodevelopment.
Endocrinology consultation should not be unnecessarily delayed.
Q3. Which medication is the standard initial treatment for confirmed
congenital hypothyroidism?
A) Levothyroxine
B) Methimazole
C) Propranolol
, D) Radioactive iodine
Correct Answer: A) Levothyroxine
Rationale: Levothyroxine replaces deficient thyroid hormone and should be
started promptly after congenital hypothyroidism is confirmed or strongly
suspected. Early adequate replacement is critical because thyroid hormone
is essential for normal brain growth and development.
Q4. Which clinical pattern most strongly suggests acquired
hypothyroidism in a school-age child?
A) Weight loss, tremor, and heat intolerance
B) Tachycardia, diarrhea, and hyperreflexia
C) Slowed growth, fatigue, constipation, and cold intolerance
D) Polyuria, polydipsia, and weight loss
Correct Answer: C) Slowed growth, fatigue, constipation, and cold
intolerance
Rationale: Reduced thyroid hormone activity can slow linear growth and
metabolism, producing fatigue, constipation, cold intolerance, dry skin, and
other manifestations. Growth deceleration may be an especially important
clue in pediatric patients.
Q5. An 8-year-old has poor concentration, hyperreflexia,
tremulousness, and a goiter. Which disorder should be considered
first?
A) Congenital hypothyroidism
B) Hyperthyroidism
C) Type 2 diabetes
D) Constitutional growth delay
Correct Answer: B) Hyperthyroidism
Rationale: Hyperreflexia, tremor, goiter, restlessness, tachycardia, heat
intolerance, and difficulty concentrating are compatible with excess thyroid
hormone activity. Thyroid function testing helps distinguish hyperthyroidism
from behavioral and other endocrine conditions.
