NUR 311 Exam 4 Study Questions with
Correct Detailed Answers 2025
What two hormones does the thyroid produce? -Correct Answers ✔-
Triiodothyronine (T3)
Thyroxine (T4)
Which thyroid hormone is converted in the periphery? -Correct Answers ✔-T4 is
converted to T3
Which thyroid hormone is more potent? -Correct Answers ✔-T3
Describe the steps of thyroid hormone regulation. (TRH, TSH, T3, T4, negative
feedback loop) -Correct Answers ✔-TRH from hypothalmus -> TSH from anterior
pituitary -> T3 & T4 from thyroid -> inhibit TSH from anterior pituitary
Describe the relationship of TSH levels to T3 and T4 levels. -Correct Answers ✔-
Low T3 or T4 increases TSH, high T3 or T4 lowers TSH
Describe common clinical signs and symptoms of hypothyroidism? -Correct
Answers ✔-Goiter: puffy, expressionless face; cold/dry skin; brittle hair; hair loss
from scalp & outer half of eyebrows; fatigue; irritability; depression; lack of
concentration; cold intolerance; constipation; heavy menses; increased cholesterol
Persons over 50 years of age may need what change in the initial dose of
levothyroxine? -Correct Answers ✔-Lowered
Discuss the effects on the fetus of maternal hypothyrodism may need to increase
the dose of levothyroxine by how much? -Correct Answers ✔-Decreased IQ and
neuropsychological function of the child. Increase levothyroxine dose by up to
50%. Increase by 30% as soon as pregnancy confirmed
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Discuss the effects of congenital hypothyroidism in infants. -Correct Answers ✔-
Mental retardation, large tongue, pot belly, dwarfish stature, derangement of
growth - nerves, muscles, bone, teeth
How long until levothyroxine reaches a plateau? -Correct Answers ✔-One month
Levothyroxine should be given with or without food? -Correct Answers ✔-Without
food
Discuss the expected change in TSH when a patient is responding to
levothyroxine? -Correct Answers ✔-TSH decreases to normal levels
Describes the signs and symptoms of throtoxicosis. -Correct Answers ✔-
Tachycardia, angina, tremor, nervousness, insomnia, hyperthermia, heat
intolerance, sweating, weight loss, increased appetite.
Which drugs can cause decreased absorption of levothyroxine? How many hours
after the administration of levothyroxine may these drugs be given? -Correct
Answers ✔-H2-receptor blockers, proton pump inhibitors, bile-acid sequestrants
such as colestyramine (Questran) and colestipol (Colestid); sucralfate (Carafate);
calcium, iron, magnesium, aluminum.
4 hours.
Why would a nurse administer levothyroxine with caution to a patient on warfarin?
-Correct Answers ✔-Levothyroxine increases the degradation of Vitamin K-
dependent clotting factors and may increase the chance of bleeding. May need to
decrease dose of warfarin.
What is the interaction between catecholamines and levothyroxine? -Correct
Answers ✔-Levothyroxine increases the body's response to epinephrine,
norepinephrine, and dopamine.
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Why might lithothyronine (Cytomel) be given instead of levothyroxine
(Levothyroid)? -Correct Answers ✔-Rapid onset of action in myxedema coma.
Discuss the nursing care of a patient with hypothyroidism. -Correct Answers ✔-
Life-long replacement; take on an empty stomach; monitor for hypothyroidism &
hyperthyroidism; hold levothyroxine if pulse >100/min & call primary care
provider; monitor TSH, T3 & T4; minimize adverse drug interactions; monitor
warfarin levels.
What are the symptoms of thyrotoxic crisis (thyroid storm)? What usually triggers
it? -Correct Answers ✔-Restlessness, agitation, tremor, severe tachycardia,
hypotension, heart failure, hyperthermia, profound weakness, unconsciousness,
coma.
Severe illness or major surgery.
What mimics TSH in patients with Grave's Disease? -Correct Answers ✔-Thyroid-
stimulating immunoglobins (TSI)
What are some signs and symptoms of Grave's Disease? -Correct Answers ✔-
Rapid, strong heartbeat; rapid thoughts & speech; trouble concentrating; tremor;
insomnia; weakened muscles; increased body temperature; warm, moist skin;
increased appetite with weight loss; diarrhea; exophthalmos.
What TSH level is expected with hyperthyroidism? -Correct Answers ✔-
Decreased TSH
Give two ways propylthiouracil (PTU) works in hyperthyroidism? -Correct
Answers ✔-Inhibits thyroid hormone synthesis by inhibiting peroxidase.
Supresses conversion of T4 to T3 in the periphery.
Name a blood disorder caused by thionamides? -Correct Answers ✔-
Agranulocytosis - may see sore throat or fever.
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