Pharmacology Exam 3 Practice
Questions and Answers Complete
Solutions
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." - ANSWER-D
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. - ANSWER-A
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. - ANSWER-A (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 - ANSWER-D
,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." - ANSWER-C
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 - ANSWER-A
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. - ANSWER-C
Levothyroxine is synthetic:
a. TRH
b. TSH
c. T3
d. T4 - ANSWER-D
Liothyronine is synthetic:
a. TRH
b. TSH
c. T3
d. T4 - ANSWER-C
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 - ANSWER-B (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 - ANSWER-D
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. - ANSWER-D
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 - ANSWER-D
What lab values are expected for a patient with Grave's disease?
a. Decreased T3 and T4
b. Elevated T3 and T4
c. Elevated TSH - ANSWER-B
What is the preferred drug of use for hyperthyroidism?
a. Methimazole
b. Propylthiouracil
c. Levothyroxine
d. Beta-blockers - ANSWER-A
A patient has just walked into the clinic you work at and exhibits signs of brittle hair
as well as hair loss. They also have a very puffy, expressionless face. Which of the
following conditions would this patient be suspected of having?
a. Hypothyroidism
, b. Grave's disease
c. Cretinism
d. Thyrotoxicosis - ANSWER-A
Which of the following adverse effects would you expect to see in a patient taking
propylthiouracil?
a. Severe kidney injury
b. Agranulocytosis
c. Hyperthyroidism
d. Hypoglycemia - ANSWER-B
All thionamides have the following characteristics:
a. Prevention of T4 to T3 conversion in the periphery.
b. Inhibition of thyroid hormone synthesis by inhibiting peroxidase.
c. Short-half lives.
d. Immediate restoration of normalized thyroid hormone levels. - ANSWER-B
Which of the following may indicate a potentially dangerous, rare adverse effect of
thionamides?
a. Headache
b. Paresthesias
c. Rash
d. Sore throat - ANSWER-D (Sore throat indicates agranulocytosis)
The time it takes methimazole (Tapazole) to induce lower T4 levels to normal is:
a. 3 to 6 minutes
b. 24 hours
c. 1 to 2 days
d. 3 to 12 weeks - ANSWER-D
Your patient has received low dose radioactive Iodine (131). You counsel your
patient by stating that the drug:
a. prevents the synthesis and release of thyroid hormone.
b. completely destroys the thyroid gland.
c. may cause hypothyroidism over time. - ANSWER-C
You may see all of the following in an infant with congenital hypothyroidism
EXCEPT:
a. Mental retardation
b. Exophthalmus
c. Large tongue and pot belly
d. Dwarfish stature and derangement of growth - ANSWER-B
Thyroid replacement is contraindicated in patients with what condition?
Questions and Answers Complete
Solutions
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." - ANSWER-D
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. - ANSWER-A
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. - ANSWER-A (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 - ANSWER-D
,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." - ANSWER-C
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 - ANSWER-A
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. - ANSWER-C
Levothyroxine is synthetic:
a. TRH
b. TSH
c. T3
d. T4 - ANSWER-D
Liothyronine is synthetic:
a. TRH
b. TSH
c. T3
d. T4 - ANSWER-C
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 - ANSWER-B (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 - ANSWER-D
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. - ANSWER-D
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 - ANSWER-D
What lab values are expected for a patient with Grave's disease?
a. Decreased T3 and T4
b. Elevated T3 and T4
c. Elevated TSH - ANSWER-B
What is the preferred drug of use for hyperthyroidism?
a. Methimazole
b. Propylthiouracil
c. Levothyroxine
d. Beta-blockers - ANSWER-A
A patient has just walked into the clinic you work at and exhibits signs of brittle hair
as well as hair loss. They also have a very puffy, expressionless face. Which of the
following conditions would this patient be suspected of having?
a. Hypothyroidism
, b. Grave's disease
c. Cretinism
d. Thyrotoxicosis - ANSWER-A
Which of the following adverse effects would you expect to see in a patient taking
propylthiouracil?
a. Severe kidney injury
b. Agranulocytosis
c. Hyperthyroidism
d. Hypoglycemia - ANSWER-B
All thionamides have the following characteristics:
a. Prevention of T4 to T3 conversion in the periphery.
b. Inhibition of thyroid hormone synthesis by inhibiting peroxidase.
c. Short-half lives.
d. Immediate restoration of normalized thyroid hormone levels. - ANSWER-B
Which of the following may indicate a potentially dangerous, rare adverse effect of
thionamides?
a. Headache
b. Paresthesias
c. Rash
d. Sore throat - ANSWER-D (Sore throat indicates agranulocytosis)
The time it takes methimazole (Tapazole) to induce lower T4 levels to normal is:
a. 3 to 6 minutes
b. 24 hours
c. 1 to 2 days
d. 3 to 12 weeks - ANSWER-D
Your patient has received low dose radioactive Iodine (131). You counsel your
patient by stating that the drug:
a. prevents the synthesis and release of thyroid hormone.
b. completely destroys the thyroid gland.
c. may cause hypothyroidism over time. - ANSWER-C
You may see all of the following in an infant with congenital hypothyroidism
EXCEPT:
a. Mental retardation
b. Exophthalmus
c. Large tongue and pot belly
d. Dwarfish stature and derangement of growth - ANSWER-B
Thyroid replacement is contraindicated in patients with what condition?
