Methimazole is usually avoided early in pregnancy because it is linked to birth defects, so propylthiouracil is often used during that period.
Correct Answer
True
True. Methimazole exposure early in pregnancy is associated with fetal malformations, so propylthiouracil is commonly preferred then, with the plan reviewed later in pregnancy because propylthiouracil carries a risk of severe liver injury.
Category: Antithyroid Drugs
Question 2
Thionamides take several weeks to control hyperthyroidism because the gland still releases hormone it has already stored.
Correct Answer
True
True. Methimazole and propylthiouracil block the making of new hormone but do not stop release of hormone already stored in the gland, so symptoms improve gradually as those stores are used up.
Category: Antithyroid Drugs
Question 3
In a nuclear emergency, potassium iodide can protect the thyroid by saturating it so it takes up less radioactive iodine.
Correct Answer
True
True. Flooding the gland with stable iodine leaves little room for radioactive iodine to be taken up, which lowers the radiation dose to the thyroid; it does not protect other organs.
Category: Antithyroid Drugs
Question 4
Radioactive iodine therapy is contraindicated during pregnancy.
Correct Answer
True
True. Radioactive iodine crosses the placenta and can destroy the fetal thyroid, so pregnancy is ruled out before treatment and is avoided for a period afterward.
Category: Antithyroid Drugs
Question 5
In thyroid storm, the thionamide is given before the iodine so the gland cannot use the iodine to make more hormone.
Correct Answer
True
True. If iodine is given first, the overactive gland can use it as raw material for new hormone; giving the thionamide first blocks synthesis, and the iodine then reduces release of stored hormone.
Category: Antithyroid Drugs
Question 6
Levothyroxine has a narrow therapeutic index, so small dose changes can cause signs of excess or deficient thyroid hormone.
Correct Answer
True
True. The gap between an effective and a toxic levothyroxine dose is small, so doses are titrated carefully against thyroid tests and the client watches for both hypothyroid and hyperthyroid symptoms.
Category: Thyroid Replacement
Question 7
Pregnancy often increases the amount of levothyroxine a client with hypothyroidism needs.
Correct Answer
True
True. Thyroid hormone requirements rise during pregnancy, so a client taking levothyroxine notifies the provider as soon as pregnancy is confirmed or planned and has thyroid levels checked more often.
Category: Thyroid Replacement
Question 8
Cinacalcet should be taken with food or shortly after a meal.
Correct Answer
True
True. Food increases cinacalcet absorption, so it is taken with or shortly after a meal, and the tablets are swallowed whole rather than divided.
Category: Parathyroid Drugs
Question 9
Leakage of intravenous calcium into surrounding tissue can cause tissue necrosis, so the IV site is checked closely during the infusion.
Correct Answer
True
True. Intravenous calcium salts, calcium chloride in particular, are irritating to tissue, so the line must be patent and the site is watched for swelling, pain or redness during administration.
Category: Calcium and Vitamin D
Question 10
Hypocalcemia should be corrected before alendronate therapy begins.
Correct Answer
True
True. Bisphosphonates reduce the release of calcium from bone and can worsen low calcium, so hypocalcemia is a contraindication and calcium and vitamin D status are corrected first.
Category: Bisphosphonates
Question 11
Levothyroxine produces full relief of hypothyroid symptoms within hours of the first dose.
Correct Answer
False
False. Levothyroxine acts slowly, and full symptom relief takes several weeks; the client keeps a record of symptoms and continues the drug while the dose is adjusted.
Category: Thyroid Replacement
Question 12
Liothyronine and levothyroxine are interchangeable at the same dose.
Correct Answer
False
False. Liothyronine is synthetic T3, which is more potent and shorter acting than levothyroxine, so the two are not substituted for one another dose for dose; their similar names are a known source of medication errors.
Category: Thyroid Replacement
Question 13
Calcium chloride may be given by intramuscular injection when IV access is not available.
Correct Answer
False
False. Calcium chloride is given only intravenously, because injecting it into muscle or other tissue can cause severe irritation and necrosis.
Category: Calcium and Vitamin D
Question 14
Clients with untreated hypothyroidism are less sensitive than usual to opioids and sedatives.
Correct Answer
False
False. A slowed metabolic rate makes clients with untreated hypothyroidism more sensitive to opioids and sedatives, so these drugs are used cautiously and respiratory status is monitored.
Category: Thyroid Replacement
Question 15
The thyroid-suppressing effect of iodine solutions lasts indefinitely, which makes them good long-term therapy for hyperthyroidism.
Correct Answer
False
False. The gland escapes the suppressing effect of iodine after a short time, so iodine solutions are used briefly, such as before thyroidectomy or in thyroid storm, not as long-term therapy.
Category: Antithyroid Drugs
Question 16
Severe kidney impairment is not a concern with bisphosphonates, because the liver clears them.
Correct Answer
False
False. Bisphosphonates are excreted by the kidneys, so they are not recommended in severe kidney impairment, and kidney function is checked before therapy begins.
Category: Bisphosphonates
Question 17
Desiccated thyroid extract made from pig glands is an FDA-approved thyroid hormone product.
Correct Answer
False
False. Desiccated thyroid extract is marketed without FDA approval, and its hormone content can vary; levothyroxine is the standard approved replacement.
Category: Thyroid Replacement
Question 18
Hashimoto thyroiditis is treated with antithyroid drugs such as methimazole.
Correct Answer
False
False. Hashimoto thyroiditis is an autoimmune disease that destroys the thyroid and causes hypothyroidism, so it is treated with thyroid hormone replacement such as levothyroxine.
Category: Thyroid Replacement
Question 19
Starting levothyroxine often lowers the amount of insulin or oral diabetes drug a client needs.
Correct Answer
False
False. Thyroid hormone can worsen glucose control and raise insulin or oral antidiabetic requirements, so blood glucose is monitored after levothyroxine is started or its dose is changed.
Category: Thyroid Replacement
Question 20
Calcium supplements are recommended for clients with hypercalcemia caused by hyperparathyroidism.
Correct Answer
False
False. Excess parathyroid hormone already raises serum calcium, and added calcium can worsen hypercalcemia and kidney stone risk, so hyperparathyroidism is a caution or contraindication for calcium supplements.
Category: Calcium and Vitamin D