Hyperthyroid Disorder Practice Questions

A huge request that I get from nursing students all the time is more practice problems. I know that nclex style questions can be pretty tricky to understand and to answer properly. So I really wanted to bring you more practice problems to really help the information come together for you so you can actually understand how to answer these types of questions and how to think through them better. So what we're going to do in this video is we're going to go through several questions around hyperthonic thyroidism or Graves disease. Now, I have a whole YouTube video on Graves disease. You could check that out here. But these questions are going to come off of that video and really do a quick knowledge check for you so that we can help all the info come together for you so you can pass your nursing school exam. Let's dive in now. Anytime we answer and collect style questions, we want to make sure that we are looking at what the question is asking and how it's asking it. We're going to use some strategies to help answer these questions. And I want to make sure that anytime you are looking at practice problems in nursing school that you are understanding why the answers are incorrect and why the answers are correct. So whatever answers are correct, you want to understand why those are the correct ones. And whatever answers are incorrect, you want to understand why those are the incorrect ones. Okay. That will really deepen your critical thinking skills as you go to practice and study and as you go to take your exams. So that's what we're going to do here. So I have a few practice questions to go through. All right, let's do it. So the first question is a client or arrived in the emergency room with symptoms of a fever, tachycardia, and restlessness. The nurse would expect what lab test to be ordered to check for problems with the thyroid. Select all that apply. Okay, so anytime you're reading an nclex style question, you want to make sure that you are picking out the key information. So key information here. Select all that apply. So make sure, like, you can easily miss this on a nursing school exam. Make sure that you select all that apply. You're not just clicking one answer. Okay. Make sure that you go through the list. Select all that apply. Okay, now we're looking for lab tests. What lab tests need to be ordered to check with problems for the what? The thyroid. Okay, so let's go through these. The first A is international normalized ratio or the INR. Then total thyroxine, T4, total triodithyronine, which is T3, alanine. Transmenase ALT. Right, that ALT, thyroid stimulating hormone or TSH. So those are the answers that we have available to us. Okay, so let's figure out, we'll go down the list and see which ones apply to the thyroid. Okay, so does the INR International normalized ratio apply to the third? And actually, before I go through and answer this, here's what I want to tell you about select all apply questions. Whenever you walk through a select all that apply question or get it on on your NCLEX or on a nursing school exam, you want to answer them as if they are a true false question. Okay? So you're going to go through each of these answers. We're going to go through them and we're going to see is this true or false as it relates to the question. So what's the question here? We're trying to figure out what lab tests indicate problems with the thyroid. So an inr, what is that going to be helpful with? Well, an INR test is not for the thyroid, is for blood clotting. Okay, so we can disseminate. Miss that one right away. The INR really is not going to help us diagnose any issues with the thyroid. It is a blood clotting test. Okay, so A is out. Okay, Total thyroxine of that T4, that is a thyroid. That is A. That is the thyroid hormone. So that is going to help us to diagnose an issue with the thyroid. So yes, we're going to choose B. All right, so that one is true as it relates to the question. Right, but the INR is false. False. It's not going to help us. Okay, diagnose any issues with the thyroid. Now CT3, okay, T3, that's one of the active thyroid hormones, right? So yes, it is going to help us to diagnose an issue with the thyroid gland. Now, alanine transmenase A L, T that. What is that one, my friend? Do you know what that one is? It's a liver function test. So it's a, it's a part of the liver function test. So it is a liver. We call it a liver lab. So it helps to see how the liver is functioning, but it doesn't help to see how the thyroid is functioning. Okay, so we're not going to choose that one. That one is false as it relates to the question. Okay, then the letter E. The last one is thyroid stimulating hormone of tsh. So this one, as we learned in the previous video on hyperthyroidism, is it thyroid stimulating hormone? Yes, that helps to stimulate. Stimulate the thyroid to make that T4 and T3. So, yes, this one will help us to diagnose how. How the thyroid is functioning or figure out how the thyroid is functioning. So for this question here, the correct answers are B, C, and E. Did you get it right? Does that all make sense? It's really, really important. Like I said, when you walk through a select all that apply question that you are going to answer by answer and seeing is it true or is it false as it relates to the question, that is the absolute best way to answer those select all the pie questions. All right? Now, question number two. The nurse is assessing the lab report for a client with suspected Graves disease. Okay, key point here. Graves disease. Which lab result does the nurse recognize as a possible indicator for hyperthyroidism? Okay, another key point. So anytime, right, you are reading an unclicked style question or taking a nursing school exam. Watch that key information. We're looking for Graves disease. Which lab result does the nurse recognize as a possible indicator for hyperthyroidism? All right, so we're not looking for hypothyroidism. We're not looking for pancreatitis. We're not looking for Crohn's disease. We are looking for what? Hyperthyroidism. Okay, so let's go through it. A is a TSH value of 0.3 milli international units per liter. That's a long thing to say. And a total T4 value of 18 micrograms per deciliter. Okay, that's A. Now, B is a TSH value of 1.6. All right? And a total T4 value of 11. And then C is a total T4 value of 9 micrograms per deciliter. And a T3 value of 9 nanograms per deciliter. And then D is a TSH value of 6.5. Okay. Milli International units per liter. And a total T4 value of 2.1 micrograms per decimal. All right, so which one of these, which lab result does the nurse recognize as a possible indicator for hyperthyroidism? So they're giving us all these lab values. We now need to decide which one is an indicator for hyperthyroidism. So we have to know the normal ranges. Okay? Now, if you remember from the previous video, TSH level is between 0.5 to 5. All right? Milli International units per liter, right? 0.5 to 5. Now, total. Total T4, okay, remember, is 5 to 12. Now, a free T4 level is 0.8 to 1.8. And T3 is around 60 to 180. Okay. Nanograms per deciliter. So when we're looking at this question, we need to keep these lab values in our mind so that we can answer it appropriately. Because if you don't know the lab values, then we're going to get it wrong. Right? So we need to keep those normal ranges in our minds. So letter A, a TSH value of 0.3 and a total T4 of 18. So in this one, is the TSH low or high? Well, it's low, right? A TSH normal is between 0.5 and 5. This one is low, it's 0.3. And then T4, this is a value of 18, whereas a normal total T4 is between 5 to 12. So 18. Ooh, that is high. Okay, so keep that in mind. The TSH is low and the T4 is high. Okay. I think you might already know the answer if you watched the previous video. I think I'm going to guess that one. Now, b, a TSH value of 1.6 and a total T4 value of 11. Well, this one is normal. So 1.6 is a TSH, and that falls within the normal range. And then 11 for a T4 level, that's with a normal range too. So that is normal. And then C is a total t4 value of 9 and a t3 value of 90. So total t4 value of 9, that's normal. Total t3 value of 90, that's normal, too. So that one's normal. B and C are both normal. Now, a TSH value of 6.5, TSH value of 6.5. That is high on the high end of TSH, not on the high end. It is over the high end. So that is abnormal. That one's high. And a total T4 value of 2.5. Okay, now that one's low. Total T4 of 2.1. That is below the regular range, which would be 5 to 12. Right. So 2.1. So in this one, in D, looks like the TSH is high and the T4 is low. Now, that would indicate hypothyroidism. But A, if you remember from that previous video, when we are looking at hyperthyroidism, which is what this question is asking us for, it's asking us for hyperthyroidism, not hypothyroidism. Okay? That's why you have to understand what the question's asking. We want to make sure we're answering the right question. So when A. When we're looking at answer A, the TSH the TSH value is low and the T4 is high. So in hyperthyroidism, we recognize like, we know that when a patient has hyperthyroidism that TSH is going to be low and the T4 level is going to be high because they are. It's being stimulated, stimulated, stimulated. All that T4 and T3 is being released. And then that tells the brain that, hey, I don't need any more T4 and T3. So the brain stops releasing TSH. So that TSH value is going to be low, but the T4 is going to be elevated. Does that make sense? So in this question, A is the correct answer, B and C are normal, and D is that would, could indicate hypothyroidism. Okay, I hope that makes sense. Now the next question number three is the nurse is assessing a client who has just been diagnosed with Graves disease. The nurse recognizes that Graves disease is caused by what problem with the thyroid gland? A, the thyroid gland does not produce enough thyroxine that T4 hormone. The thyroid gland does not produce thyroid stimulating hormone. Tsh. The thyroid gland produces too much thyroxine T4 hormone. Or the thyroid gland produces too much thyroid releasing hormone, or trh. Now, this one's a really good question because it really makes us think about where hormones come from and what all the moving parts are in that endocrine system. So what is this question asking us for? The nurse recognizes that Graves disease, Graves disease is caused by what problem with the thyroid gland? So that's what we're looking at. What's the problem here? So A, the thyroid gland does not produce enough thyroxine, T4 hormone. Okay, so in Graves disease, if you remember from the previous video, the problem is too much T4, T3. Okay, so the, the, those antibodies are attacking that thyroid gland and they're releasing too much T4 and T3. And then that's going to tell the brain to stop releasing, reduce, releasing that TRH and the tsh. Okay, so for number a, letter A, letter A, the thyroid gland does not produce enough thyroxine hormone. Well, if the thyroid gland isn't producing enough thyroxine, that T4, that would be hypothyroid, not hyperthyroid. We're talking about Graves disease, which is hyperthyroid here in this question. I guess that's another thing that we need to recognize when we're answering this question is that Graves disease means hyperthyroid. Thyroid, not hypothyroid. That would be Hashimoto's. Okay, but Graves disease is hyperthyroid. Now B, the thyroid gland does not produce thyroid stimulating hormone, tsh. So just at, you know, any time the thyroid gland doesn't produce thyroid stimulating hormone, the anterior pituitary gland releases that hormone. So the thyroid gland is not responsible for producing thyroid stimulating hormone of that tsh, that is the anterior pituitary gland. So B is out. And then C, the thyroid gland produces too much thyroxine, that T4 hormone. That is the problem here with hyperthyroidism or with Graves disease is that that thyroid gland is producing too much T4, right? Antibodies, antibodies, antibodies, antibodies. They're stimulating those receptors, releasing the, the T4 hormone and T3. Now D, the thyroid gland produces too much thyroid releasing hormone or trh. Now again, TRH is not, not released by the thyroid gland. It's actually the hypothalamus that releases that one. So D is out as well. So the correct answer for this one is C, the thyroid gland produces too much thyroxine, T4 hormone. Okay, so if you want a deep dive into all of that info and how the moving parts are working together with the endocrine system specifically for hypothyroidism, I highly, highly suggest that you watch that previous video on the pathophysiology of hyperthyroidism. I really tried to give a really nice, smooth breakdown of where all the hormones are going and what they're doing, because I know that can be a really, really complicated kind of process to figure out in nursing school. So I hope that you check out that video and I hope that that's helpful for you. And if you loved this video with these practice questions, please, please, please let me know in the comments below. This is the first time I'm doing a video like this and I'm really excited about it personally. But I want to make sure that it is so helpful for you. That's why I do everything that I do, right? I want to make sure that it's beneficial to you. And if it's not, then I don't want to do it. But if it is, I want to do more. So if you want to see more videos like this, let me know in the comments, please. That would be so helpful for me. And as always, my friend, go become the nurse that God created only you to be. And I will see you over there in that next video.