Thyroid Disorders Practice Questions
20 free Thyroid Disorders practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
Which thyroid disorder is most likely when a patient presents with weight gain, cold intolerance, dry skin, and bradycardia?
- A Hyperthyroidism
- B Hypothyroidism
- C Thyroid storm
- D Subclinical hyperthyroidism
Correct answer: Hypothyroidism
These symptoms (weight gain, cold intolerance, dry skin, slow heart rate) reflect a decreased metabolic state typical of hypothyroidism.
Which laboratory finding would be expected in primary hyperthyroidism?
- A Low TSH, high T3/T4
- B High TSH, low T3/T4
- C Low TSH, low T3/T4
- D High TSH, high T3/T4
Correct answer: Low TSH, high T3/T4
In primary hyperthyroidism the thyroid produces excess T3/T4, suppressing TSH via negative feedback, so TSH is low and T3/T4 are high.
What is a life-threatening complication of untreated hyperthyroidism characterised by high fever, tachycardia, agitation, and possibly coma?
- A Myxedema coma
- B Thyroid storm
- C Grave’s ophthalmopathy
- D Goiter crisis
Correct answer: Thyroid storm
Thyroid storm is the acute, extreme hyperthyroid state with systemic decompensation and requires emergency management.
Which of the following is a common cause of hypothyroidism in developed countries?
- A Graves’ disease
- B Toxic multinodular goitre
- C Hashimoto’s thyroiditis
- D Iodine excess
Correct answer: Hashimoto’s thyroiditis
Hashimoto's thyroiditis (autoimmune destruction of thyroid) is the most common cause of hypothyroidism in developed countries.
A nurse is caring for a patient with hyperthyroidism. Which nursing intervention is most appropriate to support the patient’s comfort?
- A Encourage a warm pack and warm environment
- B Provide a cool, quiet room and limit stimulation
- C Discourage rest and promote high-stimulus environment
- D Use excessive blankets to keep patient warm
Correct answer: Provide a cool, quiet room and limit stimulation
In hyperthyroidism the metabolic rate is elevated and the patient is heat-intolerant, so providing a cool, calm environment helps reduce stress and heat load.
A patient with hypothyroidism is prescribed levothyroxine. What teaching point should a nurse emphasise?
- A Take the medication together with the largest meal of the day
- B Take it each morning at the same time on an empty stomach
- C It can be stopped as soon as your symptoms have resolved
- D Only take it on days when you happen to feel cold or tired
Correct answer: Take it each morning at the same time on an empty stomach
Levothyroxine should be taken consistently, typically in the morning on an empty stomach, to optimise absorption and hormone levels.
Which symptom is more typical of hyperthyroidism than hypothyroidism?
- A Constipation
- B Cold intolerance
- C Heat intolerance and palpitations
- D Weight gain without appetite change
Correct answer: Heat intolerance and palpitations
Hyperthyroidism leads to increased metabolic rate, causing heat intolerance, palpitations, tremor, and other sympathetic symptoms.
What physical exam finding is most characteristic of Graves’ disease, a form of hyperthyroidism?
- A Myxedema around ankles
- B Exophthalmos (protruding eyes)
- C Hypertrophy of thyroid with hypothyroid labs
- D Hypothermia and bradycardia
Correct answer: Exophthalmos (protruding eyes)
Exophthalmos is a hallmark of Graves’ disease (autoimmune hyperthyroidism) due to retro-orbital tissue changes.
In hypothyroidism, the nurse recognises the patient is at risk for which serious complication if untreated?
- A Thyroid storm
- B Myxedema coma
- C Grave’s ophthalmopathy
- D Hyperthyroid cardiomyopathy
Correct answer: Myxedema coma
Myxedema coma is the extreme manifestation of untreated hypothyroidism with hypothermia, altered mentation and multi-system failure.
A nurse is planning care for a patient with hypothyroidism who reports constipation. Which intervention is appropriate?
- A Encourage coffee and spicy foods
- B Increase dietary fiber, adequate fluids and regular activity
- C Restrict fluids to reduce bloating
- D Discourage bowel movement until medication kicks in
Correct answer: Increase dietary fiber, adequate fluids and regular activity
Constipation in hypothyroidism is due to slowed metabolism; dietary fiber, fluids and activity help alleviate it.
A patient with a large goitre and hyperthyroidism is admitted for thyroidectomy. Pre-operation the nurse expects which preparation?
- A High-iodine diet to shrink gland
- B Full thyroid hormone replacement to normalise
- C No special preparation required
- D Promote hyperthermia to increase metabolism
Correct answer: High-iodine diet to shrink gland
High-iodine diet (or iodine solution) is used pre-operatively to decrease thyroid vascularity and hormone release in preparation for surgery (common in hyperthyroid goitre).
Which laboratory profile is most consistent with primary hypothyroidism?
- A Low TSH, high T4
- B High TSH, low T4
- C Low TSH, low T4
- D High TSH, high T4
Correct answer: High TSH, low T4
In primary hypothyroidism the thyroid cannot produce enough T4, so T4 is low and TSH from pituitary is elevated in compensation.
A patient with hyperthyroidism is started on a beta blocker such as propranolol. What is the purpose of this medication?
- A To increase the gland's output of thyroid hormone
- B To block peripheral conversion of T4 into active T3
- C To relieve symptoms such as tachycardia, tremor, and anxiety
- D To directly correct underlying hypothyroid symptoms
Correct answer: To relieve symptoms such as tachycardia, tremor, and anxiety
Beta blockers are used in hyperthyroid patients to manage sympathetic symptoms such as tachycardia, tremor and anxiety while definitive therapy is instituted.
A patient taking levothyroxine reports palpitations and weight loss. The nurse should assess for:
- A Under-dosing of the prescribed thyroid hormone replacement
- B Overtreatment causing iatrogenic hyperthyroidism
- C Poor gastrointestinal absorption of the medication
- D New onset of worsening primary hypothyroidism
Correct answer: Overtreatment causing iatrogenic hyperthyroidism
Symptoms of tachycardia and weight loss suggest overtreatment of thyroid hormone leading to a hypermetabolic state mimicking hyperthyroidism.
Which dietary advice is relevant for a patient with hypothyroidism?
- A Encourage unlimited caffeine intake and very spicy foods
- B Increase fiber, monitor calories, and avoid excess iodine if not needed
- C Permanently restrict all dietary carbohydrate sources
- D No dietary modifications of any kind are required at all
Correct answer: Increase fiber, monitor calories, and avoid excess iodine if not needed
Hypothyroid patients often have weight gain and slow metabolism; fiber helps constipation and calorie monitoring prevents further weight gain.
In a patient with hyperthyroidism, the nurse should monitor closely for development of:
- A Bradycardia, hypotension, and a slowed metabolic rate
- B Arrhythmias, heart failure, and osteoporosis from hypermetabolism
- C Myxedema, hypothermia, and progression to coma
- D Hypothermia, hypoglycemia, and depressed mental status
Correct answer: Arrhythmias, heart failure, and osteoporosis from hypermetabolism
Hyperthyroidism increases cardiac workload and bone turnover, leading to arrhythmias, heart failure risk, and osteoporosis.
A patient with hypothyroidism has a history of sleep apnoea and weight gain. The nurse recognises which of the following contributes?
- A A markedly slowed metabolic rate reducing energy demand
- B Reduced metabolism and elevated BMI causing airway obstruction
- C An excess of circulating thyroid hormone driving metabolism
- D Excessive sympathetic nervous system activity at rest
Correct answer: Reduced metabolism and elevated BMI causing airway obstruction
Hypothyroidism slows metabolism, often causes weight gain and fluid retention, which may worsen sleep apnoea due to airway narrowing and increased body mass.
Which statement about thyroid hormone replacement in hypothyroidism is true?
- A It can be taken at varied times each day for flexible dosing
- B It is usually lifelong and needs regular TSH monitoring
- C It can be discontinued once the patient's symptoms resolve
- D It should always be taken with meals to boost its absorption
Correct answer: It is usually lifelong and needs regular TSH monitoring
Hormone replacement with levothyroxine is generally lifelong, dosing monitored via TSH and thyroid hormones to ensure efficacy and avoid over/undertreatment.
A patient with hyperthyroidism complains of increased bowel movements, trembling, and irritability. The nurse knows these symptoms are due to:
- A An abnormally slowed metabolic rate from low hormone levels
- B Excess thyroid hormone speeding metabolism and sympathetic activity
- C Insufficient thyroid hormone production by the gland
- D Primary gastrointestinal disease unrelated to thyroid function
Correct answer: Excess thyroid hormone speeding metabolism and sympathetic activity
Excess thyroid hormone increases basal metabolic rate and stimulates sympathetic nervous system causing tremor, irritability, increased GI motility.
In preparation for discharge, what teaching should a nurse include for a thyroidectomy patient to prevent complications?
- A The patient may stop checking TSH levels permanently after surgery
- B Teach signs of hypocalcemia (tingling, muscle cramps) from parathyroid injury
- C Lifelong endocrine follow-up after surgery is no longer necessary
- D The patient may resume an unrestricted high-iodine diet immediately
Correct answer: Teach signs of hypocalcemia (tingling, muscle cramps) from parathyroid injury
After thyroidectomy parathyroid glands may be damaged or removed, leading to hypocalcemia; patients must learn to recognise tingling, muscle cramps, and seek medical attention.