Nokea
A nurse is caring for a client with hyperthyroidism. The physician prescribes methimazole to the client. The nurse observes that the client has developed skin rashes after the drug is administered. Which of the following interventions should the nurse perform while caring for the client?
- A. Offer suggestions to alter the drug schedule.
- B. Instruct the client to avoid applying lubricants.
- C. Instruct the client to use soap sparingly.
- D. Check if discoloration of the hair occurs.
Correct Answer: C
Rationale: The nurse should instruct the client to use soap sparingly and apply soothing creams or lubricants until the rash subsides. The nurse need not offer suggestions to alter the drug schedule, instruct the client to avoid applying lubricants, or check if discoloration of hair occurs.
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A nurse is caring for a client with thyroid storm. Which of the following would the nurse expect to assess?
- A. Memory impairment
- B. Cold intolerance
- C. Constipation
- D. Altered mental status
Correct Answer: D
Rationale: A severe form of hyperthyroidism called thyroid storm is characterized by high fever, extreme tachycardia, and altered mental status. The nurse need not observe for memory impairment, cold intolerance, or constipation as characteristics of thyroid storm. Memory impairment, cold intolerance, and constipation are the manifestations of myxedema, which is a severe form of hypothyroidism.
A nurse completing a preadministration assessment on a 70-year-old client prior to the administration of levothyroxine may confuse which of the following symptoms of hypothyroidism with which symptoms associated with the aging process? Select all that apply.
- A. Constipation
- B. Confusion
- C. Unsteady gait
- D. Decreased visual acuity
- E. Cold intolerance
Correct Answer: B,C,E
Rationale: The symptoms of hypothyroidism may be confused with symptoms associated with aging, such as depression, cold intolerance, weight gain, confusion, or unsteady gait.
A group of nursing students are reviewing information about thyroid disorders. The students demonstrate understanding of the information when they identify which of the following as indicative of hyperthyroidism? Select all that apply.
- A. Low body temperature
- B. Weight loss
- C. Tachycardia
- D. Hypotension
- E. Sleepiness
Correct Answer: B,C
Rationale: The signs and symptoms of hyperthyroidism include increased metabolism, heat intolerance, elevated body temperature; weight loss; tachycardia; hypertension; nervousness; anxiety; insomnia; exophthalmos; flushed, warm, moist skin; thinning hair, goiter; and irregular or scant menses.
A nurse is caring for a client undergoing thyroid hormone replacement therapy. The nurse instructs the client to take the drug at which time?
- A. Before bedtime
- B. Just before dinner
- C. After lunch
- D. Before breakfast
Correct Answer: D
Rationale: The nurse should inform the client undergoing thyroid hormone replacement therapy to take the drug in the morning, preferably before breakfast. The nurse should not ask the client to take the drug before bedtime, just before dinner, or after lunch as that is not generally recommended by the health care provider.
A nurse is preparing to administer the thyroid hormone replacement drug levothyroxine to a client. The nurse understands which of the following about this drug? Select all that apply.
- A. Equivalent to all other thyroid hormone replacement drugs
- B. More uniform potency than other thyroid hormone replacement drugs
- C. Twice-daily dosing necessary
- D. Relatively inexpensive
- E. Less frequent lab monitoring required
Correct Answer: B,D
Rationale: The following is true of the thyroid hormone replacement drug levothyroxine: it is relatively inexpensive, requires once-daily dosing, and has a more uniform potency than do other thyroid hormone replacement drugs.