Nokea
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.
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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.
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 describing the action of thyroid hormones to a client. The nurse would include information that thyroid hormones are principally concerned with the increase in the metabolic rate of tissues that can result in which of the following? Select all that apply.
- A. Increased heart rate
- B. Decreased respiratory rate
- C. Increased body temperature
- D. Increased cardiac output
- E. Decreased oxygen consumption
Correct Answer: A,C,D
Rationale: Thyroid hormones are principally concerned with the increase in the metabolic rate of tissues, which results in increases in the heart and respiratory rate, body temperature, cardiac output, oxygen consumption, and metabolism of fats, proteins, and carbohydrates.
During ongoing assessment the nurse should observe a client taking levothyroxine for which of the following indicating a therapeutic response? Select all that apply.
- A. Weight loss
- B. Mild diuresis
- C. Increased appetite
- D. Increased mental activity
- E. Decreased pulse rate
Correct Answer: A,B,C,D
Rationale: Signs of therapeutic response to levothyroxine include weight loss; mild diuresis; increased appetite; increased pulse rate; decreased puffiness of face, hands, and feet; and client report of increased mental activity and increased sense of well-being.
A client diagnosed with hyperthyroidism has been prescribed propylthiouracil. After administering the drug, the nurse would assess the client for which of the following?
- A. Skin rash
- B. Tachycardia
- C. Nervousness
- D. Constipation
Correct Answer: A
Rationale: The adverse reactions to propylthiouracil include paresthesias, numbness, headache, skin rash, nausea, vomiting, and agranulocytosis. The nurse need not observe for tachycardia, nervousness, and constipation as adverse reactions associated with propylthiouracil. Tachycardia, nervousness, and vomiting are the adverse reactions associated with the thyroid hormone levothyroxine sodium \left(\mathrm{T}_4\right).