Nokea
What would the nurse expect the health care provider to order for a client with hypothyroidism?
- A. Levothyroxine sodium
- B. Methimazole
- C. Propranolol
- D. Propylthiouracil
Correct Answer: A
Rationale: Hypothyroidism is treated with thyroid replacement therapy, in the form of desiccated thyroid extract or a synthetic product, such as levothyroxine sodium (Synthroid) or liothyronine sodium (Cytomel). Methimazole and propylthiouracil are antithyroid agents used to treat hyperthyroidism. Propranolol is a beta blocker that can be used to treat hyperthyroidism.
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A client with severe hypoparathyroidism is experiencing tetany. What medication, prescribed by the physician for emergency use, will the nurse administer to correct the deficit?
- A. Sodium bicarbonate
- B. Fludrocortisone
- C. Calcium gluconate
- D. Methylprednisolone
Correct Answer: C
Rationale: Tetany and severe hypoparathyroidism are treated immediately by the administration of an IV calcium salt, such as calcium gluconate. The other medications are not effective for the treatment of calcium deficit.
A client is suspected of having acromegaly. What definitive diagnostic testing is the most reliable method of confirming acromegaly?
- A. A serum glucose level
- B. Glucose tolerance test in combination with a GH measurement
- C. Growth hormone levels
- D. Bone radiographs
Correct Answer: B
Rationale: A glucose tolerance test in combination with a GH measurement is the most reliable method of confirming acromegaly. Ingestion of a bolus of glucose should lower GH levels, but GH levels remain elevated in persons with acromegaly. Increased blood levels of IGF-1 can also indicate acromegaly in nonpregnant women, they typically have IGF-1 levels two to three times higher than normal in pregnant women. A serum glucose level is not an indicator of acromegaly. Growth hormone levels and bone radiographs may support the diagnosis but are not reliable indicators.
A client with diabetes insipidus is extremely dehydrated and is unable to take oral fluids. Fluid therapy is prescribed. Which intervention would be most important for the client?
- A. Measuring the urine output every 30 minutes
- B. Monitoring the rate of IV infusions
- C. Measuring the fluid intake
- D. Weighing the client daily
Correct Answer: A
Rationale: The nurse must measure the urine output every 30 minutes when administering prescribed fluid and drug therapy when the client is acutely ill or extremely dehydrated, fails to take oral fluids, or is beginning to receive medical treatment. Doing so ensures adequate kidney function. Although monitoring the rate of IV infusions, measuring fluid intake, and weighing the client daily are important, measuring the urine output every 30 minutes is the priority.
A client is receiving a test to determine adrenal function. What medication does the nurse administer as a screening test?
- A. Cosyntropin
- B. Sodium bicarbonate
- C. Fludrocortisone
- D. Glucagon
Correct Answer: A
Rationale: A dose of synthetic ACTH, cosyntropin, is administered intramuscularly as a screening test for adrenal function. The other medications are not screening medications to determine adrenal function.
The nurse is administering a medication to a client with hyperthyroidism to block the production of thyroid hormone. The client is not a candidate for surgical intervention at this time. What medication should the nurse administer to the client?
- A. Levothyroxine
- B. Spironolactone
- C. Propylthiouracil
- D. Propranolol
Correct Answer: C
Rationale: Antithyroid drugs, such as propylthiouracil and methimazole, are given to block the production of thyroid hormone preoperatively or for long-term treatment for clients who are not candidates for surgery or radiation treatment. Levothyroxine would increase the level of thyroid and be contraindicated in this client. Spironolactone is a diuretic and does not have the action of blocking production of thyroid hormone, and neither does propranolol, which is a beta-blocker.