A client has a history of atrial fibrillation and is taking an oral anticoagulant. The client has been newly diagnosed with hypothyroidism and placed on levothyroxine.
What assessment should the nurse prioritize?
Monitoring the client for increased bruising.
Assessing for signs and symptoms of infection.
Assessing the client’s level of consciousness.
Monitoring the client’s electrolyte levels.
The Correct Answer is A
This is because levothyroxine can increase the anticoagulant effect of oral anticoagulants and increase the risk of bleeding. The nurse should check the client’s prothrombin time and international normalized ratio (INR) regularly and report any abnormal values to the prescriber.
Choice B is wrong because hypothyroidism does not increase the risk of infection.
Choice C is wrong because hypothyroidism does not affect the level of consciousness unless it is severe and causes myxedema coma.
Choice D is wrong because hypothyroidism does not cause electrolyte imbalances.
Normal ranges for prothrombin time are 11 to 13.5 seconds and for INR are 0.8 to 1.22.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This is because antiemetics should be given to prevent motion sickness rather than after nausea or vomiting develop. Taking the medication 30 minutes before departing allows enough time for the drug to be absorbed and reach its peak effect.
Choice A is wrong because avoiding eating or drinking for 6 hours before the trip may cause dehydration and low blood sugar, which can worsen nausea and vomiting.
It is better to eat a light meal or snack before the trip and avoid spicy, greasy, or acidic foods.
Choice C is wrong because taking two doses if relief is not achieved may cause overdose and adverse effects.
Antiemetics should be taken as prescribed and not exceeded without consulting a doctor.
Choice D is wrong because increasing fluid intake to prevent urinary retention is not relevant for motion sickness.
Urinary retention is a possible side effect of some antiemetics, such as anticholinergics, but it is not a common problem for most people.
Fluid intake should be moderate and not excessive to avoid stomach distension.
Correct Answer is C
Explanation
Propylthiouracil (PTU) is an antithyroid drug that blocks the synthesis of thyroid hormones by interfering with the oxidation of iodine and the coupling of iodotyrosines.
This reduces the levels of triiodothyronine (T) and thyroxine (T) in the blood and relieves the symptoms of hyperthyroidism.
Choice A is wrong because PTU does not destroy any part of the thyroid gland.
It only inhibits the production of thyroid hormones within the gland.
Choice B is wrong because PTU does not suppress the anterior pituitary gland’s secretion of thyroid-stimulating hormone (TSH).
TSH is a hormone that stimulates the thyroid gland to produce thyroid hormones.
PTU does not affect the feedback loop between the hypothalamus, pituitary, and thyroid glands.
Choice D is wrong because PTU does not suppress the hypothalamus’s production of thyrotropin-releasing hormone (TRH).
TRH is a hormone that stimulates the pituitary gland to secrete TSH.
PTU does not affect the feedback loop between the hypothalamus, pituitary, and thyroid glands.
Normal ranges for T are 80 to 220 ng/dL, for T are 4.5 to 11.2 mcg/dL, and for TSH are 0.4 to 4.0 mIU/L.
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