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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Dronabinol is a synthetic cannabinoid that can cause psychoactive effects such as euphoria, anxiety, hallucinations, and paranoia. The nurse should monitor the client’s mental status after administering the drug and report any changes or adverse reactions.

Choice A is wrong because dronabinol does not affect the heart rate significantly.

Choice B is wrong because dronabinol may lower or raise the blood pressure depending on the dose and the individual response, but this is not a priority assessment.

Choice D is wrong because dronabinol does not affect the skin integrity directly.

A. Proton pump inhibitor. B. Histamine-2 antagonist. C. Prostaglandin. D. Antipeptic agent.

Correct Answer is A

Explanation

This is because proton pump inhibitors (PPIs) are drugs that block the enzyme that produces hydrochloric acid in the stomach, thereby reducing the amount of acid secreted into the lumen. PPIs are commonly used to treat peptic ulcer disease and gastroesophageal reflux disease.

Choice B. Histamine-2 antagonist is wrong because histamine-2 antagonists (H blockers) are drugs that block the action of histamine on the parietal cells of the stomach, thereby reducing the amount of acid secreted into the lumen.

However, PPIs are more potent and effective than H blockers in suppressing acid secretion.

Choice C. Prostaglandin is wrong because prostaglandins are substances that protect the stomach lining from the damaging effects of acid and other factors.

Prostaglandins do not directly affect the secretion of acid into the lumen, but they may increase the production of mucus and bicarbonate that buffer the acid.

Choice D. Antipeptic agent is wrong because antipeptic agents are drugs that form a protective barrier over the ulcer crater, preventing further damage from acid and pepsin.

Antipeptic agents do not affect the secretion of acid into the lumen, but they may enhance healing by creating a favorable environment for tissue repair.

Normal ranges for hydrochloric acid secretion in the stomach are 1.5 to 3.5 liters per day, with a pH of 1.5 to 3.53.

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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?

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Naxlex Comprehensive Predictor Exams

A client has responded poorly to conservative treatment for nausea and vomiting and has subsequently been prescribed dronabinol. In addition to monitoring the client’s nausea, the nurse should prioritize what assessment after administering the drug?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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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?