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 A

Explanation

Ginseng is a herbal supplement that may have some antidiabetic effects, such as improving glucose tolerance and insulin resistance. However, ginseng may also interact with certain diabetes medications, especially insulin and sulfonylureas, and cause hypoglycemia (low blood sugar)2. Therefore, the nurse should inform the client about this potential risk and advise them to consult their doctor before taking ginseng.

Choice B is wrong because there is a reason ginseng cannot be taken by people with diabetes without medical supervision.

As explained above, ginseng may lower blood glucose levels too much and cause hypoglycemia.

Choice C is wrong because there is some research to indicate what effect ginseng will have on diabetes.

Several studies have shown that ginseng may have beneficial effects on blood glucose control, but also some adverse effects such as hypoglycemia.

Choice D is wrong because ginseng does not increase the risk for high blood

A. “Remain in the upright position for 30 minutes after taking it.”. B. “Take the medication with a full glass of water.”. C. “Take the medication before going to bed at night.”. D. “Take the medication after breakfast.”.

Correct Answer is B

Explanation

Levothyroxine is a synthetic thyroid hormone that is used to treat hypothyroidism. It should be taken on an empty stomach, preferably in the morning, with a full glass of water to facilitate absorption and prevent choking. Taking the medication with food or other substances may interfere with its effectiveness.

Choice A is wrong because levothyroxine does not need to be taken after breakfast.

In fact, taking it after breakfast may reduce its absorption and efficacy.

Choice C is wrong because levothyroxine does not require the patient to remain in the upright position for 30 minutes after administering.

This instruction is more applicable to bisphosphonates, which are drugs used to treat osteoporosis.

Choice D is wrong because levothyroxine should not be taken at night.

Taking it at night may cause insomnia, as well as reduced absorption and efficacy.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with type 2 diabetes presents at the clinic for a routine follow-up appointment. The client asks the nurse whether he or she can take the herbal supplement ginseng. What is the correct response by the nurse?

Correct Answer is A

Explanation

The nurse is providing client teaching regarding the administration of levothyroxine. What is the nurse’s priority teaching point?

Correct Answer is B

Explanation

The nurse teaches the client to best promote optimal GI function by including what in the daily routine?

The nurse is caring for a client with hypothyroidism who has a history of myocardial infarction and heart failure. What thyroid replacement drug would the nurse expect to be ordered?

The nurse should question an order for bismuth salts for a client with what condition?

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The nurse is caring for a pediatric client with a new onset of hypercalcemia. What condition would be most likely to cause this altered serum calcium level?

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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?

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?