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 D

Explanation

Oxygen cannot diffuse rapidly across the membrane to tissues in the eye. Diabetic retinopathy is caused by damage to the blood vessels of the retina, which is the light-sensitive tissue at the back of the eye. This damage can reduce the oxygen supply to the retina and lead to vision problems.

Choice A is wrong because cells in the eye can reproduce normally, but they may not function properly due to high blood sugar levels or lack of oxygen.

Choice B is wrong because diabetic retinopathy does not affect the production of aqueous humor, which is the fluid that fills the front part of the eye.

However, diabetes can cause another eye condition called glaucoma, which is caused by increased pressure from too much aqueous humor.

Choice C is wrong because diabetic retinopathy does not affect the nerve innervations throughout the eye.

However, diabetes can cause another eye condition called diabetic neuropathy, which is caused by damage to the nerves that control eye movement and pupil dilation.

A. Liver failure. B. Radiation injury. C. Malignancy. D. Hypothyroidism.

Correct Answer is C

Explanation

Hypercalcemia is a condition caused by having too much calcium in the blood, which can affect the function of nerves, muscles, kidneys and heart. Hypercalcemia can occur in children due to various causes, both acquired and genetic. One of the most common causes of hypercalcemia in children is cancer, especially cancers that affect the bones or produce substances that mimic parathyroid hormone (PTH), which regulates calcium levels.

Choice A is wrong because liver failure does not directly cause hypercalcemia, although it can affect vitamin D metabolism and calcium absorption.

Choice B is wrong because radiation injury does not cause hypercalcemia, unless it damages the parathyroid glands or causes bone destruction.

Choice D is wrong because hypothyroidism does not cause hypercalcemia, although it can affect bone turnover and calcium excretion.

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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

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Correct Answer is D

Explanation

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Correct Answer is C

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?