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

Guaifenesin is an expectorant that helps thin and loosen mucus in the lungs, making it easier to cough up the sputum. Some possible explanations for the other choices are:

Choice A. Benzonatate is wrong because benzonatate is an antitussive that suppresses the cough reflex by numbing the throat and lungs.

It does not help with sputum production or clearance.

Choice B. Dextromethorphan is wrong because dextromethorphan is also an antitussive that acts on the brain to reduce the urge to cough.

It does not affect the mucus or bronchial secretions.

Choice C. Hydrocodone is wrong because hydrocodone is a narcotic antitussive that works by binding to opioid receptors in the brain and spinal cord, blocking pain signals and decreasing cough.

It can cause sedation, respiratory depression, and dependence, and is not indicated for bronchitis.

Normal ranges for sputum production vary depending on the individual and the cause of the cough, but generally range from 10 to 100 mL per day.

Excessive or abnormal sputum may indicate an infection, inflammation, or obstruction of the airways.

A. St. John’s wort. B. Alcohol. C. Calcium channel blockers. D. Selective serotonin reuptake inhibitors (SSRIs).

Correct Answer is B

Explanation

The nurse should caution the student to avoid using alcohol with trimethobenzamide because this combination can cause side effects such as drowsiness, dizziness, and impaired reactions. Alcohol can also worsen the symptoms of nausea and vomiting.

Choice A is wrong because St.

John’s wort is a herbal supplement that is used to treat depression and anxiety.

It does not interact with trimethobenzamide.

Choice C is wrong because calcium channel blockers are a class of medications that are used to treat high blood pressure and heart problems.

They do not interact with trimethobenzamide.

Choice D is wrong because selective serotonin reuptake inhibitors (SSRIs) are a class of medications that are used to treat depression and anxiety.

They do not interact with trimethobenzamide.

Trimethobenzamide is an antihistamine that works by blocking the D receptor in the brain and suppressing the chemoreceptor trigger zone that causes nausea and vomiting.

It is available as an oral capsule or an intramuscular injection.

It can cause side effects such as skin rash, tremors, parkinsonism, and jaundice.

It should not be used in children or people with liver or kidney disease.

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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 presents at the clinic with a dry nonproductive cough. The client is diagnosed with bronchitis, and it has been determined that assistance is needed in thinning the sputum so the cough can become productive. What does the nurse expect the provider will prescribe?

Correct Answer is D

Explanation

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Correct Answer is B

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?

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?