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
Metoclopramide is a medication that increases muscle contractions in the upper digestive tract and speeds up the rate at which the stomach empties into the intestines. It is used to treat gastroparesis (slow stomach emptying) in people with diabetes, which can cause heartburn and stomach discomfort after meals.
Choice A is wrong because impaction is a condition where a large mass of dry, hard stool becomes stuck in the rectum and cannot be passed.
Metoclopramide does not treat impaction, but laxatives or enemas may be used instead.
Choice C is wrong because encopresis is a condition where a child over the age of 4 has involuntary bowel movements, usually due to chronic constipation.
Metoclopramide does not treat encopresis, but behavioral therapy, laxatives, or dietary changes may be used instead.
Choice D is wrong because metoclopramide is not used for clients requiring diagnostic procedures involving the stomach or intestines.
However, it may be used to prevent nausea and vomiting caused by chemotherapy or surgery.
Correct Answer is C
Explanation
The nurse should question the administration of human insulin to this client because they do not need exogenous insulin to maintain normal blood glucose levels. Human insulin is indicated for clients who have type 1 diabetes or type 2 diabetes that cannot be controlled by oral antidiabetic agents, diet, or exercise.
Choice A is wrong because a client who has been diagnosed with gestational diabetes may need human insulin to control their blood glucose levels during pregnancy, as oral antidiabetic agents are contraindicated.
Choice B is wrong because a client with type 2 diabetes, controlled with oral antidiabetic agents, who has a systemic infection may need human insulin to manage their blood glucose levels during periods of stress, as infection can increase blood glucose levels and impair the action of oral antidiabetic agents.
Choice D is wrong because a client who has been living with type 1 diabetes for 20 years needs human insulin to replace the endogenous insulin that their pancreas cannot produce.
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