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
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.
Correct Answer is A
Explanation
This is because phenothiazines are contraindicated in patients with suspected or established subcortical brain damage. Phenothiazines can cause central nervous system effects such as drowsiness, dizziness, and extrapyramidal symptoms that may worsen the condition of a client with a brain injury.
Choice B is wrong because phenothiazines are not contraindicated in clients with ischemic heart disease.
However, they should be used with caution as they can cause hypotension and cardiac arrhythmias.
Choice C is wrong because phenothiazines are not contraindicated in pediatric clients.
However, they should be used with caution as they can cause sedation, anticholinergic effects, and paradoxical excitement.
Choice D is wrong because phenothiazines are not contraindicated in clients with type 2 diabetes.
However, they should be used with caution as they can cause hyperglycemia and alter the effects of antidiabetic drugs.
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