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 B

Explanation

Thyroid-stimulating hormone - Wikipedia Thyroid-stimulating hormone (TSH) is a hormone produced by the anterior pituitary gland that stimulates the thyroid gland to release its own hormones, triiodothyronine (T) and thyroxine (T).12 If the anterior pituitary gland is dysfunctional, it will not produce enough TSH, leading to low levels of T and T. This condition is called secondary or pituitary hypothyroidism.123

Choice A is wrong because tetraiodothyronine is another name for thyroxine (T), which is a hormone produced by the thyroid gland, not the anterior pituitary gland.14

Choice C is wrong because triiodothyronine (T) is also a hormone produced by the thyroid gland, not the anterior pituitary gland.14

Normal ranges for TSH are 0.4 to 4.0 mIU/L, for T are 100 to 200 ng/dL, and for T are 4.5 to 11.2 mcg/dL.1

A. Decrease in serum calcium and increase in serum phosphorous. B. Increase in serum calcium and decrease in serum phosphorous. C. Increase in serum calcium and phosphorous. D. Decrease in serum calcium and phosphorous.

Correct Answer is B

Explanation

This is because teriparatide affects calcium and phosphorus metabolism in a pattern consistent with the known actions of endogenous PTH (eg, increases serum calcium and decreases serum phosphorus)12.

Choice A is wrong because teriparatide does not decrease serum calcium, but increases it.

Choice C is wrong because teriparatide does not increase serum phosphorus, but decreases it.

Choice D is wrong because teriparatide does not decrease serum calcium, but increases it.

Normal ranges for serum calcium are 8.5 to 10.2 mg/dL and for serum phosphorus are 2.5 to 4.5 mg/dL.

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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

The nurse is working with a client who is newly diagnosed with hypothyroidism. Diagnostic testing has indicated that the client’s health problem is caused by anterior pituitary dysfunction. This client’s hypothyroidism is rooted in a deficiency of:

Correct Answer is B

Explanation

The nurse administers teriparatide and evaluates the drug as effective in achieving desired effects when what is assessed?

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?