A client presents at the emergency department reporting a raspy voice, cold intolerance, and fatigue. Laboratory tests indicate an elevated thyroid stimulating hormone (TSH) and low T3 and T4 levels. After the client is admitted to the telemetry unit, which intervention is most important for the nurse to implement?

Offer additional blankets and a warm drink.

Note the client's most recent hemoglobin level.

Administer prescribed dose of levothyroxine.

Assess for presence of non-pitting edema.

Answer and Explanation

The Correct Answer is C

A)   Incorrect- While providing comfort measures like blankets and warm drinks can help the client feel more comfortable, they do not address the underlying thyroid hormone imbalance.
B)   Incorrect- Hemoglobin level is not directly related to the client's symptoms or the thyroid hormone imbalance. Monitoring hemoglobin is important in assessing anemia but is not the priority in this case.
C)   Correct- The client's symptoms (raspy voice, cold intolerance, fatigue) along with an elevated TSH and low T3 and T4 levels suggest hypothyroidism. Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism. Administering the prescribed dose of levothyroxine is crucial to address the thyroid hormone imbalance and alleviate the symptoms.
D. Incorrect- Non-pitting edema is not a common symptom of hypothyroidism. The client's symptoms and lab results are more indicative of hypothyroidism, and addressing the thyroid hormone imbalance is the priority.

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Correct Answer is A

Explanation

The information that the nurse should obtain from the client first is: Reason for taking the aspirin.

It is important to first understand why the client was taking aspirin in order to determine the potential implications of switching to ibuprofen. Aspirin and ibuprofen are both nonsteroidal anti-inflammatory drugs (NSAIDs), but they have different indications and effects. Aspirin is commonly used for its antiplatelet properties to reduce the risk of heart attacks and strokes, while ibuprofen is primarily used for its analgesic and anti-inflammatory properties.

By understanding the reason for taking aspirin, the nurse can assess if the client was using it for its antiplatelet effects, which is important information to consider for the client's overall health and well-being.

Once the reason for taking aspirin is determined, the nurse can proceed to inquire about the other relevant information, such as the dosage of ibuprofen taken, presence of gastric pain, and amount of pain control. These details will help in assessing the client's current medication regimen, potential side effects or complications, and overall pain management.

A. Eat high protein foods to achieve ideal body weight. B. Report experiencing right upper quadrant discomfort. C. Use electric heating pad when pain is at its worse. D. Replace dietary table salt with salt substitutes.

Correct Answer is B

Explanation

Febuxostat is a medication used to manage hyperuricemia and prevent gout attacks. However, it has been associated with hepatotoxicity, including liver enzyme elevations and liver failure. Therefore, it is important for the nurse to instruct the client to report any signs or symptoms of liver dysfunction, such as right upper quadrant discomfort. This will allow for prompt evaluation and appropriate management if hepatotoxicity occurs.

While maintaining a healthy weight and dietary modifications may be beneficial for managing gout, specific instructions regarding protein intake should be individualized and provided by a healthcare provider or a registered dietitian.

Using an electric heating pad when pain is at its worst may provide temporary symptomatic relief for gout attacks, but it is not specific to the use of febuxostat. The focus of discharge teaching should be on medication adherence, monitoring for adverse effects, and lifestyle modifications to prevent gout attacks.

Replacing dietary table salt with salt substitutes is not a specific instruction for a client taking febuxostat. While reducing sodium intake may be recommended as part of an overall healthy diet, it is not directly related to the use of febuxostat or management of gout attacks. Dietary modifications for gout management should be individualized and based on the client's specific needs and preferences.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who reports running out of aspirin 1 week ago and taking ibuprofen as a replacement. Which information should the nurse obtain from the client first?

Correct Answer is A

Explanation

A client who has been taking allopurinol prophylactically comes into the clinic with reoccurring gout attack episodes in left ankle. The healthcare provider changes the prescription to febuxostat. Which instruction should the nurse include in the discharge teaching?

Correct Answer is B

Explanation

The nurse has completed the diet teaching of a client who is being discharged following treatment of a leg wound. A high protein diet is encouraged to promote wound healing. Which lunch choice by the client Indicates that the teaching was effective?

An older client is being admitted to a short-term rehabilitation facility after a long hospitalization. The nurse is performing a functional assessment with the client. Which action should the nurse implement?

The nurse is assigned to provide care for a client who is scheduled for a laparoscopic cholecystectomy in two hours, at 0900. What nursing action is most important?

The nurse is preparing to send a client to the cardiac catheterization lab for an angioplasty. Which client report is most important for the nurse to explore further prior to the start of the procedure?

When caring for a client with full-thickness burns to both lower extremities, which assessment finding(s) warrant immediate intervention by the nurse? (Select all that apply.)

The nurse is performing an admission assessment for a newborn who has asymmetrical buttocks. Which assessment test results should the nurse report to the healthcare provider?