A nurse in a provider's office is assessing a client who has hypothyroidism and has been taking levothyroxine for 2 months.
Which of the following statements by the client indicates a therapeutic response to the medication?
"I am taking a laxative for constipation”
"I have noticed I'm not as cold as I use to be”
"I am losing weight without dieting”
"I seem to be sleeping more than usual”
The Correct Answer is B
Levothyroxine is a thyroid hormone medicine used to treat hypothyroidism (low thyroid hormone)1.
It works by replacing thyroid hormone that is normally produced by the body.
Cold intolerance is a common symptom of hypothyroidism2, so if the client reports that they are not as cold as they used to be, it indicates that the medication is working and their hormone levels are returning to a healthy range.
Choice A is wrong because constipation is a common symptom of hypothyroidism2, so taking a laxative for constipation does not indicate a therapeutic response to the medication.
Choice C is wrong because weight loss without dieting can be a side effect of taking too much levothyroxine.
Choice D is wrong because sleeping more than usual can be a symptom of hypothyroidism2, so it does not indicate a therapeutic response to the medication.
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Related Questions
Correct Answer is C
Explanation
- A. Assist the client to a left lateral position.
- This is generally used for clients at risk of aspiration, and it's not indicated based on the lithium level.
- B. Implement fluid restrictions.
- Fluid restrictions are usually implemented when there is a risk of fluid overload or hyponatremia, and not in this case. In fact, dehydration can raise lithium levels to toxic levels, so proper hydration is important.
- C. Request a dosage increase from the provider.
- While 0.6 mEq/L is within the therapeutic range, some providers may want to see a level slightly higher for maintenance. So requesting a dosage increase from the provider is the correct action.
- D. Prepare the client for hemodialysis.
- Hemodialysis is used to remove lithium from the blood in cases of severe lithium toxicity, which is indicated by levels significantly higher than 1.5 mEq/L. This is not needed when the lithium level is 0.6 mEq/L.
Correct Answer is D
Explanation
Confusion is the priority for the nurse to report to the provider because it can be a sign of a serious side effect of citalopram.

Choice A is wrong because weight loss is not mentioned as a serious side effect of citalopram.
Choice B is wrong because bruxism is not mentioned as a serious side effect of citalopram.
Choice C is wrong because insomnia is a common side effect of citalopram but not considered a serious side effect that requires immediate medical attention.
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