A nurse is caring for a client who has Graves' disease and is to start therapy with propylthiouracil. The nurse should expect which of the following outcomes?

Increased Hct

Decreased WBC count

Decreased heart rate

Increased blood pressure

Answer and Explanation

The Correct Answer is C

A. Increased Hct. Propylthiouracil (PTU) is an antithyroid medication that reduces excessive thyroid hormone production in Graves' disease. It does not directly affect hematocrit (Hct) levels. While anemia can occur in some clients with untreated hyperthyroidism, PTU itself is not expected to raise Hct.

B. Decreased WBC count. A serious adverse effect of PTU is agranulocytosis, which results in a dangerously low white blood cell (WBC) count, increasing the risk of infection. However, this is a potential complication rather than an expected therapeutic outcome. Clients on PTU require regular monitoring of WBC levels to detect early signs of agranulocytosis.

C. Decreased heart rate. Graves’ disease causes hyperthyroidism, which increases metabolism and leads to symptoms such as tachycardia. PTU works by inhibiting thyroid hormone synthesis, leading to a gradual reduction in heart rate as thyroid function normalizes. This is a desired outcome of treatment, helping to reduce cardiovascular strain associated with hyperthyroidism.

D. Increased blood pressure. Hyperthyroidism can cause elevated blood pressure due to increased cardiac output. As PTU lowers thyroid hormone levels, blood pressure is expected to decrease or stabilize rather than increase. An increase in blood pressure would be unexpected and may indicate another underlying issue requiring evaluation.

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Correct Answer is ["B","C"]

Explanation

A. Breastfeeding. Ceftriaxone is generally considered safe during breastfeeding because only a small amount is excreted in breast milk. While monitoring for gastrointestinal disturbances or thrush in the infant is advised, breastfeeding is not a contraindication for ceftriaxone use.

B. Client allergy. The client has a penicillin allergy, which raises concerns about cross-reactivity with cephalosporins, including ceftriaxone. Although the cross-reactivity rate is low, clients with a history of severe allergic reactions (e.g., anaphylaxis, angioedema, or urticaria) to penicillin should avoid cephalosporins. The nurse should clarify the nature of the penicillin allergy before administering ceftriaxone.

C. Gentamycin prescription. Ceftriaxone and gentamicin are both nephrotoxic, and using them together increases the risk of kidney damage. The client should be monitored for renal function impairment, and alternative antibiotic therapy may be considered if necessary. The nurse should discuss this potential drug interaction with the provider before administration.

D. Hematocrit. The client’s hematocrit (32%) is low but does not require withholding ceftriaxone. A slightly decreased hematocrit is expected postpartum, especially in cases of infection or recent delivery. Ceftriaxone is not known to cause significant hematologic suppression that would make this a contraindication.

E. Hemoglobin. The client’s hemoglobin (9 g/dL) is lower than normal, likely due to postpartum blood loss or infection-related inflammation. However, ceftriaxone does not directly affect hemoglobin levels, so this is not a reason to withhold the medication.

A. "Do not take more than 200 milligrams of this medication within 24 hours.” B. "You can take a second dose of this medication at least 2 hours after the initial dose if the headache persists.” C. "You should discontinue this medication if pregnancy is planned or suspected.” D. "You might experience a rash on your skin while taking this medication." E. "You might experience a feeling of pressure in your chest after taking this medication." F. "This medication can cause you to feel tired." G. "This medication should start to alleviate the headache within 1 hour."

Correct Answer is ["A","B","C","E","F","G"]

Explanation

A. "Do not take more than 200 milligrams of this medication within 24 hours." This statement is correct for oral sumatriptan, which has a maximum recommended dose of 200 mg per 24 hours. Clients can take one 50 mg or 100 mg dose initially, and if the headache persists, a second dose can be taken after at least 2 hours, provided the total daily dose does not exceed 200 mg.

B. "You can take a second dose of this medication at least 2 hours after the initial dose if the headache persists." A second dose of sumatriptan can be taken at least 2 hours after the first dose if the headache has not fully resolved. However, if the headache persists after the maximum daily dose (200 mg), the client should not take additional doses and should seek medical evaluation.

C. "You should discontinue this medication if pregnancy is planned or suspected." Sumatriptan is classified as Pregnancy Category C, meaning its effects on fetal development are not well studied. Clients who are pregnant or planning to conceive should consult their healthcare provider before using this medication.

D. "You might experience a rash on your skin while taking this medication." Skin rash is not a common side effect of sumatriptan. If a rash develops, it could indicate an allergic reaction, which should be reported to a provider. However, routine monitoring for rashes is not necessary when taking sumatriptan.

E. "You might experience a feeling of pressure in your chest after taking this medication." Chest tightness or pressure is a known side effect of sumatriptan due to its vasoconstrictive effects. This sensation is usually temporary and not dangerous, but if it becomes severe or persistent, the client should seek medical attention to rule out cardiovascular complications.

F. "This medication can cause you to feel tired." Fatigue, drowsiness, and dizziness are common side effects of sumatriptan. Clients should be cautious when driving or operating machinery until they know how the medication affects them.

G. "This medication should start to alleviate the headache within 1 hour." Sumatriptan typically begins to relieve migraine symptoms within 30 to 60 minutes when taken orally. If the headache does not improve after 2 hours, a second dose may be taken, but the total daily dose should not exceed 200 mg.

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A nurse is caring for a client who has Graves' disease and is to start therapy with propylthiouracil. The nurse should expect which of the following outcomes?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who is scheduled to receive a dose of ceftriaxone The nurse has reviewed the client's electronic medical record (EMR). Which of the following findings should the nurse recommend withholding the ceftriaxone? Select all that apply.

Correct Answer is ["B","C"]

Explanation

A nurse in an outpatient clinic is caring for a client. Select the 6 statements the nurse should include when reinforcing teaching to the client about the newly prescribed medication

Correct Answer is ["A","B","C","E","F","G"]

Explanation

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