A nurse is preparing to administer levothyroxine 50 mcg to a client. Available is levothyroxine 0.025 mg/tablet. How many tablets should the nurse administer per dose? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A. "You have already consented to this treatment, so you must continue." This response disregards the client’s autonomy. Clients have the right to withdraw consent and stop treatment at any time, even after initially agreeing to it.
B. "I will let your doctor know that you want to discontinue treatment." This response respects the client’s right to make decisions about their care and ensures that the healthcare team is informed to support the client appropriately. It demonstrates advocacy and ethical practice.
C. "You should discuss this with your family and see if they agree." While family input can be helpful, the final decision rests with the client, not their family. This response may undermine the client’s autonomy.
D. "I know this treatment is difficult for you, but you will feel better." This is a minimizing statement that may come across as dismissive. It does not acknowledge the client’s feelings or support their decision-making process.

A. Respiratory rate 10/min. This is the priority finding because it suggests respiratory depression, a serious side effect of magnesium sulfate therapy. Magnesium acts as a CNS depressant, and a respiratory rate below 12/min is a potential sign of magnesium toxicity, which can lead to respiratory arrest if not promptly addressed.
B. 2+ deep-tendon reflexes. This indicates normal neuromuscular function and is actually a reassuring finding in a client receiving magnesium sulfate. Reflexes are typically monitored to detect early signs of toxicity, and a 2+ rating means the dose is likely therapeutic.
C. 3+ pedal edema. While significant, pedal edema is a common feature of preeclampsia and not directly related to magnesium sulfate toxicity. It should be monitored but does not require immediate action compared to respiratory compromise.
D. Urinary output 35 mL/hr. This is slightly above the minimum acceptable output of 30 mL/hr, indicating the kidneys are excreting adequately. While magnesium is excreted renally and output must be monitored, this value does not indicate an acute risk.