A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?

Increased energy levels

Increase in weight

Decrease in level of thyroxine (T4)

Reduction of appetite

Answer and Explanation

The Correct Answer is A

A.   Increased energy levels are a common and positive sign of therapeutic response to levothyroxine. Hypothyroidism often leads to fatigue and low energy. When levothyroxine is effective, it helps normalize thyroid hormone levels, which can lead to improved energy levels and a reduction in symptoms like fatigue and lethargy.
B.   An increase in weight is not a desired outcome of levothyroxine therapy. In hypothyroidism, weight gain is a common symptom due to slowed metabolism. Successful levothyroxine treatment should help stabilize or reduce weight if it was previously increased due to hypothyroidism. An increase in weight could indicate that the dose of levothyroxine needs adjustment or that other factors are influencing the patient's weight.
C.   A decrease in the level of thyroxine (T4) would not typically indicate a therapeutic response to levothyroxine. In fact, the goal of treatment is to normalize T4 levels, so they should be within the normal reference range. An adequate dose of levothyroxine should result in normal or near-normal T4 levels, not a decrease below the normal range.
D.   A reduction in appetite is not a common or specific indicator of a therapeutic response to levothyroxine. While levothyroxine can help normalize metabolism and other symptoms of hypothyroidism, a reduction in appetite is not a typical outcome of effective therapy. Appetite changes are not usually used to gauge the effectiveness of thyroid hormone replacement.

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Correct Answer is C

Explanation

A. Otitis media is an infection or inflammation of the middle ear. This condition primarily affects the middle ear structures and can cause conductive hearing loss, which is due to problems with sound transmission through the outer or middle ear.
B. An injury to the eardrum, such as a perforation, can lead to conductive hearing loss. This occurs because the eardrum (tympanic membrane) is crucial for transmitting sound waves from the outer ear to the middle ear. While an eardrum injury affects sound transmission, it does not directly damage the inner ear or auditory nerve, so it does not typically cause sensorineural hearing loss.
C. Exposure to loud noise is a common cause of sensorineural hearing loss. Prolonged or intense noise exposure can damage the sensory hair cells in the cochlea or the auditory nerve pathways, leading to permanent hearing loss. This type of hearing loss is due to damage in the inner ear or auditory nerve rather than the outer or middle ear structures.
D. Impacted earwax can cause conductive hearing loss by blocking sound transmission through the ear canal. This type of hearing loss is due to a blockage and is usually reversible once the wax is removed. It does not cause sensorineural hearing loss, which involves damage to the inner ear or auditory nerve.

A. The late-phase response occurs due to an influx of additional inflammatory cells B. The symptoms of the late-phase response tend to respond better to a rescue inhaler than the symptoms of the early-phase response C. The late-phase response occurs because the client did not use their rescue inhaler properly D. The late-phase response only occurs if the client continues to be exposed to their trigger after the initial attack

Correct Answer is A

Explanation

A. The late-phase response in asthma is characterized by a delayed and prolonged inflammatory reaction that can occur 4 to 6 hours after exposure to a trigger. It involves the recruitment of additional inflammatory cells, such as eosinophils and T cells, which contribute to ongoing airway inflammation, increased mucus production, and bronchoconstriction. This phase often leads to a return of symptoms or worsening of symptoms after the initial relief provided by a rescue inhaler.
B. The late-phase response does not typically respond as well to rescue inhalers (such as albuterol) as the early-phase response does. Rescue inhalers are primarily effective for the immediate, bronchospastic component of asthma (early-phase response).
C. The late-phase response occurs as part of the natural progression of asthma inflammation and is not necessarily related to improper use of a rescue inhaler. Even with proper use of a rescue inhaler, the late-phase response can still occur due to the underlying inflammatory processes.
D. The late-phase response can occur even if the trigger is no longer present. It is related to the ongoing inflammatory process rather than continued exposure to the trigger. Although continued exposure to triggers can exacerbate symptoms, the late-phase response can still occur independently of further exposure.

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A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

Correct Answer is A

Explanation

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