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 B

Explanation

A. This action is crucial if there is a suspicion of elder abuse, as adult protective services (APS) can investigate the situation thoroughly and take necessary measures to protect the client. However, before making such a notification, it is important to assess the immediate safety of the client and gather preliminary information.
B. This is a prudent initial action to ensure that the client is in a safe environment away from the caregiver, who may be the suspected abuser. It allows the nurse to conduct a private and thorough assessment of the client without the potential influence or intimidation from the caregiver. This step is critical for ensuring the client's safety and obtaining unbiased information.
C. While reporting to the caregiver’s employment agency may be a step in the process, it is not the immediate priority. The primary focus should be on ensuring the client’s safety and assessing the situation before contacting external agencies.
D. While it is important to gather information about how the injury occurred, the immediate priority is to ensure the client's safety and provide an opportunity for a private assessment. The presence of the caregiver during this conversation could influence the client's responses or cause additional stress.

A. Low adrenocorticotropic hormone (ACTH) and low cortisol B. Elevated adrenocorticotropic hormone (ACTH) and elevated cortisol C. Low adrenocorticotropic hormone (ACTH) and elevated cortisol D. Elevated adrenocorticotropic hormone (ACTH) and low cortisol

Correct Answer is C

Explanation

A. This would indicate adrenal insufficiency, not Cushing syndrome.
B. Elevated adrenocorticotropic hormone (ACTH) and elevated cortisol would indicate Cushing syndrome caused by pituitary adenoma, not adrenal gland hyperplasia.
C. Low adrenocorticotropic hormone (ACTH) and elevated cortisol is consistent with Cushing syndrome caused by adrenal gland hyperplasia. In this condition, the adrenal glands produce excess cortisol independently of ACTH stimulation.
D. Elevated adrenocorticotropic hormone (ACTH) and low cortisol would indicate adrenal insufficiency, not Cushing syndrome.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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