A nurse is teaching about levothyroxine with a client who has primary hypothyroidism. Which of the following statements should the nurse use when teaching the client?

Symptoms improve immediately after starting the medication

The medication decreases the overproduction of the thyroid hormone thyroxine

Take this medication until your symptoms are gone and then discontinue

Tremors, nervousness, and insomnia may indicate your dose is too high

Answer and Explanation

The Correct Answer is D

Choice A reason: Levothyroxine takes weeks to normalize metabolism in hypothyroidism as T4 converts to T3 gradually, so immediate symptom relief isn’t accurate or expected.

Choice B reason: Levothyroxine supplements, not decreases, thyroxine in hypothyroidism. Decreasing overproduction applies to hyperthyroidism treatments like antithyroid drugs, not this condition.

Choice C reason: Hypothyroidism requires lifelong levothyroxine since the thyroid can’t produce hormone. Stopping when symptoms resolve risks recurrence, making this advice incorrect.

Choice D reason: Excess levothyroxine mimics hyperthyroidism, causing tremors, nervousness, and insomnia from overstimulated metabolism, correctly indicating a need for dose adjustment.

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Correct Answer is A

Explanation

Choice A reason: CT scan rapidly detects ischemic stroke or hemorrhage in the brain, critical for numbness, headache, and speech issues, guiding urgent treatment decisions.

Choice B reason: Hemoglobin and hematocrit assess blood count, not brain pathology like stroke, which requires imaging to identify infarction or bleeding, not anemia.

Choice C reason: MRI offers detailed stroke imaging but is slower than CT, less ideal for acute ER settings needing immediate diagnosis of neurological symptoms.

Choice D reason: Pulmonary angiography evaluates lung vessels for embolism, irrelevant to stroke symptoms (numbness, headache, speech difficulty), which localize to brain issues.

A. A client with an intestinal obstruction whose nasogastric tube has drained 150 mL in 8 hours B. A client with ascites who has a respiratory rate of 26 and oxygen saturation level of 90% C. A client with acute pancreatitis who has decreased breath sounds with increased crackles D. A client with stable esophageal varices and a blood pressure of 92/45

Correct Answer is A

Explanation

Choice A reason: 150 mL NG drainage in 8 hours is low for obstruction, suggesting stability; it’s less urgent than respiratory compromise in other clients.

Choice B reason: Respiratory rate 26 and 90% saturation indicate distress in ascites, but crackles suggest fluid overload, less acute than pancreatitis’s pulmonary risk.

Choice C reason: Decreased breath sounds and crackles in pancreatitis signal pleural effusion or ARDS, a life-threatening complication, prioritizing immediate respiratory assessment.

Choice D reason: BP 92/45 with stable varices is concerning but not acutely unstable without bleeding signs, less critical than respiratory failure in pancreatitis.

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A nurse is teaching about levothyroxine with a client who has primary hypothyroidism. Which of the following statements should the nurse use when teaching the client?

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Naxlex Comprehensive Predictor Exams

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