Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

Intolerance to cold.

Constipation.

Restlessness.

Decreased appetite.

Answer and Explanation

The Correct Answer is C

A) Intolerance to cold: Intolerance to cold is a common symptom of hypothyroidism, not a sign of taking too much levothyroxine sodium. Therefore, this symptom would not indicate an overdose of the medication.

B) Constipation: Constipation can be a symptom of hypothyroidism, and it may improve with appropriate thyroid hormone replacement therapy. It is not typically associated with taking too much levothyroxine sodium.

C) Restlessness: This is the correct answer. Restlessness, anxiety, nervousness, or feeling jittery are symptoms of hyperthyroidism, which can occur if the client is taking too much levothyroxine sodium. If the dose of levothyroxine is too high, it can lead to hyperthyroid symptoms, even though the medication is intended to treat hypothyroidism.

D) Decreased appetite: Decreased appetite is not a typical symptom of taking too much levothyroxine sodium. In fact, weight loss is more commonly associated with hyperthyroidism, which can occur if the dose of levothyroxine is too high. However, decreased appetite alone may not specifically indicate an overdose of levothyroxine.

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Correct Answer is D

Explanation

A) Take the benzodiazepine at the same time of taking the morphine: This statement is incorrect. Benzodiazepines and morphine are both central nervous system depressants and can potentiate each other’s effects, leading to increased sedation and respiratory depression. Taking them together without proper supervision or dosage adjustment can be dangerous. Therefore, this statement indicates a misunderstanding of the medication regimen.

B) Do not drink grapefruit juice after taking morphine: While grapefruit juice can interact with certain medications by affecting their metabolism, there is no specific interaction between grapefruit juice and morphine that requires avoidance. Therefore, this statement is not directly related to the use of morphine for bone pain.

C) Watch for signs of agitation and record any insomnia: While it is important to monitor for side effects of morphine, such as agitation and insomnia, this statement does not directly relate to the management of constipation, which is a common side effect of opioid analgesics like morphine.

D) Observe bowel movement pattern and take a stool softener: This is the correct answer. Morphine is known to cause constipation as a side effect due to its action on opioid receptors in the gastrointestinal tract. Therefore, monitoring bowel movements and taking a stool softener can help prevent or alleviate constipation associated with morphine use. This statement indicates an understanding of the potential side effects of the medication and the importance of managing them appropriately.

A. Obtain another transdermal patch and position it on the client’s left upper chest. B. Withhold further doses of nitroglycerin until contacting the healthcare provider. C. Leave the patch in place and administer a PRN dose of sublingual nitroglycerin. D. Reassure the client that the patch will begin to take effect within a few minutes.

Correct Answer is C

Explanation

A) Applying another transdermal patch is not recommended without healthcare provider approval. Doubling the dose of nitroglycerin could increase the risk of hypotension and other adverse effects.

B) Withholding further doses of nitroglycerin without healthcare provider guidance may lead to inadequate control of angina symptoms. However, in this scenario, the client has already received a dose of transdermal nitroglycerin, so withholding further doses may not be appropriate if the client’s symptoms persist.

C) Leaving the patch in place and administering a sublingual dose of nitroglycerin is the correct action in this situation. Sublingual nitroglycerin provides rapid relief of angina symptoms by dilating blood vessels and improving myocardial oxygen supply. The transdermal patch may not have reached therapeutic levels yet, but the sublingual form can provide more immediate relief.

D) While it’s important to reassure the client, especially during an episode of chest pain, relying solely on the transdermal patch to take effect may not provide timely relief. Administering sublingual nitroglycerin allows for faster absorption and symptom relief.

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Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

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Naxlex Comprehensive Predictor Exams

The nurse is providing discharge instructions for a client with metastatic cancer who is proscribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

Correct Answer is D

Explanation

A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?

Correct Answer is C

Explanation

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