The healthcare provider prescribes propylthiouracil (PTU) and Lugol’s solution, a strong iodine solution, for a client with hyperthyroidism. How should the nurse schedule the administration of these medications?

Administer iodine one hour before PTU.

Schedule both medications at bedtime.

Administer both drugs together with a meal.

Give parenteral dose once every 24 hours.

Answer and Explanation

The Correct Answer is A

Choice A reason:

Administering iodine one hour before PTU is recommended because iodine can help reduce the thyroid hormone levels more effectively when given before PTU. This sequence ensures that the iodine is absorbed and utilized by the thyroid gland before PTU inhibits the synthesis of new thyroid hormones.

Choice B reason:

Scheduling both medications at bedtime is not appropriate. PTU and iodine solutions should be administered at specific times to maximize their effectiveness. PTU is typically given in divided doses throughout the day, while iodine solutions are often given before meals.

Choice C reason:

Administering both drugs together with a meal is incorrect. PTU should be taken on an empty stomach to ensure proper absorption, and iodine solutions are usually given before meals.

Choice D reason:

Giving a parenteral dose once every 24 hours is not applicable for these medications. PTU is administered orally in divided doses, and iodine solutions are also given orally.

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Correct Answer is A

Explanation

Choice A reason:

Avoiding crowds and people who are sick is crucial for clients taking methotrexate and adalimumab. Both medications suppress the immune system, increasing the risk of infections. Methotrexate is an immunosuppressant that can reduce the body’s ability to fight infections. Adalimumab, a TNF inhibitor, also lowers the immune response, making clients more susceptible to infections. Therefore, avoiding exposure to potential sources of infection is essential to prevent serious health complications.

Choice B reason:

While undergoing annual eye examinations is important for overall health, it is not directly related to the use of methotrexate and adalimumab. Methotrexate can cause ocular side effects, but these are relatively rare. Regular eye exams are a good practice but not the most critical instruction in this context.

Choice C reason:

Obtaining routine vaccinations is generally recommended for clients on immunosuppressive therapy. However, live vaccines should be avoided as they can cause infections in immunocompromised individuals. Non-live vaccines, such as the flu shot, are safe and should be administered according to the vaccination schedule. This instruction is important but secondary to avoiding exposure to infections.

Choice D reason:

Having a chest x-ray prior to the first dose of adalimumab is necessary to check for latent tuberculosis (TB). Adalimumab can reactivate latent TB, so screening is essential before starting the medication. However, this is a one-time requirement and not an ongoing instruction like avoiding crowds and sick people.

A. Explain that the client should not use the discus more than twice daily. B. Clients using the discus may experience decreased blood pressure. C. When using the discus, have the client breathe out rapidly into the mouthpiece. D. Offer the discus to the client for use during an acute asthma attack.

Correct Answer is A

Explanation

Choice A Reason:

The fluticasone propionate and salmeterol discus inhalation system is designed to be used twice daily, approximately 12 hours apart. Using it more frequently can increase the risk of side effects without providing additional benefits. The medication is intended to provide long-term control of asthma symptoms, not immediate relief during an acute attack.

Choice B Reason:

There is no significant evidence to suggest that using the fluticasone propionate and salmeterol discus inhalation system causes decreased blood pressure. The primary side effects are related to the respiratory system, such as throat irritation, hoarseness, and oral thrush. Therefore, this instruction is not relevant to the proper use of the medication.

Choice C Reason:

When using the discus, the client should breathe out gently and away from the mouthpiece before inhaling the medication. Breathing out rapidly into the mouthpiece can cause the medication to be expelled from the device, reducing its effectiveness. Proper technique involves exhaling gently, then inhaling quickly and deeply through the mouthpiece.

Choice D Reason:

The fluticasone propionate and salmeterol discus inhalation system is not intended for use during an acute asthma attack. It is a maintenance medication designed to prevent asthma symptoms over time. For acute asthma attacks, a short-acting bronchodilator, such as albuterol, should be used. Using the discus during an acute attack will not provide the rapid relief needed.

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The healthcare provider prescribes propylthiouracil (PTU) and Lugol’s solution, a strong iodine solution, for a client with hyperthyroidism. How should the nurse schedule the administration of these medications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who takes methotrexate for rheumatoid arthritis and receives a prescription for adalimumab. Which instructions should the nurse provide the client?

Correct Answer is A

Explanation

To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client’s caregivers?

Correct Answer is A

Explanation

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