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?

Schedule both medications at bedtime.

Administer iodine one hour before PTU.

Give parental dose once every 24 hours.

Offer both drugs together with a meal.

Answer and Explanation

The Correct Answer is B

A) Schedule both medications at bedtime:
Administering both medications at bedtime may not be the most appropriate schedule. PTU is typically administered multiple times a day to maintain consistent therapeutic levels in the bloodstream. Additionally, administering Lugol’s solution at bedtime may not provide sufficient time for the iodine to take effect before the PTU.

B) Administer iodine one hour before PTU:
This option is correct. Lugol’s solution, a strong iodine solution, is often given before antithyroid medications such as PTU or methimazole to temporarily block thyroid hormone production. Administering iodine about one hour before PTU allows the iodine to be taken up by the thyroid gland, effectively reducing thyroid hormone synthesis before the PTU starts to inhibit the conversion of T4 to T3.

C) Give parental dose once every 24 hours:
This option does not address the timing of administration between PTU and Lugol’s solution. While it may be correct for the dosing frequency of PTU, it does not specify when to administer Lugol’s solution in relation to PTU.

D) Offer both drugs together with a meal:
Administering both drugs together with a meal may not be appropriate, especially considering that Lugol’s solution needs to be absorbed into the bloodstream to exert its effect on the thyroid gland. Administering Lugol’s solution and PTU together may not allow adequate time for the iodine to take effect before the PTU starts to inhibit thyroid hormone production.

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Correct Answer is D

Explanation

A) Keep an oral liquid or glucose source available:
While it's essential to have a readily available source of glucose in case of hypoglycemia, ensuring consistency in meal timing is more critical for managing blood sugar levels in clients receiving insulin lispro. However, having a glucose source available is still important as a precautionary measure.

B) Check blood glucose levels every six hours:
Frequent monitoring of blood glucose levels is essential in managing diabetes, but checking levels every six hours may not be necessary for all clients. The frequency of blood glucose monitoring should be individualized based on factors such as the client's overall glycemic control, insulin regimen, meal timing, and activity level.

C) Assess for hypoglycemia between meals:
While assessing for hypoglycemia is important, especially in clients receiving insulin therapy, ensuring consistent meal timing is a more proactive measure to prevent hypoglycemia. Clients should ideally consume meals or snacks containing carbohydrates around the same time they administer rapid-acting insulins like insulin lispro to prevent blood sugar fluctuations.

D) Provide meals at the same time this insulin is given:
This is the correct intervention. Insulin lispro is a rapid-acting insulin that is typically administered just before meals to control postprandial blood sugar levels effectively. Providing meals at consistent times relative to insulin administration helps synchronize the peak action of the insulin with the rise in blood glucose that occurs after eating, minimizing the risk of hypoglycemia and hyperglycemia.

Correct Answer is ["200"]

Explanation

The nurse should program the infusion pump to deliver 200 mL/hr.

Although the medication dosage is 400 mg, the infusion pump rate is determined by the total volume of the IV fluid (including the medication) and the desired infusion time.

In this case:

Total volume of IV bag (D,W): 200 mL

Infusion time: 1 hour

Since the medication is already diluted in the 200 mL bag, the entire volume needs to be delivered over the course of the hour. Therefore, the nurse should program the pump to deliver the full 200 mL of the solution at a rate of:

200 mL / 1 hour = 200 mL/hr

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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

Which intervention is most important for the nurse to implement for a client with type 2 diabetes mellitus (DM) who is receiving insulin lispro?

Correct Answer is D

Explanation

A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (D,W) 200 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.)

Correct Answer is ["200"]

Explanation

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