The nurse is caring for a client newly diagnosed with hypothyroidism. The client also takes theophylline to control asthma symptoms.
What change may need to be made to the client’s theophylline dose?
Decrease theophylline dosage immediately.
Decrease theophylline dose when normal thyroid function returns.
Discontinue the client’s theophylline.
Increase theophylline dosage immediately.
The Correct Answer is B
This is because hypothyroidism can reduce the metabolism and clearance of theophylline, leading to higher serum levels and increased risk of toxicity. Therefore, when the thyroid function is restored by levothyroxine or liothyronine, the dose of theophylline may need to be lowered to avoid excessive effects.
Choice A is wrong because decreasing theophylline dosage immediately may result in suboptimal control of asthma symptoms.
The dose adjustment should be based on serum theophylline levels and clinical response.
Choice C is wrong because discontinuing the client’s theophylline may cause worsening of asthma and potentially life-threatening complications.
Theophylline is an important bronchodilator that should not be stopped abruptly without medical supervision.
Choice D is wrong because increasing theophylline dosage immediately may cause overdose and adverse effects such as nausea, vomiting, headache, tachycardia, arrhythmias, seizures and even death.
The dose of theophylline should be carefully titrated according to serum levels and clinical response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Metoclopramide is a medication that increases muscle contractions in the upper digestive tract and speeds up the rate at which the stomach empties into the intestines. It is used to treat gastroparesis (slow stomach emptying) in people with diabetes, which can cause heartburn and stomach discomfort after meals.
Choice A is wrong because impaction is a condition where a large mass of dry, hard stool becomes stuck in the rectum and cannot be passed.
Metoclopramide does not treat impaction, but laxatives or enemas may be used instead.
Choice C is wrong because encopresis is a condition where a child over the age of 4 has involuntary bowel movements, usually due to chronic constipation.
Metoclopramide does not treat encopresis, but behavioral therapy, laxatives, or dietary changes may be used instead.
Choice D is wrong because metoclopramide is not used for clients requiring diagnostic procedures involving the stomach or intestines.
However, it may be used to prevent nausea and vomiting caused by chemotherapy or surgery.
Correct Answer is D
Explanation
Glulisine is a rapid-acting insulin that has an onset of action of 2 to 5 minutes and peaks in 30 to 90 minutes, making it the fastest among the choices. Some possible explanations for the other choices are:
Choice A. Aspart is also a rapid-acting insulin, but it has a slightly longer onset of action (10 to 20 minutes) and peak time (1 to 3 hours) than glulisine.
Choice B. Lispro is another rapid-acting insulin, but it has a similar onset of action (<15 minutes) and peak time (30 to 90 minutes) as glulisine, so it is not the fastest.
Choice C. Regular is a short-acting insulin that has a much longer onset of action (30 to 60 minutes) and peak time (2 to 4 hours) than glulisine, so it is not suitable for fast therapeutic effects.
Normal ranges for blood glucose levels are 70 to 130 mg/dL before meals and less than 180 mg/dL after meals.
Insulin doses are adjusted based on blood glucose monitoring, carbohydrate intake, physical activity, and other factors.
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