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 C
Explanation
A. A 12-year-old child with obsessive-compulsive disorder is not typically a candidate for misoprostol, as it is not indicated for this condition.
B. A 46-year-old trial lawyer with hypertension might need caution when using misoprostol, as it can cause diarrhea and abdominal pain, which could be problematic.
C. An 83-year-old client with rheumatoid arthritis is the best candidate for misoprostol, particularly if they are taking nonsteroidal anti-inflammatory drugs (NSAIDs) for their condition. Misoprostol is often used to prevent NSAID-induced gastric ulcers in patients at high risk, such as elderly individuals or those with a history of ulcers.
D. A 22-year-old pregnant client should not be given misoprostol unless it is used for specific obstetric indications under close supervision. Misoprostol can induce uterine contractions and is contraindicated in pregnancy unless used for medical reasons like inducing labor or treating postpartum hemorrhage.
Correct Answer is C
Explanation
The nurse should question the administration of human insulin to this client because they do not need exogenous insulin to maintain normal blood glucose levels. Human insulin is indicated for clients who have type 1 diabetes or type 2 diabetes that cannot be controlled by oral antidiabetic agents, diet, or exercise.
Choice A is wrong because a client who has been diagnosed with gestational diabetes may need human insulin to control their blood glucose levels during pregnancy, as oral antidiabetic agents are contraindicated.
Choice B is wrong because a client with type 2 diabetes, controlled with oral antidiabetic agents, who has a systemic infection may need human insulin to manage their blood glucose levels during periods of stress, as infection can increase blood glucose levels and impair the action of oral antidiabetic agents.
Choice D is wrong because a client who has been living with type 1 diabetes for 20 years needs human insulin to replace the endogenous insulin that their pancreas cannot produce.
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