The nurse is caring for a client with hypothyroidism who has a history of myocardial infarction and heart failure.
What thyroid replacement drug would the nurse expect to be ordered?

Levothyroxine.

Thyroid desiccated.

Methimazole.

Liothyronine.

Answer and Explanation

The Correct Answer is A

Levothyroxine is a synthetic form of thyroxine, the hormone that the thyroid gland normally produces. It is used to treat hypothyroidism by replacing the missing hormone and restoring the normal metabolism.

Some explanations for the other choices are:

• Choice B. Thyroid desiccated is a natural thyroid hormone derived from animal thyroid glands.

It contains both T4 and T3 hormones, which may cause side effects or complications in some people with hypothyroidism. It is not recommended as a first-line treatment for hypothyroidism.

• Choice C. Methimazole is an antithyroid drug that blocks the production of thyroid hormones.

It is used to treat hyperthyroidism, not hypothyroidism. Giving methimazole to someone with hypothyroidism would worsen their condition.

• Choice D. Liothyronine is a synthetic form of T3, the active thyroid hormone.

It is sometimes used in combination with levothyroxine to treat hypothyroidism, but it is not a standard treatment. It has a shorter half-life and more variable effects than levothyroxine, and it may increase the risk of cardiac arrhythmias or osteoporosis.

Normal ranges for thyroid function tests vary depending on the laboratory and the method used, but generally they are:

• TSH: 0.4 to 4.0 mIU/L

• Free T4: 0.8 to 2.0 ng/dL

• Free T3: 2.3 to 4.2 pg/mL

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Correct Answer is B

Explanation

Levothyroxine is a synthetic thyroid hormone that is used to treat hypothyroidism. It should be taken on an empty stomach, preferably in the morning, with a full glass of water to facilitate absorption and prevent choking. Taking the medication with food or other substances may interfere with its effectiveness.

Choice A is wrong because levothyroxine does not need to be taken after breakfast.

In fact, taking it after breakfast may reduce its absorption and efficacy.

Choice C is wrong because levothyroxine does not require the patient to remain in the upright position for 30 minutes after administering.

This instruction is more applicable to bisphosphonates, which are drugs used to treat osteoporosis.

Choice D is wrong because levothyroxine should not be taken at night.

Taking it at night may cause insomnia, as well as reduced absorption and efficacy.

A. Amount of fluid intake. B. Timing of medication administration. C. Previous effectiveness of laxatives. D. The amount of fiber intake.

Correct Answer is A

Explanation

The nurse should ask this question because the client is taking a chemical stimulant laxative, which can cause dehydration and electrolyte imbalance, especially in combination with medications for heart failure and osteoarthritis that may also affect fluid and electrolyte balance. The nurse should assess the client’s hydration status and risk of hypovolemia or hypotension.

Choice B. Timing of medication administration is wrong because it is not the priority question in this situation.

The nurse should ask this question later to determine if the client is taking the medications as prescribed and if there are any drug interactions or adverse effects.

Choice C. Previous effectiveness of laxatives is wrong because it is not relevant to the client’s current condition.

The nurse should ask this question later to evaluate the client’s bowel habits and history of constipation.

Choice D. The amount of fiber intake is wrong because it is not the priority question in this situation.

The nurse should ask this question later to educate the client about dietary measures to prevent constipation and promote bowel health.

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The nurse is caring for a client with hypothyroidism who has a history of myocardial infarction and heart failure. What thyroid replacement drug would the nurse expect to be ordered?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing client teaching regarding the administration of levothyroxine. What is the nurse’s priority teaching point?

Correct Answer is B

Explanation

A client taking a chemical stimulant laxative and medications for heart failure and osteoarthritis calls the clinic and reports, “I’m just not feeling right.” What is the priority question the nurse should ask this client?

Correct Answer is A

Explanation

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The nurse is caring for a client with hypothyroidism who has a history of myocardial infarction and heart failure.
What thyroid replacement drug would the nurse expect to be ordered?