A 19-year-old woman has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 6 months, she calls the nurse to say that she feels better and wants to stop the medication. Which response by the nurse is correct?

"You can stop the medication if your symptoms have improved."

"You need to stay on this medication until you become pregnant."

"You need to stay on the medication for at least 1 year before a decision about stopping it can be made."

"Medication therapy for hypothyroidism is usually lifelong, and you should not stop taking the medication."

Answer and Explanation

The Correct Answer is D

A. "You can stop the medication if your symptoms have improved.": Hypothyroidism is a chronic condition, and levothyroxine is typically required lifelong. Stopping the medication without medical guidance could lead to the return of symptoms and complications.

B. "You need to stay on this medication until you become pregnant.": Stopping the medication solely when planning for pregnancy is not the correct advice. Lifelong treatment is usually necessary for hypothyroidism, regardless of pregnancy status.

C. "You need to stay on the medication for at least 1 year before a decision about stopping it can be made.": There is no set timeframe for stopping levothyroxine based on a specific duration. The decision to stop the medication should be based on medical evaluation.

D. Levothyroxine is required for lifelong management of hypothyroidism. Even if symptoms improve, the thyroid gland does not typically recover its ability to produce thyroid hormones, and stopping the medication can lead to the return of hypothyroid symptoms.

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Correct Answer is B

Explanation

A. Notify the night supervisor of the patient's deteriorating condition: While it’s important to keep supervisors informed, hypoglycemia needs to be treated immediately. The priority action is to raise the patient’s blood glucose level, not waiting to notify the supervisor.

B. The patient is experiencing symptoms of hypoglycemia, and the best initial action is to give a fast-acting carbohydrate like orange juice (about 15g of sugar). After 15 minutes, the blood sugar should be rechecked. Following the treatment with a complex carbohydrate and protein helps to maintain blood glucose levels and prevent recurrence of hypoglycemia.

C. Ambulate the patient in the hall to use up excess glucose with exercise: Exercise can lower blood glucose levels, which would be dangerous in a hypoglycemic patient. The priority is to raise the blood sugar rather than use exercise to manage glucose levels.

D. Give insulin by sliding scale based on glucometer reading: The patient’s blood sugar is low (51 mg/dL), which indicates hypoglycemia, not hyperglycemia. Insulin should not be administered in this situation, as it would further decrease the blood glucose levels.

A. Pulse oximeter reading 96% B. Serum blood glucose level of 74 mg/dL C. The client is lethargic and sleeps all the time D. Telemetry reading showing sinus bradycardia

Correct Answer is D

Explanation

A. Pulse oximeter reading 96%: A pulse oximeter reading of 96% is within the normal range (95-100%) and does not warrant immediate intervention. This indicates that the client's oxygen saturation is adequate.

B. Serum blood glucose level of 74 mg/dL: A serum blood glucose level of 74 mg/dL is within the normal range (70-100 mg/dL) for a fasting blood glucose level. This does not indicate an urgent issue, and no immediate intervention is needed for this value.

C. The client is lethargic and sleeps all the time: Lethargy and excessive sleep can be symptoms of myxedema coma, as it is a severe form of hypothyroidism. However, this is a common manifestation of the condition and does not require immediate intervention

D. Telemetry reading showing sinus bradycardia: Sinus bradycardiais common in myxedema coma due to the decreased metabolic rate associated with severe hypothyroidism. However, if the heart rate becomes too low, it can lead to serious complications like cardiac arrest.

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A 19-year-old woman has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 6 months, she calls the nurse to say that she feels better and wants to stop the medication. Which response by the nurse is correct?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The client is admitted to the intensive care department diagnosed with myxedema coma. Which assessement data warrant immediate intervention by the nurse?

Correct Answer is D

Explanation

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