A client diagnosed with hyperthyroidism will be taking propylthiouracil (PTU). The nurse provides medication instructions and determines that the client understands the information if the client states that it is most important to report which of the following symptoms to the physician?

Sore throat

Excitability

Muscle aches

Weight loss

Answer and Explanation

The Correct Answer is A

A. Sore throat: A sore throat could be a sign of agranulocytosis, a serious side effect of propylthiouracil (PTU), which can lower the white blood cell count, leading to a weakened immune system. It is essential to report this symptom to the physician immediately, as this may indicate a need for discontinuing the medication or adjusting the treatment plan.

B. Excitability: Excitability is not typically a serious side effect of PTU. In fact, hyperthyroidism itself can cause symptoms like anxiety and nervousness, but these are not as critical as other potential adverse effects like agranulocytosis.

C. Muscle aches: While muscle aches can occur in people with hyperthyroidism or as a side effect of medications, they are not as concerning as sore throat in the case of PTU therapy. Muscle aches are more common in hypothyroid conditions or as a non-specific symptom.

D. Weight loss: Weight loss can be a symptom of hyperthyroidism, but it is not as urgent as the potential for agranulocytosis and is not a reason to immediately report to the physician unless it is extreme or accompanied by other symptoms of serious complications.

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Correct Answer is A

Explanation

A. Turn the lights down and shut the client's door: Increased body temperature can be an early sign of thyroid storm. Decreasing environmental stimuli (such as light and noise) helps lower stress on the body and may prevent exacerbating the symptoms.

B. Call for an immediate electrocardiogram (ECG): While thyroid storm can cause tachycardia and arrhythmias, an elevated temperature by 1° F alone does not warrant an ECG. The priority is to manage the potential triggers for the rise in temperature first.

C. Administer a dose of acetaminophen: A mild temperature increase in Graves' disease could indicate the beginning of thyroid storm, which requires more immediate interventions like cooling measures and possibly antithyroid medications.

D. Calculate the client's apical-radial pulse deficit: Monitoring for a pulse deficit could be important if the client is experiencing arrhythmias or tachycardia, but the priority is to address the rising temperature and environmental factors, as these can escalate into a thyroid storm.

A. Give the client juice or hard candy immediately. B. Call the health care provider. C. Have the client lie down and see if symptoms subside. D. Assess the blood glucose level, and administer glucose in the most appropriate form.

Correct Answer is D

Explanation

A. Give the client juice or hard candy immediately: While giving juice or hard candy is an appropriate treatment for hypoglycemia, assessing the blood glucose level first is crucial to confirm that the symptoms are indeed due to low blood sugar.

B. Call the health care provider: While it's important to notify the healthcare provider if the situation worsens or if there's a concern about the client's safety, the first priority is to assess the blood glucose level and take immediate action to treat the hypoglycemia.

C. Have the client lie down and see if symptoms subside: Lying down does not address the underlying cause of hypoglycemia. The client may need glucose to raise their blood sugar levels, so this is not the most effective first action.

D. Assess the blood glucose level, and administer glucose in the most appropriate form: Assessing the blood glucose level will confirm whether the symptoms are indeed due to hypoglycemia, and then the nurse can proceed with administering glucose in the most appropriate form (such as oral glucose, juice, or glucose tablets).

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A client diagnosed with hyperthyroidism will be taking propylthiouracil (PTU). The nurse provides medication instructions and determines that the client understands the information if the client states that it is most important to report which of the following symptoms to the physician?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While assessing a client with Graves' disease, the nurse notes that the client's temperature has risen 1° F. Which action should the nurse take first?

Correct Answer is A

Explanation

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Correct Answer is D

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