A client diagnosed with hypothyroidism has been taking the thyroid hormone levothyroxine for three months. Which client statement could indicate the client is receiving too much dose of the medication?

"My hands seem to shake when I write or take a fork."

"I have a bowel movement more frequently."

"I can now enjoy the winter weather."

"I have a lot of energy and now I can work almost all day."

Answer and Explanation

The Correct Answer is A

Choice A rationale: This statement could indicate that the client is receiving too much dose of the medication, which can cause hyperthyroidism. Hyperthyroidism is a condition where the thyroid gland produces too much thyroid hormone, which can speed up the body's metabolism and cause symptoms such as tremors, nervousness, weight loss, increased heart rate, and heat intolerance.

Choice B rationale: More frequent bowel movements could be a normal effect of the medication, as levothyroxine can improve constipation that is often associated with hypothyroidism.

Choice C rationale: The ability to enjoy cold weather might suggest improved tolerance to cold, which would align with normalized thyroid function.

Choice D rationale: This could be a sign of improved well-being and quality of life due to the medication, as levothyroxine can improve fatigue and depression that are often associated with hypothyroidism.

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Correct Answer is B

Explanation

Choice A rationale: Intubation and mechanical ventilation may be needed if the respiratory muscles are affected by GBS, but this is not a routine intervention at this stage.

Choice B rationale: One of the main treatments of GBS is IV immunoglobulin therapy (IVIG), which involves infusing antibodies from donated blood plasma to block the harmful immune response that damages the nerves. Sandoglobulin is one of the brand names of IVIG used for GBS. IVIG can help shorten the duration and severity of the disease, and improve the recovery rate.

Choice C rationale: Methylprednisolone is a corticosteroid that can reduce inflammation, but it is not recommended for GBS, as it may worsen the condition or increase the risk of infection.

Choice D rationale: NG feeding tube may be required if the patient has difficulty swallowing, but this is also not a standard intervention at this time.

A. TSH low,T3 & T4 elevated B. TSH elevated, T3 & T4 low C. TSH,T3 & T4 low D. TSH, T4 elevated and T3 low

Correct Answer is B

Explanation

Choice A rationale: Elevated T3 and T4 with low TSH levels are indicative of hyperthyroidism, not a side effect of radioactive iodine treatment.

Choice B rationale: One of the expected side effects of RAI treatment for hyperthyroidism is permanent hypothyroidism (or underactive thyroid, when the thyroid does not produce enough hormones). Elevated TSH levels with low T3 and T4 are indicative of hypothyroidism.

Choice C rationale: Low TSH, T3, and T4 levels are not typical outcomes of radioactive iodine treatment; typically, the treatment leads to a decrease in T3 and T4 with increased TSH levels.

Choice D rationale: Elevated TSH and low T3 is major side effect of radioactive iodine treatment for hyperthyroidism. However, it does not cause elevated T4 levels.

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A client diagnosed with hypothyroidism has been taking the thyroid hormone levothyroxine for three months. Which client statement could indicate the client is receiving too much dose of the medication?

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