A client has a history of atrial fibrillation and is taking an oral anticoagulant. The client has been newly diagnosed with hypothyroidism and placed on levothyroxine.
What assessment should the nurse prioritize?
Monitoring the client for increased bruising.
Assessing for signs and symptoms of infection.
Assessing the client’s level of consciousness.
Monitoring the client’s electrolyte levels.
The Correct Answer is A
This is because levothyroxine can increase the anticoagulant effect of oral anticoagulants and increase the risk of bleeding. The nurse should check the client’s prothrombin time and international normalized ratio (INR) regularly and report any abnormal values to the prescriber.
Choice B is wrong because hypothyroidism does not increase the risk of infection.
Choice C is wrong because hypothyroidism does not affect the level of consciousness unless it is severe and causes myxedema coma.
Choice D is wrong because hypothyroidism does not cause electrolyte imbalances.
Normal ranges for prothrombin time are 11 to 13.5 seconds and for INR are 0.8 to 1.22.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A.Isoetharine is a bronchodilator that works by relaxing muscles in the airways to improve breathing. It is not a mast cell stabilizer.
Choice B is wrong because aminophylline is a bronchodilator that relaxes the muscles in the airways and is used in the treatment of asthma and chronic obstructive pulmonary disease (COPD). It is not a mast cell stabilizer.
Choice C is wrong becauseIpratropium is an anticholinergic bronchodilator that helps to open up the airways in the lungs. It is used in the treatment of COPD and sometimes asthma, but it is not a mast cell stabilizer.
Choice D. Cromolyn is a mast cell stabilizer that helps prevent the release of substances in the body that cause inflammation and asthma symptoms. It is used for the prevention of asthma attacks and is particularly effective in managing exercise-induced asthma and allergic asthma triggers.
Correct Answer is A
Explanation
Prednisone is a glucocorticoid that suppresses the production of natural cortisol by the adrenal glands. Taking prednisone on alternate days allows the adrenal glands to recover and produce some cortisol on the days without prednisone.
Choice B is wrong because prednisone does not eliminate adverse side effects, but may cause some such as weight gain, fluid retention, increased blood pressure, increased blood glucose, and increased risk of infection.
Choice C is wrong because there is no evidence of steroid tolerance, which means that higher doses are needed to achieve the same effect.
Choice D is wrong because prednisone does not prolong therapeutic effects, but may decrease them over time due to feedback inhibition of cortisol secretion.
Normal ranges for cortisol are 6 to 23 mcg/dL in the morning and 2 to 11 mcg/dL in the afternoon.
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