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 B
Explanation
This is because hypothyroidism can reduce the metabolism and clearance of theophylline, leading to higher serum levels and increased risk of toxicity. Therefore, when the thyroid function is restored by levothyroxine or liothyronine, the dose of theophylline may need to be lowered to avoid excessive effects.
Choice A is wrong because decreasing theophylline dosage immediately may result in suboptimal control of asthma symptoms.
The dose adjustment should be based on serum theophylline levels and clinical response.
Choice C is wrong because discontinuing the client’s theophylline may cause worsening of asthma and potentially life-threatening complications.
Theophylline is an important bronchodilator that should not be stopped abruptly without medical supervision.
Choice D is wrong because increasing theophylline dosage immediately may cause overdose and adverse effects such as nausea, vomiting, headache, tachycardia, arrhythmias, seizures and even death.
The dose of theophylline should be carefully titrated according to serum levels and clinical response.
Correct Answer is A
Explanation
Diaphoresis means excessive sweating, which is one of the symptoms of hypoglycemia. Hypoglycemia occurs when the blood sugar level is lower than the normal range, which can cause dizziness, confusion, weakness, hunger, and other signs.
Choice B is wrong because flushing of the face is not a symptom of hypoglycemia.
Flushing can be caused by other conditions, such as fever, allergic reactions, or rosacea.
Choice C is wrong because fruity breath is a symptom of hyperglycemia, not hypoglycemia.
Hyperglycemia means high blood sugar level, which can cause the body to produce ketones that give the breath a fruity odor.
Choice D is wrong because unpredictable behaviors are not a specific symptom of hypoglycemia.
However, hypoglycemia can cause confusion, irritability, or anxiety, which may affect the behavior of some people.
The normal range of blood sugar level for most people is between 70 and 130 mg/dL (3.9 and 7.2 mmol/L) before meals and less than 180 mg/dL (10 mmol/L) after meals.
However, this may vary depending on the individual and the type of diabetes.
It is important to monitor the blood sugar level regularly and treat hypoglycemia promptly by eating or drinking a simple sugar source.
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