A client is scheduled for a procedure for treatment of hyperthyroidism. Prior to the procedure, the client will be given medications to reach an euthyroid state. What is the rationale for doing this?
Prevent possible hypothyroidism
Prevent thyroid storm
Help medications for hyperthyroidism be more effective
Minimize the risk of bleeding during the surgical procedure
The Correct Answer is B
Choice A reason: Achieving euthyroid state before hyperthyroidism procedures, like thyroidectomy, aims to normalize thyroid hormone levels, not prevent hypothyroidism. Post-procedure hypothyroidism is a separate concern managed with hormone replacement. This statement is inaccurate, as the primary goal is to stabilize metabolism, not prevent low thyroid function.
Choice B reason: Medications like methimazole or propylthiouracil are used pre-procedure to achieve euthyroid state, reducing thyroid hormone levels to prevent thyroid storm—a life-threatening hypermetabolic crisis triggered by surgery or stress. This statement is accurate, as stabilizing thyroid function minimizes perioperative complications like tachycardia or hyperthermia.
Choice C reason: Euthyroid state does not directly enhance the efficacy of anti-thyroid medications but rather prepares the patient for surgery by reducing hyperthyroid symptoms. Medications are effective independently, and this statement is inaccurate, as the rationale focuses on patient safety, not drug potentiation.
Choice D reason: While euthyroid state reduces metabolic stress, it does not primarily minimize bleeding risk. Bleeding is managed through surgical techniques and coagulation status, not thyroid hormone levels. This statement is inaccurate, as bleeding risk is not the primary concern addressed by achieving euthyroid state pre-procedure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Renal disease affects drug clearance, particularly for psychopharmacological medications like lithium, which is renally excreted. Impaired renal function can lead to toxicity, necessitating dose adjustments or alternative drugs. This statement is accurate, as renal function is critical in tailoring psychotropic therapy to ensure safety and efficacy.
Choice B reason: Many psychopharmacological drugs, like SSRIs, are metabolized by cytochrome P450 enzymes, leading to potential drug interactions. Inhibitors or inducers of these enzymes can alter medication levels, affecting efficacy or toxicity. This statement is accurate, as P450 interactions are a key consideration in psychotropic prescribing.
Choice C reason: Psychopharmacological dosing varies significantly across age groups. Elderly patients often require lower doses due to slower metabolism and higher sensitivity, while children’s doses are weight-based. This statement is inaccurate, as age-specific dosing adjustments are essential to prevent adverse effects and ensure therapeutic efficacy.
Choice D reason: Hepatic disease impacts drug metabolism, particularly for psychotropics like antipsychotics or SSRIs, which are hepatically cleared. Liver dysfunction can increase drug levels, risking toxicity, requiring dose adjustments. This statement is accurate, as hepatic function is a critical factor in psychopharmacological dosing and safety.
Correct Answer is A
Explanation
Choice A reason: Physiologic doses of glucocorticoids, like hydrocortisone, mimic normal cortisol production (20-30 mg/day) in adrenal insufficiency, restoring hypothalamic-pituitary-adrenal axis feedback. This maintains metabolism, stress response, and immune function without excess. This statement is accurate, as these doses replace deficient cortisol to stabilize endocrine function.
Choice B reason: Physiologic doses have minimal impact on fluid and electrolyte balance compared to pharmacologic doses, which cause sodium retention via mineralocorticoid effects. In adrenal insufficiency, physiologic doses normalize cortisol without significant fluid shifts. This statement is inaccurate, as electrolyte effects are secondary and less pronounced.
Choice C reason: Physiologic doses replace cortisol in adrenal insufficiency, not treat inflammation. Pharmacologic (higher) doses suppress inflammation in diseases like rheumatoid arthritis by inhibiting cytokine production. This statement is inaccurate, as physiologic doses are insufficient for anti-inflammatory effects required in such conditions.
Choice D reason: Glucocorticoids increase, not lower, blood glucose by promoting gluconeogenesis and insulin resistance. Physiologic doses maintain normal glucose metabolism in adrenal insufficiency but do not replace insulin’s role. This statement is inaccurate, as glucocorticoids oppose insulin’s glucose-lowering effects, even at physiologic levels.
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