A client with hypothyroidism was prescribed levothyroxine (Synthroid), a T4 replacement. The client was reading about hypothyroidism and asked the nurse why they are receiving only T4 replacement when hypothyroidism causes low T3 and T4 levels. What is the best response by the nurse?

T4 replacement does not require any TSH monitoring as is required with T3

Your body effectively converts T4 into T3 so replacing T3 is unnecessary

T3 and T4 cannot be administered together because they will become inactive

Drug therapy does not replace T3 because it is the inactive precursor to T4

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: Levothyroxine (T4) replacement requires TSH monitoring to ensure adequate dosing, as TSH reflects thyroid function. T3 replacement also requires monitoring, but T3 is less commonly used due to its short half-life. This statement is inaccurate, as TSH monitoring is essential for T4 therapy.

Choice B reason: The body converts levothyroxine (T4) to triiodothyronine (T3) via deiodinase enzymes in peripheral tissues, restoring both hormone levels. T3 replacement is unnecessary, as T4 provides a stable precursor for T3 production, making this statement accurate for explaining hypothyroidism treatment rationale.

Choice C reason: T3 and T4 can be administered together in specific cases (e.g., combination therapy) without becoming inactive. However, T4 alone is standard due to its longer half-life and conversion to T3. This statement is inaccurate, as it falsely claims biochemical incompatibility between the hormones.

Choice D reason: T3 is the active thyroid hormone, not an inactive precursor to T4. T4 is converted to T3, which binds receptors to regulate metabolism. This statement is inaccurate, as it reverses the roles of T3 and T4 in thyroid hormone physiology and therapy.

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Correct Answer is A

Explanation

Choice A reason: Sweating, trembling, and confusion indicate hypoglycemia in type 1 diabetes, likely from excess insulin. Administering fast-acting carbohydrates (e.g., glucose tablets, juice) rapidly raises blood glucose by providing readily absorbable sugars, reversing neuroglycopenic symptoms. This is the first action to prevent seizures or coma, ensuring immediate stabilization.

Choice B reason: Administering insulin during hypoglycemia would further lower blood glucose, exacerbating symptoms and risking severe outcomes like unconsciousness. Insulin drives glucose into cells, worsening the deficit. This action is contraindicated and dangerous, as it directly opposes the need to raise blood sugar immediately.

Choice C reason: Complex carbohydrates and proteins digest slowly, providing delayed glucose release, unsuitable for acute hypoglycemia requiring rapid correction. While appropriate for long-term glucose stability, this is not the first action, as it fails to address the urgent need for fast-acting sugars to reverse symptoms.

Choice D reason: Calling the healthcare provider delays treatment of hypoglycemia, which requires immediate carbohydrate administration to prevent neurological damage. While provider consultation may follow for insulin adjustment, it is not the first action. This choice is inappropriate, as it postpones critical intervention needed for symptom resolution.

A. Osteoporosis B. Systemic lupus erythematosus C. Osteoarthritis D. Rheumatoid arthritis

Correct Answer is A

Explanation

Choice A reason: Osteoporosis causes bone density loss, leading to fractures, not primary joint pain. Pain occurs secondary to fractures, not joint inflammation or degeneration. This condition is the least likely to cause joint pain directly, as its pathology focuses on bone fragility rather than synovial or cartilage issues.

Choice B reason: Systemic lupus erythematosus (SLE) causes joint pain due to autoimmune-mediated synovitis, affecting multiple joints symmetrically. Inflammatory cytokines drive pain and swelling, making SLE a common cause of joint pain, unlike osteoporosis, which primarily affects bone structure without direct joint involvement.

Choice C reason: Osteoarthritis causes joint pain due to cartilage degeneration and bone-on-bone friction, particularly in weight-bearing joints like knees. Mechanical stress and inflammation contribute to chronic pain, making osteoarthritis a frequent cause of joint pain, unlike osteoporosis, which lacks primary joint pathology.

Choice D reason: Rheumatoid arthritis causes significant joint pain through autoimmune synovial inflammation, leading to swelling, stiffness, and cartilage damage. This systemic condition affects multiple joints, making it a primary cause of joint pain, unlike osteoporosis, which is associated with bone loss, not joint inflammation.

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A client with hypothyroidism was prescribed levothyroxine (Synthroid), a T4 replacement. The client was reading about hypothyroidism and asked the nurse why they are receiving only T4 replacement when hypothyroidism causes low T3 and T4 levels. What is the best response by the nurse?

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Naxlex Comprehensive Predictor Exams

A client with type 1 diabetes is receiving insulin therapy. The nurse observes the patient experiencing symptoms such as sweating, trembling, and confusion. What is the nurse’s first action?

Correct Answer is A

Explanation

A client presents in the emergency department with joint pain. Which condition would be least likely to cause this symptom?

Correct Answer is A

Explanation

The client has been ordered allopurinol (Zyloprim) and is preparing for discharge. What should the nurse include in the discharge instructions?

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A client with hypothyroidism was prescribed levothyroxine (Synthroid), a T4 replacement. The client was reading about hypothyroidism and asked the nurse why they are receiving only T4 replacement when hypothyroidism causes low T3 and T4 levels. What is the best response by the nurse?