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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: In fever, pyrogens reset the hypothalamic thermoregulatory set point, causing the body to raise core temperature via shivering and vasoconstriction. Once reached, diaphoresis and flushing occur to dissipate heat, preventing overheating. This statement accurately describes the body’s response to achieving the fever’s set point in pneumonia.
Choice B reason: Exogenous pyrogens (e.g., bacterial toxins) act via endogenous pyrogens (cytokines) to reset the hypothalamic, not anterior pituitary, set point. The pituitary regulates hormones, not thermoregulation. This statement is inaccurate, as it misidentifies the anatomical site and mechanism of fever induction.
Choice C reason: Hyperthermia involves uncontrolled heat gain (e.g., heat stroke), not a regulated fever like in pneumonia. The client’s diaphoresis and flushing indicate intact heat loss mechanisms, not failure. This statement is inaccurate, as fever, not hyperthermia, drives the observed symptoms in this scenario.
Choice D reason: Endogenous pyrogens (e.g., IL-1, IL-6) stimulate prostaglandins, not leukotrienes, to reset the hypothalamic set point in fever. Leukotrienes are involved in allergic responses, not thermoregulation. This statement is inaccurate, as it misattributes the biochemical mediator of fever in pneumonia.
Correct Answer is B
Explanation
Choice A reason: Semaglutide, a GLP-1 receptor agonist, is not considered safe in pregnancy due to limited data and potential fetal risks. Animal studies suggest possible teratogenicity, and it is typically avoided in pregnant patients with type 2 diabetes, making this statement inaccurate and irrelevant to its mechanism.
Choice B reason: Semaglutide mimics GLP-1, enhancing glucose-dependent insulin secretion, suppressing glucagon release, slowing gastric emptying, and promoting satiety. These actions lower blood glucose and support weight loss in type 2 diabetes. This statement is accurate, as GLP-1-mediated insulin production is central to its mechanism of action.
Choice C reason: Semaglutide is primarily used for type 2 diabetes, not type 1, as it relies on functional beta cells to enhance insulin secretion. Type 1 diabetes involves absolute insulin deficiency, rendering GLP-1 agonists ineffective. This statement is inaccurate, as semaglutide is not indicated for type 1 diabetes.
Choice D reason: Semaglutide requires regular blood sugar monitoring, as hypoglycemia can occur, especially with concomitant insulin or sulfonylureas. Its glucose-lowering effects necessitate careful management to prevent adverse events. This statement is inaccurate, as monitoring remains critical to ensure safe and effective diabetes control.
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