A nurse is caring for a client who has Graves' disease and is to start therapy with propylthiouracil. The nurse should expect which of the following outcomes?

Increased Hct

Decreased WBC count

Decreased heart rate

Increased blood pressure

Answer and Explanation

The Correct Answer is C

A. Increased Hct. Propylthiouracil (PTU) is an antithyroid medication that reduces excessive thyroid hormone production in Graves' disease. It does not directly affect hematocrit (Hct) levels. While anemia can occur in some clients with untreated hyperthyroidism, PTU itself is not expected to raise Hct.

B. Decreased WBC count. A serious adverse effect of PTU is agranulocytosis, which results in a dangerously low white blood cell (WBC) count, increasing the risk of infection. However, this is a potential complication rather than an expected therapeutic outcome. Clients on PTU require regular monitoring of WBC levels to detect early signs of agranulocytosis.

C. Decreased heart rate. Graves’ disease causes hyperthyroidism, which increases metabolism and leads to symptoms such as tachycardia. PTU works by inhibiting thyroid hormone synthesis, leading to a gradual reduction in heart rate as thyroid function normalizes. This is a desired outcome of treatment, helping to reduce cardiovascular strain associated with hyperthyroidism.

D. Increased blood pressure. Hyperthyroidism can cause elevated blood pressure due to increased cardiac output. As PTU lowers thyroid hormone levels, blood pressure is expected to decrease or stabilize rather than increase. An increase in blood pressure would be unexpected and may indicate another underlying issue requiring evaluation.

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Free Nursing Study Resources

Correct Answer is ["3"]

Explanation

Convert pounds to kilograms:

Conversion factor: 1 kg = 2.2 lb

66 lb / 2.2 lb/kg = 30 kg

Calculate the dose to administer:

Dose (mg) = Weight (kg) × Dosage (mg/kg)

=30 kg × 0.1 mg/kg

= 3 mg

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

NSAID use. The client has been taking ibuprofen (an NSAID) twice daily while also receiving prednisone (a corticosteroid) for asthma exacerbation. Both NSAIDs and corticosteroids inhibit prostaglandin production, which normally protects the stomach lining. This combination increases the risk of gastric irritation, peptic ulcers, and gastrointestinal bleeding.
Recent immunization. The client received the influenza vaccine three days ago, but this does not significantly increase the risk of infection. The flu shot contains inactivated or weakened virus, meaning it cannot cause the flu. The client’s asthma may increase their risk of complications from the flu, but the vaccine helps reduce this risk rather than increasing it.
Weight gain. The client has gained 1.36 kg (3 lb) in one week, which is likely due to fluid retention from prednisone use. While long-term corticosteroid use can lead to Cushing syndrome, this condition develops over weeks to months of high-dose steroid therapy, not within a short period. Therefore, the client is at a higher risk of peptic ulcers rather than Cushing syndrome.
Cushing syndrome. Cushing syndrome results from chronic corticosteroid use leading to fat redistribution, muscle weakness, skin thinning, and hyperglycemia. However, this client is on a short-term tapering dose of prednisone, making Cushing syndrome unlikely at this stage.
Influenza. Although the client has asthma, which increases the risk of complications from respiratory infections, there is no indication that they have developed the flu. The flu shot helps prevent infection, and there are no reports of fever, body aches, or respiratory symptoms suggestive of influenza.
Peptic ulcers. The combination of NSAIDs and corticosteroids significantly increases the risk of peptic ulcer disease by weakening the stomach lining and promoting acid production. The client should be advised to monitor for signs of gastric irritation, such as abdominal pain, black stools, or nausea, and may require a proton pump inhibitor (PPI) like omeprazole for ulcer prevention.

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A nurse is caring for a client who has Graves' disease and is to start therapy with propylthiouracil. The nurse should expect which of the following outcomes?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer morphine 0.1 mg/kg IM to a school-age child who weighs 66 lb. What is the dose that the nurse should administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["3"]

Explanation

A nurse in a primary care clinic is caring for a client. Complete the following sentence by using the lists of options. The client is most at risk for developing ....... due to their ...........

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

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