A nurse is caring for a client with hypothyroidism who is starting levothyroxine.
What should the nurse understand about the initial start of levothyroxine for hypothyroidism?

Choice A rationale

Allowing a child with hemophilia to participate in any sport without restriction significantly increases the risk of severe bleeding episodes, especially in contact sports. Hemophilia involves a deficiency in clotting factors, making even minor trauma potentially life-threatening due to uncontrolled hemorrhage, which can lead to joint damage, organ damage, or intracranial bleeding, severely impacting their long-term health and mobility.

Choice B rationale

Encouraging participation in age-appropriate, low-impact activities like cycling with proper protective gear promotes physical activity and psychosocial development. This approach minimizes the risk of traumatic injuries that could trigger bleeding while still fostering a sense of normalcy and social integration. Regular physical activity also helps maintain muscle strength and joint integrity, which can be beneficial in managing hemophilia.

Choice C rationale

Completely restricting a child with hemophilia from all sports or physical activity can negatively impact their physical and psychological well-being. While safety is paramount, total avoidance can lead to muscle atrophy, obesity, and social isolation. A balanced approach that allows for modified, safe activities is crucial for holistic development, promoting self-esteem and peer interaction.

Choice D rationale

Discouraging activities like bike riding or skateboarding even with classmates, implies excessive restriction. While high-risk activities should be avoided, moderate-risk activities can be managed with appropriate precautions, such as helmets and padding. This extreme limitation can hinder the child's physical development, social integration, and mental health, leading to feelings of difference and isolation from peers.

Choice A rationale

Scabies typically presents as intensely pruritic papules, vesicles, and burrows, rather than non-pruritic blisters. The characteristic itch is often worse at night and is caused by the mite’s burrowing and excretions under the skin, leading to a hypersensitivity reaction, and does not typically resolve with crusting within 7 days.

Choice B rationale

Prophylactic treatment for household members and close contacts is highly recommended to prevent re-infestation and control the spread of scabies. Even asymptomatic contacts can harbor mites and transmit the infection, making simultaneous treatment crucial for effective eradication and breaking the transmission cycle.

Choice C rationale

Scabies eggs typically hatch within 3 to 4 days after being laid by the female mite in the stratum corneum. The entire life cycle, from egg to adult, takes approximately 10 to 17 days. A 30-day incubation period for eggs is inaccurate and significantly longer than the actual biological process.

Choice D rationale

Scabies is caused by the microscopic mite *Sarcoptes scabiei* var. *hominis*, which burrows into the superficial layers of the epidermis. The female mite deposits eggs and feces within these burrows, leading to an intensely itchy hypersensitivity reaction in the host. This direct infestation causes the characteristic symptoms.