A nurse is preparing to administer levothyroxine 275 mcg PO to a client. The amount available is levothyroxine 137 mcg/tablet.

How many tablets should the nurse administer? (Round to the nearest whole number. Use a leading zero if it applies.

(Do not use a trailing zero)

Choice A rationale
High fever in the early morning is not a typical finding in pulmonary tuberculosis. TB patients may experience low-grade fevers, but high fevers are less common and usually occur in the evening or at night.
Choice B rationale
Fatigue is a common symptom of pulmonary tuberculosis. TB is a chronic infectious disease that can cause prolonged periods of fatigue and weakness due to the body’s ongoing immune response to the infection.
Choice C rationale

Increased appetite is not a typical finding in pulmonary tuberculosis. TB patients often experience a loss of appetite and unintentional weight loss due to the systemic effects of the infection.
Choice D rationale
Night sweats are a classic symptom of pulmonary tuberculosis. TB patients often experience drenching night sweats as a result of the body’s immune response to the infection. This symptom, along with chronic cough and weight loss, is a key indicator of TB.

The correct answer is Choice A, Choice E

Choice A rationale: Orange juice contains approximately 496 mg of potassium per 8 oz serving, making it a high-potassium beverage. In chronic kidney disease, impaired renal excretion of potassium leads to accumulation and risk of hyperkalemia. Normal serum potassium levels range from 3.5 to 5.0 mEq/L. Elevated levels can cause cardiac arrhythmias, muscle weakness, and paralysis. Avoiding potassium-rich fluids like orange juice is essential to prevent life-threatening complications in clients with reduced glomerular filtration rates.

Choice B rationale: White rice contains approximately 26 mg of potassium per 1 cup cooked, classifying it as a low-potassium food. It is safe for clients with chronic kidney disease and often recommended due to its minimal contribution to serum potassium levels. Unlike whole grains, white rice has reduced mineral content, including potassium and phosphorus. Maintaining serum potassium within the normal range of 3.5 to 5.0 mEq/L is critical, and white rice does not pose a risk of hyperkalemia.

Choice C rationale: Corn flakes cereal contains approximately 30 to 40 mg of potassium per 1 cup serving, making it a low-potassium option suitable for renal diets. It lacks the bran and whole grain components that elevate potassium content in other cereals. In chronic kidney disease, dietary potassium restriction is necessary to prevent hyperkalemia. Corn flakes do not significantly affect serum potassium levels, which should remain between 3.5 and 5.0 mEq/L to avoid neuromuscular and cardiac disturbances.

Choice D rationale: Watermelon contains approximately 112 mg of potassium per 100 grams, which is considered low to moderate. While excessive intake could contribute to potassium load, typical servings do not pose a significant risk. In chronic kidney disease, potassium restriction targets foods exceeding 200 mg per serving. Watermelon’s potassium content is below this threshold, making it generally safe when consumed in moderation. Serum potassium should be maintained within 3.5 to 5.0 mEq/L to prevent hyperkalemia.

Choice E rationale: Bananas contain approximately 422 mg of potassium per medium fruit, placing them among the highest potassium-containing fruits. In chronic kidney disease, potassium excretion is impaired, and consuming bananas can rapidly elevate serum potassium levels. Hyperkalemia increases the risk of ventricular arrhythmias and cardiac arrest. Dietary potassium restriction is essential to maintain levels within the safe range of 3.5 to 5.0 mEq/L. Therefore, bananas should be avoided to prevent life-threatening electrolyte disturbances.