A nurse is reinforcing education for the parents of a client with hypothyroidism who has been prescribed levothyroxine (Synthroid). The nurse should reinforce the ongoing need for which of the following monitoring or screenings?

Frequent assessments of blood glucose levels

Routine monitoring of thyroid-stimulating hormone (TSH) levels

Regular monitoring of blood pressure

Continuous monitoring of body temperature

Answer and Explanation

The Correct Answer is B

A. Frequent assessments of blood glucose levels. While hypothyroidism can affect metabolism, levothyroxine does not typically require frequent blood glucose monitoring unless the client has diabetes or another metabolic condition.

B. Routine monitoring of thyroid-stimulating hormone (TSH) levels. TSH is the primary indicator used to assess whether levothyroxine dosage is effective. Routine TSH monitoring ensures that thyroid hormone levels remain within the target range, preventing complications such as under-treatment (persistent hypothyroid symptoms) or over-treatment (hyperthyroid symptoms like palpitations and weight loss).

C. Regular monitoring of blood pressure. While thyroid dysfunction can affect blood pressure, routine BP monitoring is not the primary focus of hypothyroidism management unless the client has additional risk factors for hypertension.

D. Continuous monitoring of body temperature. Hypothyroidism can cause cold intolerance, but continuous body temperature monitoring is not necessary unless the client is at risk for severe hypothyroidism complications such as myxedema coma.

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Correct Answer is B

Explanation

A. The vaccine is administered subcutaneously, or just underneath the skin. The pneumococcal vaccine (PCV13) is given intramuscularly (IM), not subcutaneously. The preferred injection sites are the anterolateral thigh (for infants) or the deltoid muscle (for older children).

B. The first dose of the vaccine is administered at 2 months of age. This is correct. The pneumococcal conjugate vaccine (PCV13) is routinely given at 2, 4, 6, and 12–15 months of age to protect against Streptococcus pneumoniae, which can cause pneumonia, meningitis, and sepsis.

C. The vaccine is contraindicated in individuals who are allergic to gelatin. This is incorrect. The pneumococcal vaccine is not formulated with gelatin. Gelatin allergies are more relevant for vaccines like MMR and varicella. However, PCV13 should not be given to those with severe allergic reactions to any previous dose of the vaccine.

D. The vaccine is given in a series of six doses spread throughout the first 5 years of life. The PCV13 vaccine is given in a series of four doses, not six. While some high-risk children may require additional doses of PPSV23 (pneumococcal polysaccharide vaccine), the routine childhood schedule consists of four doses.

A. Print out a copy of the asthma action plan and thoroughly review it with the child and the school nurse prior to discharge. B. Write out a detailed schedule of the child's medications and a list of their healthcare providers addresses and phone numbers in case they should need it. C. Empower the child's parent to help manage the asthma by offering comprehensive education on the condition, treatment plan, and managing potential complications at home. D. Contact child protective services to intervene in the family since the child's parent does not seem adequately prepared to manage the client's illness at home.

Correct Answer is C

Explanation

A. Print out a copy of the asthma action plan and thoroughly review it with the child and the school nurse prior to discharge. While an asthma action plan is essential, it is not sufficient if the parent is not actively engaged. The parent also needs education and support to properly manage the child's condition at home.

B. Write out a detailed schedule of the child's medications and a list of their healthcare providers’ addresses and phone numbers in case they should need it. Providing a medication schedule is helpful, but it does not address the root issue—parental disengagement. Simply handing out information does not ensure the parent understands or feels empowered to manage the child's asthma.

C. Empower the child's parent to help manage the asthma by offering comprehensive education on the condition, treatment plan, and managing potential complications at home. Parental education and engagement are crucial for managing uncontrolled asthma. Offering clear explanations, demonstrating medication use (such as inhalers and spacers), and discussing signs of worsening asthma can help the parent feel more confident and involved in their child’s care.

D. Contact child protective services to intervene in the family since the child's parent does not seem adequately prepared to manage the client's illness at home. CPS involvement is not appropriate unless there are signs of medical neglect (e.g., refusal to seek care, persistent non-adherence). In this case, the best first step is education and support to encourage parental involvement.

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A nurse is reinforcing education for the parents of a client with hypothyroidism who has been prescribed levothyroxine (Synthroid). The nurse should reinforce the ongoing need for which of the following monitoring or screenings?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a parent about the pneumococcal vaccine. Which of the following should the nurse include?

Correct Answer is B

Explanation

Correct Answer is C

Explanation

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A home health nurse is collecting data on an adolescent who has cystic fibrosis. The child expresses concern about experiencing increasing episodes of respiratory distress and asks the nurse for insight into the possible reasons. Which of the following responses should the nurse make?

A nurse is reinforcing education for the parents of a client with hypothyroidism who has been prescribed levothyroxine (Synthroid). The nurse should reinforce the ongoing need for which of the following monitoring or screenings?