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 {"A":{"answers":"A,B"},"B":{"answers":"A"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"B"}}

Explanation

Eczema (Atopic Dermatitis)

Discomfort level: Pain 3/10 (more likely due to itching than infection)
History of mosquito bites and prolonged scratching
No fever (Temperature 37°C/98.6°F)
Multiple scabs and lesions from scratching

Cellulitis

Redness, warmth, and swelling on the left lower leg
History of skin breakdown (scratching increases infection risk)
Lesions present (Possible infection due to prolonged scratching)

Rationale:

Eczema (Atopic Dermatitis):

Eczema is a chronic inflammatory skin condition that causes itching, dryness, and irritation, often triggered by allergens or skin trauma. The child’s history of mosquito bites and excessive scratching aligns with eczema, as scratching worsens skin irritation and can lead to scabbed lesions. The absence of fever and a mild pain level (3/10) suggest this is primarily an inflammatory response rather than an infection.

Cellulitis:

Cellulitis is a bacterial skin infection that develops when bacteria enter through a break in the skin, often causing redness, warmth, swelling, and pain. The redness, warmth, and swelling on the left lower leg indicate possible early cellulitis, likely caused by bacteria introduced through scratching. However, the absence of fever and only mild pain suggest it may not be a severe infection yet.

A. Weight gain B. Irritability C. Osteoporosis D. Hypertension E. Nausea

Correct Answer is ["A","B"]

Explanation

A. Weight gain. Corticosteroids cause fluid retention and increased appetite, leading to significant weight gain. In a 6-year-old, this can affect self-esteem and social interactions, potentially leading to body image concerns and difficulty fitting in with peers.

B. Irritability. Mood changes, including irritability, anxiety, and mood swings, are common side effects of corticosteroids. These emotional changes can impact relationships with family and friends, affecting the child's psychosocial well-being.

C. Osteoporosis. While long-term corticosteroid use can lead to osteoporosis, it is primarily a physical concern rather than a psychosocial one. Bone health issues typically become more evident later in life rather than in early childhood.

D. Hypertension. Elevated blood pressure is a physiological side effect of corticosteroids but does not directly impact the child’s psychosocial development. It is more of a medical concern requiring monitoring rather than a factor affecting social interactions.

E. Nausea. Although nausea can cause discomfort, it does not have a significant impact on the child's psychosocial development compared to mood changes and body image issues caused by corticosteroid therapy.

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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 caring for a 10-year-old client in a pediatric clinic. Exhibits For each potential provider's prescription, click to specify if the assessment findings are consistent with Eczema or Cellulitis. Each finding may support more than 1 disease process.

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"B"}}

Explanation

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Correct Answer is ["A","B"]

Explanation

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