A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?

Increased energy levels

Increase in weight

Decrease in level of thyroxine (T4)

Reduction of appetite

Answer and Explanation

The Correct Answer is A

A.   Increased energy levels are a common and positive sign of therapeutic response to levothyroxine. Hypothyroidism often leads to fatigue and low energy. When levothyroxine is effective, it helps normalize thyroid hormone levels, which can lead to improved energy levels and a reduction in symptoms like fatigue and lethargy.
B.   An increase in weight is not a desired outcome of levothyroxine therapy. In hypothyroidism, weight gain is a common symptom due to slowed metabolism. Successful levothyroxine treatment should help stabilize or reduce weight if it was previously increased due to hypothyroidism. An increase in weight could indicate that the dose of levothyroxine needs adjustment or that other factors are influencing the patient's weight.
C.   A decrease in the level of thyroxine (T4) would not typically indicate a therapeutic response to levothyroxine. In fact, the goal of treatment is to normalize T4 levels, so they should be within the normal reference range. An adequate dose of levothyroxine should result in normal or near-normal T4 levels, not a decrease below the normal range.
D.   A reduction in appetite is not a common or specific indicator of a therapeutic response to levothyroxine. While levothyroxine can help normalize metabolism and other symptoms of hypothyroidism, a reduction in appetite is not a typical outcome of effective therapy. Appetite changes are not usually used to gauge the effectiveness of thyroid hormone replacement.

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Correct Answer is D

Explanation

A. Cool, clammy skin can be a sign of a myocardial infarction. It occurs due to the body's stress response during an MI, leading to decreased perfusion and sweating. This symptom is consistent with the autonomic response to a heart attack.
B. Chest pain radiating into the back, jaw, or arms is a classic symptom of myocardial infarction. This radiation of pain is due to the way pain signals are transmitted and referred from the heart to other parts of the body. It is a common and significant symptom of MI.

C. Nausea and vomiting can occur during a myocardial infarction, particularly in older adults. These symptoms are related to the autonomic nervous system's response to the stress of an MI and can sometimes be the presenting symptoms, especially in women and older adults.
D. Peripheral edema is generally not a direct symptom of myocardial infarction. It is more commonly associated with chronic heart failure or other conditions leading to fluid overload. While MI can lead to heart failure over time, peripheral edema itself is not a typical acute symptom of an MI.

A. Prednisone B. Etanercept C. Ibuprofen D. Hydroxychloroquine

Correct Answer is C

Explanation

A. Prednisone is a corticosteroid used to reduce inflammation and suppress the immune system. While effective for reducing inflammation and pain, corticosteroids are generally not the first-line treatment for osteoarthritis. They are more commonly used for inflammatory arthritis conditions like rheumatoid arthritis.
B. Etanercept is a biologic agent used to treat autoimmune conditions like rheumatoid arthritis and psoriatic arthritis by targeting tumor necrosis factor-alpha (TNF-alpha) to reduce inflammation. It is not indicated for osteoarthritis, which is a non-inflammatory degenerative joint disease rather than an autoimmune inflammatory disease.
C. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to manage pain and inflammation associated with osteoarthritis. NSAIDs like ibuprofen are often the first-line treatment for osteoarthritis because they help reduce pain and inflammation, improve function, and enhance the quality of life for patients. Ibuprofen is a suitable and preferred option for managing symptoms of osteoarthritis.
D. Hydroxychloroquine is an antimalarial drug that is also used to treat autoimmune diseases such as rheumatoid arthritis and lupus. It works by modulating the immune system and reducing inflammation. However, it is not typically used for osteoarthritis, which is not an autoimmune condition.

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A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?

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