A nurse is teaching a client who has hypothyroidism. Which of the following information should the nurse include in the teaching? (Select all that apply)

You will take medication for this condition for several months

This condition can cause you to gain weight

We will perform laboratory tests to monitor the effect of your medication

You might notice that you perspire more with this condition

You will need to eat a high-fiber diet to prevent complications of this condition

Answer and Explanation

Correct Answer : B,C,E

Choice A reason: Hypothyroidism requires lifelong levothyroxine because the thyroid gland doesn’t regain function in most cases, such as Hashimoto’s disease. Stating several months misleads the client, implying a temporary treatment, which is inaccurate. This chronic condition demands continuous hormone replacement to maintain metabolism, energy, and organ function. Temporary therapy applies to transient conditions, not primary hypothyroidism, so this statement fails to reflect the long-term nature of management needed.

Choice B reason: Hypothyroidism slows metabolism due to low thyroid hormone levels, reducing basal metabolic rate and calorie burning. This leads to weight gain as energy expenditure drops, even with unchanged diet, a common symptom. Educating clients about this helps them understand and manage expectations, linking it to the condition’s physiology. It’s a key teaching point, as weight gain often prompts diagnosis and motivates adherence to levothyroxine therapy.

Choice C reason: Laboratory tests like TSH and free T4 are essential to monitor levothyroxine’s effectiveness in hypothyroidism, ensuring the dose restores euthyroid status. These tests, typically done every 6-12 weeks initially then annually, guide adjustments to prevent under- or over-treatment. Including this in teaching empowers clients to participate in their care, understanding why follow-ups matter. It reflects standard practice for managing this endocrine disorder accurately.

Choice D reason: Increased perspiration is a hyperthyroidism symptom, where excess thyroid hormone accelerates metabolism, raising body heat. Hypothyroidism, conversely, causes cold intolerance and dry skin due to slowed metabolism, reducing sweat production. This statement contradicts hypothyroidism’s physiology, misinforming the client about expected symptoms. Correct teaching would highlight cold sensitivity instead, aligning with the condition’s impact on thermoregulation and skin.

Choice E reason: Hypothyroidism slows gastrointestinal motility due to decreased thyroid hormone, often causing constipation as a complication. A high-fiber diet increases bulk and promotes bowel movements, preventing this issue. Teaching this dietary adjustment addresses a common, manageable symptom, improving quality of life. It’s a scientifically supported recommendation, as fiber counteracts the sluggish digestion typical in hypothyroid states, making it vital education.

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Correct Answer is A

Explanation

Choice A reason: Omega-3 fish oil, rich in EPA and DHA, lowers triglycerides by reducing hepatic VLDL production and enhances LDL clearance, cutting cholesterol levels. Clinical studies show it decreases cardiovascular risk in hyperlipidemia. For a client with high cholesterol, this supplement directly targets lipid metabolism, offering a therapeutic benefit, making it the appropriate choice here.

Choice B reason: Glucosamine, derived from shellfish, supports cartilage repair in osteoarthritis by aiding glycosaminoglycan synthesis, not affecting cholesterol pathways. It lacks lipid-lowering properties, focusing on joint health instead. For a client with high cholesterol, this supplement offers no benefit to lipid profiles, rendering it irrelevant to the goal of reducing levels.

Choice C reason: Cranberry tablets inhibit bacterial adhesion in the urinary tract, preventing infections, but have no impact on cholesterol metabolism or lipid levels. Their anthocyanins benefit bladder health, not cardiovascular risk factors. In high cholesterol, this supplement doesn’t address the condition, making it an ineffective choice for this client’s needs.

Choice D reason: Ginkgo biloba enhances cerebral blood flow via vasodilation, potentially aiding memory, but it doesn’t alter cholesterol synthesis or clearance. Its antioxidants target circulation, not lipids directly. For a client with high cholesterol, this supplement lacks evidence of lowering levels, failing to meet the therapeutic aim here.

A. Blood pressure 100/70 mm Hg B. Vesicular breath sounds over the peripheral lung fields C. Bilateral coarse, crackle breath sounds D. Potassium 3.2 mEq/L (3.5 mEq/L to 5.0 mEq/L)

Correct Answer is C

Explanation

Choice A reason: Blood pressure of 100/70 mm Hg may suggest fluid overload, a component of pulmonary edema, but it’s not a specific indicator for furosemide use. This finding reflects systemic effects rather than direct lung involvement. Furosemide targets fluid in the alveoli, not just blood pressure changes. Without lung-specific signs like crackles, this alone doesn’t confirm the need for the diuretic, as hypotension could also indicate other issues unrelated to pulmonary edema’s primary pathology.

Choice B reason: Vesicular breath sounds are soft, normal sounds heard over healthy lung fields, indicating no fluid accumulation. Pulmonary edema, however, presents with abnormal sounds like crackles due to fluid in alveoli. Furosemide is prescribed to clear this fluid, so normal vesicular sounds suggest the lungs are clear, not requiring diuretic intervention. This finding contradicts the condition furosemide treats, making it an inappropriate indicator for the prescription in this context.

Choice C reason: Bilateral coarse crackles are hallmark signs of pulmonary edema, caused by fluid leaking into alveoli from increased left heart pressure. Furosemide, a loop diuretic, reduces this fluid by enhancing renal excretion, relieving lung congestion. This finding directly correlates with the drug’s purpose—removing excess fluid to improve oxygenation and reduce respiratory distress. Thus, crackles confirm the prescription’s appropriateness, targeting the core pathophysiology of pulmonary edema effectively.

Choice D reason: Potassium at 3.2 mEq/L is below normal (3.5-5.0 mEq/L), often a side effect of furosemide due to increased urinary potassium loss. However, this isn’t an indication for starting the drug; it’s a consequence to monitor post-administration. Pulmonary edema’s treatment focuses on fluid removal, not electrolyte levels initially. Low potassium might require correction, but it doesn’t justify the prescription, making this finding unrelated to furosemide’s therapeutic intent.

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A nurse is teaching a client who has hypothyroidism. Which of the following information should the nurse include in the teaching? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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A nurse is teaching a client who has hypothyroidism. Which of the following information should the nurse include in the teaching? (Select all that apply)