A patient has received a new prescription for levothyroxine.
Which statement made by the patient indicates that the education was effective?

Avoid the use of iron supplements.

Consume foods that are high in iodine.

Take medication on an empty stomach.

Administer levothyroxine at bedtime.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Iron supplements can interfere with the absorption of levothyroxine, reducing its effectiveness. However, this doesn’t mean that iron should be completely avoided. It’s generally recommended to take iron supplements and levothyroxine at different times of the day.

Choice B rationale

While iodine is a key component of thyroid hormones, consuming foods high in iodine doesn’t necessarily improve the effectiveness of levothyroxine. In fact, excessive iodine intake can sometimes cause or worsen hypothyroidism.

Choice C rationale

Levothyroxine should be taken on an empty stomach, typically 30 minutes to an hour before breakfast. This allows for optimal absorption of the medication.

Choice D rationale

Although it’s not harmful to take levothyroxine at bedtime, studies suggest that taking it on an empty stomach in the morning may allow for better absorption.

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Correct Answer is C

Explanation

Choice A rationale

Decreasing cigarette use to a pack per day is not enough. Smoking can increase stomach acid and reduce the ability of the stomach lining to resist acid, thus aggravating peptic ulcer disease. Therefore, the patient should be advised to quit smoking entirely.

Choice B rationale

Lethargy could be a side effect of cimetidine. It’s important for the patient to notify the healthcare provider if they experience this, as it could indicate a need to adjust the medication.

Choice C rationale

Cimetidine should be taken with or immediately following meals for best absorption. If antacids are used, they should be taken at least one hour apart from cimetidine. Therefore, taking the medication an hour after antacids is incorrect and indicates the need for further instruction.

Choice D rationale

Sexual dysfunction is a rare but possible side effect of cimetidine. Patients should be advised to monitor for this and report any issues to their healthcare provider.

A. Notify the healthcare provider of the carbamazepine level. B. Administer the carbamazepine as prescribed. C. Withhold this dose of the carbamazepine. D. Assess the patient for side effects of carbamazepine.

Correct Answer is A

Explanation

The correct answer is A:

Choice A reason: Notifying the healthcare provider is crucial because the patient’s carbamazepine level is significantly above the therapeutic range, which is 4-12 mcg/mL. A level of 84 mcg/mL indicates a high risk of toxicity, and the healthcare provider must be informed to take appropriate action, which may include adjusting the dose or discontinuing the medication.

Choice B reason: Administering the carbamazepine as prescribed would not be safe without addressing the elevated drug level. Continuing to administer the medication could increase the risk of severe side effects and toxicity due to the already high serum level.

Choice C reason: Withholding the dose may be a necessary immediate action, but it does not address the need for medical intervention to manage the patient’s elevated drug level. Therefore, while withholding the dose might be part of the response, it should follow notifying the healthcare provider.

Choice D reason: Assessing the patient for side effects is important, but it is not the most immediate action required. The priority is to notify the healthcare provider because of the potential for serious toxicity given the high carbamazepine level.

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A patient has received a new prescription for levothyroxine.Which statement made by the patient indicates that the education was effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with peptic ulcer disease has been prescribed cimetidine.Which statement made by the patient indicates the need for further instruction by the nurse?

Correct Answer is C

Explanation

Before administering the evening dose of carbamazepine, the nurse notes that the patient’s morning carbamazepine level was 84 mcg/mL. What action should the nurse take?

Correct Answer is A

Explanation

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A patient has received a new prescription for levothyroxine.
Which statement made by the patient indicates that the education was effective?