A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse will instruct the patient to take this medication at which time of day?

At bedtime

With the evening meal

30 minutes before breakfast and other medication

With the noon meal

Answer and Explanation

The Correct Answer is C

A. At bedtime: Thyroid replacement therapy, such as levothyroxine, should not be taken at bedtime because absorption may be reduced due to the body’s metabolism slowing down during sleep. The medication is best absorbed when taken on an empty stomach.

B. With the evening meal: Levothyroxine should not be taken with food, as certain foods (like those rich in fiber, calcium, and iron) can interfere with its absorption. It should be taken on an empty stomach.

C. 30 minutes before breakfast and other medication: Levothyroxine should be taken 30 minutes to 1 hour before breakfast with a full glass of water. This allows the medication to be absorbed properly without interference from food or other medications.

D. With the noon meal: Taking levothyroxine with meals can reduce its absorption, and the patient should avoid food for at least 30 minutes after taking the medication. Taking it before breakfast is the most effective.

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Correct Answer is B

Explanation

A. Administer intermediate-acting insulin: Intermediate-acting insulin is not used in the treatment of HHS. In HHS, the primary goal is to lower blood glucose levels gradually using short-acting insulin to prevent rapid changes in glucose and fluid shifts.

B. Infuse 0.9% Normal Saline intravenously: IV fluids are a critical part of the treatment for HHS. 0.9% Normal Saline is used to correct dehydration and restore circulatory volume, which is a major concern in HHS. The goal is to gradually rehydrate the client while simultaneously lowering blood glucose levels.

C. Monitor arterial blood gas results: While monitoring arterial blood gases (ABG) is important for assessing acid-base balance, it is not the priority intervention for HHS. The primary focus should be on correcting hyperglycemia and dehydration first.

D. Perform blood glucose checks daily: Blood glucose monitoring should be more frequent than daily in a client with HHS. It is critical to monitor blood glucose levels every hour or as frequently as needed to assess the effectiveness of interventions and guide insulin therapy.

A. "I realize I will be taking this medication for the rest of my life" B. "I will not skip doses of my medication" C. "I take my medication as soon as I awake with a cup of coffee with cream and sugar" D. "I take my medication as soon as I awake, and wait 30 minutes before I eat or drink anything" E. "Flush the toilet at least 3 times after each use"

Correct Answer is C

Explanation

A. "I realize I will be taking this medication for the rest of my life": This statement shows the patient’s understanding of the lifelong nature of treatment for hypothyroidism. It does not indicate a problem with the effectiveness of the medication.

B. "I will not skip doses of my medication": Consistency in taking levothyroxine is important for maintaining thyroid hormone levels and effective management of hypothyroidism. Skipping doses would decreaseeffectiveness

C. "I take my medication as soon as I awake with a cup of coffee with cream and sugar": Levothyroxine should be taken on an empty stomach, 30-60 minutes before eating or drinking anything except water. Taking it with coffee, cream, and sugar can interfere with the absorption of the medication, potentially reducing its effectiveness.

D. "I take my medication as soon as I awake, and wait 30 minutes before I eat or drink anything": This is the appropriate way to take levothyroxine. Waiting 30 minutes before eating or drinking other than water ensures that the medication is fully absorbed by the body.

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A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse will instruct the patient to take this medication at which time of day?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The elderly client is admitted to the intensive care department with severe Hyperglycemic-Hyperosmolar State (HHS). Which collaborative intervention should the nurse include in the plan of care?

Correct Answer is B

Explanation

A nurse is collecting a health history from a patient that is taking Levothyroxine for hypothyroidism. Over the past 12 months, the dose of the medication has been increased twice. Which of the following statements made by the patient could be the reason the medication is not effective:

Correct Answer is C

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