A patient with a history of heart failure is regularly monitored.
Which test is regularly performed to monitor the patient?
Blood glucose levels.
Respiratory rate.
Blood pressure and heart rate.
Liver function tests.
The Correct Answer is C
Choice A rationale
While blood glucose levels are important for patients with heart failure who also have a history of diabetes, they are not a primary and direct monitoring parameter for the heart failure condition itself. Heart failure monitoring focuses on parameters that reflect the cardiac output, fluid balance, and workload on the heart.
Choice B rationale
Respiratory rate is a vital sign that is monitored in patients with heart failure. An elevated respiratory rate can be a sign of worsening heart failure, such as pulmonary edema. However, it is one of several vital signs and is typically monitored alongside other more direct indicators of cardiac function, such as blood pressure and heart rate.
Choice C rationale
Blood pressure and heart rate are two of the most critical vital signs to monitor in a patient with heart failure. Blood pressure reflects the workload on the heart, with hypotension potentially indicating cardiogenic shock and hypertension increasing cardiac afterload. Heart rate is a direct measure of cardiac function; a fast rate (tachycardia) can be a compensatory mechanism or a sign of poor cardiac output.
Choice D rationale
Liver function tests are not typically a primary monitoring parameter for heart failure itself. While severe chronic heart failure can lead to liver congestion and elevated liver enzymes, they are not the main or initial parameters used for routine monitoring of the condition's progression or stability. Routine monitoring focuses on cardiac output and fluid status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Taking the medication before bed is incorrect. Thyroid replacement hormones, such as levothyroxine, can increase metabolism and may cause symptoms of insomnia or restlessness if taken too close to bedtime. Therefore, patients are advised to take the medication in the morning to align with the body's natural circadian rhythm and to minimize sleep disturbances.
Choice B rationale
The full therapeutic effects of thyroid replacement medication are not seen after one week. It typically takes several weeks, often four to six, for the medication to reach a steady-state level in the blood and for the patient to experience the full benefits. The dosage may also be adjusted based on subsequent blood tests and symptom assessment.
Choice C rationale
Stopping the drug because of insomnia is incorrect. Insomnia can be a symptom of hyperthyroidism (too much medication) or other factors. The patient should not abruptly stop the medication but should consult their healthcare provider. The provider can then assess the patient's symptoms, check thyroid hormone levels, and adjust the dosage if necessary, rather than ceasing treatment entirely.
Choice D rationale
Taking the medication in the morning on an empty stomach is correct. Levothyroxine absorption is significantly reduced when taken with food, especially those containing calcium, iron, or dietary fiber. Taking it in the morning, at least 30-60 minutes before breakfast, ensures consistent and optimal absorption, which is critical for maintaining stable thyroid hormone levels.
Correct Answer is B
Explanation
Choice A rationale
Antithyroid drugs are used to treat hyperthyroidism, a condition characterized by excessive thyroid hormone production. Their primary mechanism is to decrease, not increase, the synthesis of thyroid hormones to bring the body's metabolic rate back to a normal range.
Choice B rationale
The primary action of antithyroid medications, such as methimazole and propylthiouracil, is to inhibit the synthesis of thyroid hormones within the thyroid gland. They achieve this by blocking key enzymatic steps involved in the production of triiodothyronine ($T_3$) and thyroxine ($T_4$).
Choice C rationale
Antithyroid drugs do not directly stimulate the release of thyroid-stimulating hormone (TSH). TSH is produced by the pituitary gland, and its release is primarily regulated by the hypothalamus's secretion of thyrotropin-releasing hormone (TRH) and a negative feedback loop from circulating thyroid hormones.
Choice D rationale
While some antithyroid treatments, like radioactive iodine, do destroy thyroid tissue, this is not the primary action of most antithyroid drugs such as methimazole and propylthiouracil. These drugs work by inhibiting hormone production, leaving the thyroid tissue itself intact.
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