The most dangerous toxicity of methimazole.
Liver toxicity
Thyrotoxicosis
PTU toxicity
Agranulocytosis
The Correct Answer is D
A. Methimazole can occasionally cause mild liver enzyme elevations, but severe hepatotoxicity is rare. Significant liver toxicity is more commonly associated with propylthiouracil (PTU) than methimazole. Therefore, while liver function should be monitored, it is not the most dangerous toxicity of methimazole.
B. Thyrotoxicosis is a state of excess thyroid hormone, often resulting from hyperthyroidism or over-replacement of thyroid hormone therapy. Methimazole is used to treat hyperthyroidism, so it does not induce thyrotoxicosis; this makes it an irrelevant option for methimazole toxicity.
C. PTU toxicity refers specifically to the adverse effects associated with propylthiouracil, including liver failure and vasculitis. While related pharmacologically, this is not directly a toxicity of methimazole, which has a different adverse effect profile.
D. The most serious and potentially life-threatening toxicity of methimazole is agranulocytosis, which is a severe reduction in neutrophils and other white blood cells. This can lead to rapidly developing infections, even from normally harmless bacteria. Patients on methimazole should be educated to report fever, sore throat, or signs of infection immediately, as early recognition and prompt discontinuation of the drug are critical. Routine blood counts may be monitored during therapy, especially during the first few months of treatment. Although rare, agranulocytosis requires urgent medical attention and sometimes hospitalization.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. While urinary retention is a common postoperative complication after spinal anesthesia, the priority in this scenario is the patient’s headache and hypotension, which may indicate post-dural puncture headache with potential spinal-induced hypotension. Catheterization may be necessary later but is not the first intervention.
B. Ephedrine is used to treat hypotension, but in this context, the headache associated with spinal anesthesiais typically relieved by positioning and supportive care. Immediate pharmacologic intervention may be required only if hypotension is severe or unresponsive.
C. Post-dural puncture headache is worse when the patient is uprightbecause cerebrospinal fluid leaks increase intracranial tension. Sitting up would worsen the headache, not relieve it.
D. The patient’s headache and hypotension are consistent with post-dural puncture headacheand spinal anesthesia–related sympathetic blockade. Lowering the head of the bed reduces gravitational stress on the CSF leak, helping relieve the headache, and improves venous return, which may help correct hypotension. This is an appropriate initial nursing action while monitoring vital signs and preparing for further interventions such as fluids, analgesics, or an anesthetist consult if symptoms persist.
Correct Answer is D
Explanation
A. A low BUN is not indicative of diabetic nephropathy. In fact, elevated BUN and creatinineare late signs of kidney dysfunction. Early diabetic nephropathy is usually detected before BUN rises.
B. Ketonuria is more indicative of diabetic ketoacidosis (DKA), which is an acute complication of uncontrolled diabetes, not a chronic kidney complication like nephropathy.
C. This value likely refers to 6.6%, which indicates blood glucose control over the last 2–3 months. Poor glycemic control increases the risk for nephropathy, but HbA1c alone does not confirm kidney damage.
D. Microalbuminuria refers to small amounts of albumin in the urineand is one of the earliest detectable signs of diabetic nephropathy. It indicates kidney damage caused by chronic hyperglycemia. Early detection allows interventions, such as strict glucose control and ACE inhibitors, to slow progression to chronic kidney disease.
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