The nurse is caring for a patient who has a new prescription for levothyroxine.
The nurse will include in the teaching plan that levothyroxine decreases the action of which medication?

Metformin.

Warfarin.

Sertraline.

Methylprednisolone.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Metformin is used to manage diabetes, primarily by improving insulin sensitivity and reducing glucose production in the liver. Levothyroxine, used to treat hypothyroidism, does not significantly impact the action of metformin. The two medications do not have a direct interaction that decreases metformin's efficacy.

Choice B rationale

Levothyroxine can decrease the action of warfarin by increasing the metabolism of clotting factors in the liver, which may reduce the anticoagulant effect of warfarin. This interaction necessitates closer monitoring of INR (International Normalized Ratio) levels and potential dose adjustments of warfarin to maintain its therapeutic effect.

Choice C rationale

Sertraline is an antidepressant that belongs to the selective serotonin reuptake inhibitor (SSRI) class. While it can interact with other medications, levothyroxine does not significantly decrease its action. Therefore, no major adjustments are needed when both drugs are prescribed together.

Choice D rationale

Methylprednisolone, a corticosteroid, is used for its anti-inflammatory and immunosuppressant properties. Levothyroxine does not decrease the action of methylprednisolone. These medications do not have a significant pharmacological interaction that would require adjusting methylprednisolone’s dosage.

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Correct Answer is C

Explanation

The correct answer is Choice C.

Choice A rationale

Facial swelling and jugular vein distension (JVD) are indicative of superior vena cava syndrome (SVCS), not tumor lysis syndrome (TLS). SVCS occurs when the superior vena cava, which carries blood from the head, neck, upper chest, and arms to the heart, is obstructed. This can lead to facial swelling, cyanosis, and distended neck veins due to increased venous pressure.

Choice B rationale

Muscle weakness, confusion, polyuria, and polydipsia are symptoms of hypercalcemia. Hypercalcemia is characterized by elevated levels of calcium in the blood, which can cause neuromuscular and cognitive symptoms, excessive urination, and increased thirst.

Choice C rationale

Tumor lysis syndrome (TLS) is characterized by rapid destruction of tumor cells, leading to elevated levels of uric acid, potassium, and phosphate. Symptoms include flank pain due to uric acid crystallization in the kidneys, and abnormal heart rhythms due to hyperkalemia.

Choice D rationale

Elevated liver function tests, jaundice, and blistering skin rash are symptoms of liver toxicity or hepatic dysfunction, possibly due to drug-induced liver injury. These symptoms are not related to tumor lysis syndrome (TLS).

A. Notify the provider that the patient is exhibiting signs of hypercalcemia and draw blood to obtain ionized calcium level. B. Notify the provider that the patient is exhibiting signs of tumor lysis syndrome and draw blood to obtain uric acid level. C. Notify the provider that the patient is exhibiting signs of infection and request an order for blood cultures. D. Notify the provider that the patient is exhibiting signs of bleeding and request an order for a packed red blood cell transfusion.

Correct Answer is A

Explanation

Choice A rationale

Hypercalcemia is common in patients with bone metastasis. Symptoms include weakness, fatigue, confusion, and excessive thirst. The nurse should notify the provider and draw blood to obtain the ionized calcium level for proper diagnosis and treatment.

Choice B rationale

Tumor lysis syndrome typically occurs in patients with rapidly proliferating tumors undergoing treatment, leading to the release of intracellular contents. Symptoms include hyperuricemia, not excessive thirst. This choice does not match the patient's presentation.

Choice C rationale

While infection can cause weakness and confusion, it does not typically cause extreme thirst. The patient's symptoms are more indicative of hypercalcemia, making this choice less relevant.

Choice D rationale

Bleeding can cause weakness and confusion due to anemia, but it does not cause extreme thirst. The symptoms of the patient are more aligned with hypercalcemia than bleeding.

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The nurse is caring for a patient who has a new prescription for levothyroxine.The nurse will include in the teaching plan that levothyroxine decreases the action of which medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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The nurse is caring for a patient who has a new prescription for levothyroxine.
The nurse will include in the teaching plan that levothyroxine decreases the action of which medication?