The nurse is teaching a client who has been prescribed propylthiouracil (PTU) for hyperthyroidism. Which statement by the client indicates an understanding of the teaching? (Select 3 options)

“I will need to have my white blood cell count checked regularly while taking this medication."

“This medication helps by blocking the production of thyroid hormones."

“I need to check my blood glucose levels dally.”

"Once my symptoms improve, I can stop taking the medication without telling my provider."

“If I feel extremely tired or notice yellowing of my skin, I should report it immediately."

Answer and Explanation

Correct Answer : A,B,E

A. “I will need to have my white blood cell count checked regularly while taking this medication.": Propylthiouracil (PTU) can cause agranulocytosis, a condition that reduces the number of white blood cells, increasing the risk of infection. Regular monitoring of the white blood cell count is important to detect this potential side effect early.

B. “This medication helps by blocking the production of thyroid hormones.": Propylthiouracil (PTU) works by inhibiting the production of thyroid hormones in the thyroid gland, which helps in the treatment of hyperthyroidism.

C. “I need to check my blood glucose levels daily.”: PTU does not directly affect blood glucose levels. Monitoring blood glucose is recommended for patients on medications that affect insulin or blood sugar regulation, such as corticosteroids or some antipsychotic medications, not PTU.

D. “Once my symptoms improve, I can stop taking the medication without telling my provider.”: Clients should continue taking PTU as prescribed, even if symptoms improve. Discontinuing the medication without consulting the provider could lead to relapse or worsening of hyperthyroidism.

E. “If I feel extremely tired or notice yellowing of my skin, I should report it immediately.": Fatigue and yellowing of the skin (jaundice) can be signs of liver toxicity, a serious side effect of PTU. Any such symptoms should be reported immediately to prevent further complications.

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Correct Answer is A

Explanation

A. The patient is demonstrating improved control of hyperglycemia over the last several months: The HbA1c level reflects the average blood glucose level over the past 2-3 months. A drop from 9.4% to 5.4% indicates a significant improvement in blood sugar control.

B. The patient has less need for insulin: A drop in HbA1c indicates improved blood sugar control, but it doesn't directly indicate that the patient has reduced insulin needs. Insulin requirements can still vary depending on the individual’s treatment plan and overall health.

C. The patient is experiencing a reduction in insulin sensitivity: Improved control of hyperglycemia (as evidenced by the drop in HbA1c) suggests better insulin sensitivity, not a reduction. Insulin sensitivity typically improves with better glucose control.

D. The patient has been less compliant with the prescribed treatment regimen: A lower HbA1c suggests better compliance with treatment; usually indicates successful management of blood glucose levels, which often results from adhering to the prescribed regimen.

A. Turn the lights down and shut the client's door. B. Call for an immediate electrocardiogram (ECG) C. Administer a dose of acetaminophen D. Calculate the client's apical-radial pulse deficit

Correct Answer is A

Explanation

A. Turn the lights down and shut the client's door: Increased body temperature can be an early sign of thyroid storm. Decreasing environmental stimuli (such as light and noise) helps lower stress on the body and may prevent exacerbating the symptoms.

B. Call for an immediate electrocardiogram (ECG): While thyroid storm can cause tachycardia and arrhythmias, an elevated temperature by 1° F alone does not warrant an ECG. The priority is to manage the potential triggers for the rise in temperature first.

C. Administer a dose of acetaminophen: A mild temperature increase in Graves' disease could indicate the beginning of thyroid storm, which requires more immediate interventions like cooling measures and possibly antithyroid medications.

D. Calculate the client's apical-radial pulse deficit: Monitoring for a pulse deficit could be important if the client is experiencing arrhythmias or tachycardia, but the priority is to address the rising temperature and environmental factors, as these can escalate into a thyroid storm.

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The nurse is teaching a client who has been prescribed propylthiouracil (PTU) for hyperthyroidism. Which statement by the client indicates an understanding of the teaching? (Select 3 options)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

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