The practical nurse (PN) notes that the pulse rate of a client newly started on levothyroxine sodium has increased from 98 to 120 beats/minute since the initial dose was administered the previous day. Which action should the PN implement?

Inform the client that the healthcare provider will need to increase the prescribed dose of levothyroxine sodium.

Hold the next dose of levothyroxine sodium and notify the charge nurse of the change in the client's pulse rate.

Explain to the client that this is an expected side effect and administer the next dose of levothyroxine sodium as prescribed.

Administer the scheduled dose of levothyroxine sodium unless the client's blood pressure is greater than 140/90 mm Hg.

Answer and Explanation

The Correct Answer is B

A. Inform the client that the healthcare provider will need to increase the prescribed dose of levothyroxine sodium: An increased heart rate is a sign of excessive thyroid hormone activity. Increasing the dosage could worsen tachycardia and precipitate complications such as arrhythmias or cardiac strain.

B. Hold the next dose of levothyroxine sodium and notify the charge nurse of the change in the client's pulse rate: Holding the next dose and promptly reporting to the charge nurse allows further evaluation and prevents potential cardiac complications from excessive thyroid hormone levels.

C. Explain to the client that this is an expected side effect and administer the next dose of levothyroxine sodium as prescribed: A rise from 98 to 120 beats/minute is excessive and warrants concern. Continuing the medication without evaluation could exacerbate symptoms of hyperthyroidism, including palpitations and chest pain.

D. Administer the scheduled dose of levothyroxine sodium unless the client's blood pressure is greater than 140/90 mm Hg: Blood pressure is not the most relevant indicator for levothyroxine dosage adjustment. The primary concern here is the elevated pulse rate, which signals potential overstimulation from the thyroid medication.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is B

Explanation

A. Check for changes in vision: Visual changes are not associated with aminoglycoside toxicity. Monitoring vision does not provide relevant information about ototoxic effects of the medication.

B. Monitor the client's hearing: Aminoglycosides can cause ototoxicity, affecting the cochlea and vestibular system. Monitoring for hearing loss, tinnitus, or balance disturbances allows early detection and intervention to prevent permanent auditory damage.

C. Observe the skin for a rash: Skin rashes are more indicative of allergic reactions rather than ototoxicity. While monitoring for hypersensitivity is important, it does not assess the auditory or vestibular effects of aminoglycosides.

D. Measure the urinary output: Although aminoglycosides can be nephrotoxic, measuring urine output assesses renal function, not ototoxicity. Monitoring hearing is the priority when evaluating for auditory side effects.

A. What are the voices uttering? B. Which medication works best? C. When are the voices most disturbing? D. How does the client cope with the voices?

Correct Answer is A

Explanation

A. What are the voices uttering?: Determining the content of the hallucinations is most important because it helps assess whether the client is at risk of harm to self or others. If the voices are commanding or threatening, immediate safety interventions are required.

B. Which medication works best?: Although medication history is relevant for long-term management, it is secondary to assessing the current safety risk posed by the hallucinations.

C. When are the voices most disturbing?: This question helps identify triggers and patterns but is not the top priority during initial assessment when safety concerns must be addressed first.

D. How does the client cope with the voices?: Exploring coping mechanisms is important for ongoing care, but the primary concern upon admission is determining the nature of the hallucinations to ensure safety.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The practical nurse (PN) notes that the pulse rate of a client newly started on levothyroxine sodium has increased from 98 to 120 beats/minute since the initial dose was administered the previous day. Which action should the PN implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is providing care for a client who is receiving an aminoglycoside to treat a bacterial infection. To assess for signs of ototoxicity, which action should the PN take?

Correct Answer is B

Explanation

A client with schizophrenia reports auditory hallucinations when admitted to the hospital. What question is most important for the practical nurse (PN) to include in the assessment of this client?

Correct Answer is A

Explanation

A client is receiving an epidural anesthesia during labor. Which observation is the most important adverse effect that the practical nurse (PN) should assess for following the administration of the epidural?

The practical nurse (PN) observes an unlicensed assistive personnel (UAP) who is leaving a client. Which immediate action should the PN take?

A client with hypertension complains of a persistent dry cough. The practical nurse (PN) should side effect of which daily medication?

The practical nurse (PN) is assigned to care for four children. Which child should be assessed first?

A client with persistent low back pain has received a prescription for an electronic stimulator (TENS) unit. After the nurse applies the electrodes and turns on the power, the client reports feeling a tingling sensation. How should the nurse respond?

The practical nurse (PN) is assigned to care for a client who had an endoscopic procedure in which a local anesthetic was sprayed on the throat. Which priority action should the PN include in this client's plan of care?

The parents of a child with pre-diabetes report to the practical nurse (PN) that the child wants to join football. What advice is the best for the PN to implement?

A client who is receiving chemotherapy has developed stomatitis. Which instruction should the practical nurse (PN) provide the unlicensed assistive personnel (UAP) who is assisting with the care of this client?