Question

A client who is recovering from thyroid storm has been started on propylthiouracil (PTU) prior to discharge. The nurse includes which priority action in the client's teaching plan for best medication absorption and distribution?

Answer 1

Correct Answers:

Take the medication at the same time every day

Rationale :

✍️ Propylthiouracil (PTU) is an antithyroid medication used to decrease the production of thyroid hormones.

✍️ Taking PTU on a consistent schedule helps maintain therapeutic medication levels and provides continuous suppression of thyroid hormone synthesis.

✍️ Consistency is especially important after a thyroid storm, when preventing recurrence of severe hyperthyroidism is essential.

✍️ The medication should be taken exactly as prescribed and at evenly spaced intervals when multiple daily doses are ordered.

✍️ The patient should use a consistent relationship to meals—taking PTU consistently with or without food—to reduce variability in absorption.

✍️ The patient should not independently change the dose or discontinue PTU because hyperthyroid manifestations can return.

✍️ Important adverse effects requiring prompt reporting include fever or sore throat, which may indicate agranulocytosis, and jaundice or dark urine, which may indicate hepatotoxicity.

✍️ Maintaining a consistent medication schedule therefore supports stable drug exposure and effective control of thyroid hormone production.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 2

Correct Answers:

Bananas

Rationale :

🖊️ Bumetanide is a loop diuretic that increases the urinary excretion of sodium, water, and potassium.

🖊️ A potassium level of 3.2 mEq/L indicates hypokalemia because the normal serum potassium level is approximately 3.5–5.0 mEq/L.

🖊️ Bananas are a well-known dietary source of potassium and are the best choice among the foods listed.

🖊️ Increasing dietary potassium can help replace potassium lost through diuretic therapy when appropriate for the patient's condition.

🖊️ Hypokalemia can cause muscle weakness, fatigue, cramps, constipation, and cardiac dysrhythmias.

🖊️ Patients with heart failure are particularly important to monitor because electrolyte disturbances can increase the risk of cardiac rhythm abnormalities.

🖊️ The nurse should continue monitoring serum potassium and assess whether potassium supplementation is prescribed if dietary replacement is insufficient.

🖊️ Choosing potassium-rich foods such as bananas therefore helps address bumetanide-associated potassium loss.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 3

Correct Answers:

Central weight gain is noted in the face and abdomen

Rationale :

🌸 Cushing’s syndrome results from prolonged exposure to excessive levels of cortisol.

🌸 Excess cortisol causes characteristic changes in fat distribution throughout the body.

🌸 Patients commonly develop central or truncal obesity, with increased fat accumulation around the abdomen.

🌸 Fat deposition in the face produces the characteristic rounded “moon face.”

🌸 Increased fat may also accumulate over the upper back and neck, producing a dorsocervical fat pad.

🌸 The extremities may appear relatively thin because cortisol promotes protein breakdown and muscle wasting.

🌸 Other common manifestations include hypertension, hyperglycemia, thin skin, purple striae, and increased infection risk.

🌸 Recognizing the characteristic pattern of central weight gain with facial rounding is therefore important when assessing a patient with hypercortisolism.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 4

Correct Answers:

Encourage the client to express their concerns and discuss possible alternative therapies such as mindfulness or relaxation techniques.

Rationale :

🌸 Therapeutic communication begins by encouraging the client to express concerns openly, which helps the nurse understand the client’s values, fears, and treatment preferences.

🌸 Concern about sexual dysfunction is clinically important because medication side effects can affect adherence, relationships, self-image, and willingness to continue treatment.

🌸 Client-centered care supports shared decision-making rather than pressuring the client to accept a treatment plan without discussion.

🌸 Discussing nonpharmacologic approaches such as mindfulness, relaxation techniques, and other anxiety-management strategies can help the client feel more involved in care.

🌸 The nurse should also encourage the client to discuss medication concerns with the prescribing healthcare provider, especially if side effects develop or interfere with quality of life.

🌸 The client should not independently stop fluoxetine because abrupt changes in treatment may worsen symptoms or create additional problems.

🌸 A respectful, collaborative approach promotes trust, autonomy, and treatment adherence while still addressing the client’s concerns.

🌸 Encouraging discussion and exploring reasonable alternatives therefore best demonstrates therapeutic communication and client-centered care.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 5

Correct Answers:

Myxedema coma

Rationale :

♦️ Hashimoto’s disease causes progressive destruction of the thyroid gland, resulting in hypothyroidism and decreased thyroid hormone production.

♦️ Levothyroxine replaces the thyroid hormone that the damaged thyroid gland can no longer produce adequately.

♦️ Missing levothyroxine for several days decreases available thyroid hormone, and an acute illness such as influenza can act as an additional physiologic stressor.

♦️ Severe, untreated or inadequately treated hypothyroidism can progress to myxedema coma, a rare but life-threatening endocrine emergency.

♦️ Manifestations can include severe hypothermia, bradycardia, hypotension, hypoventilation, hyponatremia, and progressively decreased level of consciousness.

♦️ Respiratory depression and cardiovascular instability make myxedema coma particularly dangerous and require immediate emergency treatment.

♦️ Clients receiving thyroid replacement should therefore understand the importance of consistent levothyroxine administration, including during illness unless specifically instructed otherwise by the healthcare provider.

♦️ The combination of hypothyroidism, interruption of thyroid replacement, and acute infection places this client at increased risk for severe hypothyroid decompensation.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 6

Correct Answers:

Monitor the size of the infected area
Administer antibiotics as ordered
Keep the foot elevated above the heart

Rationale :

✅ Monitor the size of the infected area

⚽ Cellulitis is an acute bacterial infection involving the deeper layers of the skin and subcutaneous tissues.

⚽ The nurse should regularly assess the affected leg for changes in redness, warmth, swelling, tenderness, and pain.

⚽ Marking the border of erythema can help determine whether the infection is spreading or responding to treatment.

⚽ An enlarging area of redness may indicate that the infection is progressing despite therapy.

⚽ Monitoring should also include systemic manifestations such as fever, chills, and increasing malaise, which may indicate worsening infection.

⚽ Serial assessment of the affected area therefore provides an objective way to evaluate the effectiveness of treatment.

✅ Administer antibiotics as ordered

⚽ Cellulitis is generally caused by bacterial infection, commonly involving streptococcal or staphylococcal organisms.

⚽ Antibiotic therapy is a primary treatment because it targets the underlying infectious process.

⚽ The route of administration depends on the severity of the infection, with more serious infections potentially requiring IV antibiotics.

⚽ The nurse should monitor the patient's response to treatment, including decreasing redness, swelling, pain, and fever.

⚽ The client should be taught to complete the entire prescribed antibiotic course, even when symptoms begin improving.

⚽ Prompt antibiotic treatment reduces the risk of complications such as abscess formation, bacteremia, and sepsis.

✅ Keep the foot elevated above the heart

⚽ Elevating the affected extremity promotes venous and lymphatic drainage from the inflamed tissues.

⚽ Elevation helps decrease dependent edema, which can contribute to discomfort and impaired tissue healing.

⚽ Reduced swelling can also improve circulation and decrease pressure within affected tissues.

⚽ The lower leg should be supported comfortably while elevated rather than allowed to remain dependent for prolonged periods.

⚽ Elevation works together with antibiotics and appropriate skin care to promote recovery from cellulitis.

⚽ Maintaining the affected leg above heart level when possible therefore helps control edema and inflammation.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 7

Correct Answers:

48

Rationale :

Formula:

🎯 mL/hr = Ordered dose ÷ Available dose × Available volume

🎯 Ordered: 2,400 units/hr

🎯 Available: 25,000 units in 500 mL

🎯 Calculation:

🎯 2,400 ÷ 25,000 × 500

🎯 = 0.096 × 500

= 48 mL/hr

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 8

Correct Answers:

Confusion

Rationale :

🌼 Older adults with pneumonia may not always present with the classic findings of high fever and productive cough.

🌼 Acute confusion or a change in mental status can be an early manifestation of infection in an older adult.

🌼 Pneumonia can impair oxygenation, and reduced oxygen delivery to the brain may contribute to confusion, restlessness, or lethargy.

🌼 Older adults often have a less pronounced inflammatory response, so serious infection may occur without dramatic fever.

🌼 A sudden change in cognition should therefore prompt assessment for infection, hypoxemia, and other acute causes.

🌼 The nurse should also assess respiratory rate, oxygen saturation, breath sounds, temperature, and overall functional status.

🌼 Recognizing confusion as a possible sign of pneumonia helps prevent delayed diagnosis in older adults.

🌼 New confusion is therefore the most characteristic finding among the choices.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 9

Correct Answers:

Chvostek's sign

Rationale :

🧿 Diabetic ketoacidosis (DKA) occurs when severe insulin deficiency causes hyperglycemia, dehydration, and production of ketone bodies.

🧿 Chvostek’s sign is facial muscle twitching produced by tapping over the facial nerve and is primarily associated with hypocalcemia, not DKA.

🧿 DKA is more commonly associated with electrolyte abnormalities involving potassium and sodium as osmotic diuresis causes substantial fluid and electrolyte losses.

🧿 Although total body potassium is depleted, the initial serum potassium level may be normal or elevated because insulin deficiency and acidosis shift potassium out of cells.

🧿 Treatment with insulin subsequently moves potassium back into cells, making careful potassium monitoring essential during DKA treatment.

🧿 A positive Chvostek’s sign therefore points toward increased neuromuscular excitability from low calcium levels, rather than a characteristic DKA manifestation.

🧿 The nurse would assess DKA primarily through findings related to hyperglycemia, dehydration, metabolic acidosis, and ketosis.

🧿 Chvostek’s sign is therefore the exception among the findings listed.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 10

Correct Answers:

50

Rationale :

🎯 Formula:

⁕ gtt/min = mL/hr × drop factor ÷ 60 min/hr

Step 1: Identify the prescribed IV rate

⁕ The client is prescribed Lactated Ringer’s at:

⁕ 150 mL/hr

Step 2: Identify the tubing drop factor

⁕ The manual IV tubing delivers:

⁕ 20 gtt/mL

Step 3: Determine the number of drops delivered in 1 hour

⁕ 150 mL/hr × 20 gtt/mL

= 3,000 gtt/hr

Step 4: Convert drops per hour to drops per minute

⁕ There are 60 minutes in 1 hour.

⁕ 3,000 gtt/hr ÷ 60 min/hr

= 50 gtt/min

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

QLexNursing

1 :
A client who is recovering from thyroid storm has been started on propylthiouracil (PTU) prior to discharge. The nurse includes which priority action in the client's teaching plan for best medication absorption and distribution?

2 :
A client taking bumetanide 1 mg daily for congestive heart failure has a potassium of 3.2 mEq/L. Which of the following foods would the client best benefit from eating?

3 :
A nurse educator is giving a presentation on Cushing's Syndrome. Which of the following statements would be included in the presentation?

5 :
A client with Hashimoto's disease receiving levothyroxine for thyroid replacement therapy develops influenza and forgets to take their medication for several days. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication?

6 :
The nurse is preparing a plan of care for a client with a diagnosis of acute cellulitis of the lower leg. The nurse anticipates which measures will be prescribed to treat this condition? (Select all that apply)

8 :
A nurse in a provider's office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client?

9 :
A nurse would expect to find all of the following with which exception when assessing a 20-year-old client in the emergency department with diabetic ketoacidosis?

QLexNursing

1 : A client who is recovering from thyroid storm has been started on propylthiouracil (PTU) prior to discharge. The nurse includes which priority action in the client's teaching plan for best medication absorption and distribution?

2 : A client taking bumetanide 1 mg daily for congestive heart failure has a potassium of 3.2 mEq/L. Which of the following foods would the client best benefit from eating?

3 : A nurse educator is giving a presentation on Cushing's Syndrome. Which of the following statements would be included in the presentation?

5 : A client with Hashimoto's disease receiving levothyroxine for thyroid replacement therapy develops influenza and forgets to take their medication for several days. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication?

6 : The nurse is preparing a plan of care for a client with a diagnosis of acute cellulitis of the lower leg. The nurse anticipates which measures will be prescribed to treat this condition? (Select all that apply)

8 : A nurse in a provider's office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client?

9 : A nurse would expect to find all of the following with which exception when assessing a 20-year-old client in the emergency department with diabetic ketoacidosis?

1 :
A client who is recovering from thyroid storm has been started on propylthiouracil (PTU) prior to discharge. The nurse includes which priority action in the client's teaching plan for best medication absorption and distribution?

2 :
A client taking bumetanide 1 mg daily for congestive heart failure has a potassium of 3.2 mEq/L. Which of the following foods would the client best benefit from eating?

3 :
A nurse educator is giving a presentation on Cushing's Syndrome. Which of the following statements would be included in the presentation?

5 :
A client with Hashimoto's disease receiving levothyroxine for thyroid replacement therapy develops influenza and forgets to take their medication for several days. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication?

6 :
The nurse is preparing a plan of care for a client with a diagnosis of acute cellulitis of the lower leg. The nurse anticipates which measures will be prescribed to treat this condition? (Select all that apply)

8 :
A nurse in a provider's office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client?

9 :
A nurse would expect to find all of the following with which exception when assessing a 20-year-old client in the emergency department with diabetic ketoacidosis?