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Chapter 37: Thyroid and Parathyroid Agents, , prepU (GRADED A) Questions and Answers REF, Karch, A. M., Focus on Nursing Pharmacology, 8th ed | 100% VERIFIED.

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Question 1 See full question3m 10s Report this Question The nurse is teaching a patient who is prescribed calcitriol about the drug. Which patient statement indicates that the teaching was successful... ? You Selected: "I need to have my calcium levels checked periodically." Correct response: "I need to have my calcium levels checked periodically." Explanation: Calcitriol increases serum calcium levels, therefore periodic monitoring is important to ensure effectiveness of therapy without causing hypercalcemia. The drug may be taken with food if GI upset occurs. Antacids containing magnesium should be avoided due to the increased risk for hypermagnesemia. Calcitriol is often combined with dietary supplementation of calcium. Dairy products are a good source of calcium and should not be limited. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Calcitriol, p. 626. Chapter 37: Thyroid and Parathyroid Agents - Page 626 Add a Note Question 2 See full question3m 3s Report this Question Based on the nurse’s knowledge about thyroid hormone supplements, the nurse administers levothyroxine cautiously to a client who has recently had which condition or disorder? You Selected: myocardial infarction Correct response: myocardial infarction Explanation: A nurse should be cautious not to administer levothyroxine to a client who has recently had a myocardial infarction. Drug interactions with oral antidiabetics and insulin with hormone supplements can cause hyperglycemia. Seizure and cataract surgery are not contraindicated with the use of levothyroxine. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Levothyroxine, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 3 See full question22s Report this Question A primary health care provider has prescribed levothyroxine to a client with hypothyroidism. Which information would the nurse include in the teaching plan to promote an optimal response to the drug therapy? You Selected: Administer the drug early in the morning before breakfast. Correct response: Administer the drug early in the morning before breakfast. Explanation: The nurse should instruct the client to administer the drug early in the morning before breakfast to promote an optimal response to the drug therapy since an empty stomach increases the absorption of the oral preparation. When methimazole and propylthiouracil are administered to the client, the nurse should recommend that the client record the pulse rates and bring the record to the primary health care provider. If the client expresses a concern about the dosage schedule, the nurse can offer suggestions to the client about the dosage schedule. If the client experiences a rash while taking methimazole or propylthiouracil, the nurse needs to inform the client to apply soothing creams or lubricants. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, THYROID AND PARATHYROID AGENTS, p. 612. Chapter 37: Thyroid and Parathyroid Agents - Page 612 Add a Note Question 4 See full question2m 13s Report this Question Which hormones are secreted by the thyroid gland? (Select all that apply.) You Selected: Adrenocoritcotropic hormone Thyroid-stimulating hormone Correct response: Thyroxine Triiodothyronine Explanation: Thyroxine and triiodothyronine are hormones secreted by the thyroid gland. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Structure and Function, p. 610. Chapter 37: Thyroid and Parathyroid Agents - Page 610 Add a Note Question 5 See full question3m 59s Report this Question The nurse is caring for a 42-year-old client who recently had a total hysterectomy that involved removal of her ovaries. What statement by the client suggests that she understands her risk of developing osteoporosis? You Selected: "The surgery increased my risk of developing the disease." Correct response: "The surgery increased my risk of developing the disease." Explanation: A loss of estrogen, which helps maintain calcium levels in bone, can lead to the development of osteoporosis. The removal of the patient's ovaries prevent her from producing estrogen. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hypoparathyroidism, p. 622. Chapter 37: Thyroid and Parathyroid Agents - Page 622 Add a Note Question 6 See full question51s Report this Question A client is brought to the emergency department after taking an overdose of levothyroxine. When assessing this client, what adverse effects would the nurse expect to find? You Selected: Nervousness and tachycardia Correct response: Nervousness and tachycardia Explanation: Excessive doses of levothyroxine, a thyroid drug, can cause the same signs and symptoms that occur with hyperthyroidism. These include nervousness and tachycardia. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Levothyroxine, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 7 See full question28s Report this Question Methimazole (Tapazole) 30 mg /day orally divided in 3 doses is prescribed for a client diagnosed with Graves' disease. The pharmacy has 5 mg tablets available. How many tablets should the nurse administer with each dose? Your Response: 2 Correct response: 2 Explanation: 30 mg/day divided in 3 doses = 10 mg/dose; 10 mg / 5 mg tablets = 2 tablets per dose Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Methimazole, p. 620. Chapter 37: Thyroid and Parathyroid Agents - Page 620 Add a Note Question 8 See full question2m 47s Report this Question The nurse administers teriparatide (Forteo) and evaluates the drug as effective in achieving desired effects when what is assessed? You Selected: Increase in serum calcium and decrease in serum phosphorous Correct response: Increase in serum calcium and decrease in serum phosphorous Explanation: With once-daily administration, teriparatide stimulates new bone formation, leading to an increase in skeletal mass. It increases serum calcium and decreases serum phosphorous. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Adverse Effects, p. 625. Chapter 37: Thyroid and Parathyroid Agents - Page 625 Add a Note Question 9 See full question1m 32s Report this Question A client's low ionized calcium levels have necessitated an infusion of an IV calcium preparation. During the administration of this medication, the nurse should prioritize what assessment? You Selected: cardiac monitoring Correct response: cardiac monitoring Explanation: Calcium imbalances can result in alterations in heart rate and rhythm; cardiac monitoring is thus necessary. The client is less likely to experience alterations in respiratory function, cognition, or vision since they are not cardiac related. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Nursing Diagnoses, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 10 See full question25s Report this Question What is the most common cause of subclinical hyperthyroidism? You Selected: excess thyroid hormone therapy Correct response: excess thyroid hormone therapy Explanation: The most common cause of subclinical hyperthyroidism is excess thyroid hormone therapy. Clients should be monitored closely for hypothyroidism while taking antithyroid drugs, which usually develops within a year after receiving treatment for hyperthyroidism. Common causes of primary hypothyroidism include treatment of hyperthyroidism with radiation therapy or surgery. Predisposing factors for myxedema coma include administration of central nervous system depressants. Untreated osteoporosis is not relevant to subclinical hyperthyroidism. Question 1 See full question36s Report this Question The home care nurse is caring for an elderly female patient who has been diagnosed with osteoporosis. When explaining the disease and its treatment to the patient, what should the nurse identify as a potentially serious complication? You Selected: Bone fracture Correct response: Bone fracture Explanation: Bone fracture is a major complication of osteoporosis, a disease characterized by reduced bone mineral density. Estrogen deficiency and negative calcium balance contribute to osteoporosis; they do not result from it. Anorexia is a potential side effect of medications used to treat the disease. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hyperparathyroidism, p. 622. Chapter 37: Thyroid and Parathyroid Agents - Page 622 Add a Note Question 2 See full question44s Report this Question A client taking levothyroxine (Synthroid) is starting a new job and will be using a new health insurance and pharmacy formulary. What teaching should the nurse provide to this client regarding Synthroid? You Selected: Notify the primary care provider if Synthroid is not covered by insurance. Correct response: Notify the primary care provider if Synthroid is not covered by insurance. Explanation: Thyroid hormone replacement drugs are not equivalent to each other. Client should not change brands without first checking with the primary care provider. The provider needs to determine the equivalent dosages when changing medication brands. Thyroid hormones are usually taken once per day. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hyperthyroidism, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 3 See full question25s Report this Question An older adult has been prescribed a thyroid hormone replacement medication. The nurse should first clarify which prescription? You Selected: Levothyroxine (Synthroid) 150 mcg orally once per day Correct response: Levothyroxine (Synthroid) 150 mcg orally once per day Explanation: Synthroid is prescribed 100-125 mcg/day orally. A dose of 150 mcg orally once per day is outside of the normally prescribed range. The other medication doses are within recommended parameters. In addition, older adults are at higher risk of adverse reactions; therefore, a smaller dose is started initially and increased in small increments over a period of weeks. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Thyroid Agents, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 4 See full question52s Report this Question The nurse is preparing to administer levothyroxine to a client. Which assessment finding would cause the nurse to hold the medication? You Selected: Blood pressure of 107/64 Correct response: Heart rate of 110 beats per minute Explanation: Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Levothyroxine, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 5 See full question17m 26s Report this Question During a general health assessment, a client indicates taking thyroid medication to increase weight loss. What statement should be the basis of the nurse’s response? You Selected: Taking excessive or unnecessary thyroid medication may produce serious or life-threatening manifestations of toxicity. Correct response: Taking excessive or unnecessary thyroid medication may produce serious or life-threatening manifestations of toxicity. Explanation: The FDA has issued a black box warning regarding the use of thyroid hormones for the treatment of obesity or weight loss, either alone or with other therapeutic agents. Significant and serious complications may develop in euthyroid clients talking thyroid hormones. Question 1 See full question39s Report this Question Serum levels of calcium must be maintained in a narrow range within the body. What is the normal range of serum calcium? You Selected: 9 and 11 mg/dL Correct response: 9 and 11 mg/dL Explanation: Calcium is an electrolyte that is used in many of the body's metabolic processes. These processes include membrane transport systems, conduction of nerve impulses, muscle contraction, and blood clotting. To achieve all of these effects, serum levels of calcium must be maintained between 9 and 11 mg/dL. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, FIGURE 37.5, p. 621. Chapter 37: Thyroid and Parathyroid Agents - Page 621 Add a Note Question 2 See full question29s Report this Question Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which assessment finding should prompt the nurse to withhold a scheduled dose of levothyroxine? You Selected: The resident's apical heart rate is 112 beats/minute with a regular rhythm. Correct response: The resident's apical heart rate is 112 beats/minute with a regular rhythm. Explanation: If the pulse rate is greater than 100 bpm, it is necessary to withhold a levothyroxine dose in an older adult. Anorexia, recent vaccination, and recent falls do not necessary indicate a need to withhold this medication. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Older Adults, p. 612. Chapter 37: Thyroid and Parathyroid Agents - Page 612 Add a Note Question 3 See full question32s Report this Question The nurse should assess for an enlarged thyroid by palpating which area? You Selected: Anterior neck Correct response: Anterior neck Explanation: The thyroid gland is located in the neck in front of the trachea. It is not located in the submandibular, midsternum, or supraclavicular areas. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Control, p. 611. Chapter 37: Thyroid and Parathyroid Agents - Page 611 Add a Note Question 4 See full question26s Report this Question A female client with a six-month-old infant has been prescribed propylthiouracil (PTU). What is the most important question the nurse should ask this client? You Selected: “Are you breastfeeding your child?” Correct response: “Are you breastfeeding your child?” Explanation: Mothers taking PTU should not breastfeed their children (pregnancy category D). For the safety of the infant, the nurse should ask the client if she’s breastfeeding. Taking thyroid medications in the past does not have an immediate impact on safety for the client or infant. Using PTU during pregnancy can cause hypothyroidism in the fetus. The time frame in which the client has had thyroid-related symptoms does not have an immediate effect on safety of the client or infant. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Contraindications and Cautions, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 5 See full question40s Report this Question A nurse is providing education to a client who will soon begin taking levothyroxine for the first time. Which teaching point should the nurse include in this education session? You Selected: “You'll most likely take this drug for the rest of your life.” Correct response: “You'll most likely take this drug for the rest of your life.” Explanation: Levothyroxine is normally taken for the duration of the client's life. It is only administered by the IV route in cases of myxedema coma. It does not require a strict diet of high protein and low carbohydrates and it does not create a need for blood glucose monitoring. The medication should be taken on an empty stomach at least one hour before breakfast or two hours after a meal. Question 1 See full question7m 41s Report this Question A client is receiving a thyroid hormone to treat hypothyroidism. Which would indicate to the nurse that the client needs a reduced dosage of the drug? You Selected: Tachycardia Correct response: Tachycardia Explanation: Tachycardia suggests hyperthyroidism due to excessive thyroid hormone; this would require a reduction in dosage. The other responses suggest hypothyroidism and drug ineffectiveness. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Evaluation, p. 618. Chapter 37: Thyroid and Parathyroid Agents - Page 618 Add a Note Question 2 See full question35s Report this Question A nurse is caring for a patient undergoing thyroid hormone replacement therapy. What should the nurse inform this patient regarding administration of the drug? You Selected: Take the drug before breakfast. Correct response: Take the drug before breakfast. Explanation: The nurse should inform the patient undergoing thyroid hormone replacement therapy to take the drug in the morning, preferably before breakfast. The nurse should not ask the patient to take the drug before bedtime, just before dinner, or after lunch as that is not generally recommended by the health care provider. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Implementation with Rationale, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 3 See full question14s Report this Question Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to: You Selected: stand or sit upright for at least 30 minutes after taking alendronate. Correct response: stand or sit upright for at least 30 minutes after taking alendronate. Explanation: To decrease gastrointestinal distress, the patient should stand or sit upright for at least 30 minutes after taking the drug. Drinking at least 6 to 8 oz of water with the drug helps maximize the therapeutic effect of the drug. The patient should also take calcium and vitamin D supplements along with lifting weights to improve the success of therapy, but these interventions would not directly serve to decrease gastrointestinal distress. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Bisphosphonates, p. 627. Chapter 37: Thyroid and Parathyroid Agents - Page 627 Add a Note Question 4 See full question1m 37s Report this Question A client presents at the clinic reporting weight loss despite an increased appetite. For which condition should this client be assessed? You Selected: Hyperthyroidism Correct response: Hyperthyroidism Explanation: Hyperthyroidism is manifested by increased appetite and metabolism. Without treatment, it may be difficult for hyperthyroid individuals to consume enough calories to prevent weight loss. Hypothyroidism, which may be caused by thyroiditis, causes decreased appetite and metabolism, and hypothyroid patients frequently experience weight gain. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hyperthyroidism, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 5 See full question15s Report this Question The nurse should review which lab result before advising a client about taking the first dose of ibandronate (Boniva)? You Selected: Calcium Correct response: Calcium Explanation: When bisphosphonates are administered, serum calcium levels are monitored before, during, and after therapy. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Drugs in Focus: Parathyroid Agents, p. 624. Chapter 37: Thyroid and Parathyroid Agents - Page 624 Add a Note Question 6 See full question32s Report this Question After teaching a group of students about bisphosphonates, the students demonstrate understanding of the information when they identify which drug as an example? You Selected: Pamidronate Correct response: Pamidronate Explanation: Pamidronate is an example of a bisphosphonate. Teriparatide and dihydrotachysterol are antihypocalcemic agents. Calcitonin-salmon is a calcitonin used to treat hypercalcemia. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Bisphosphonates, p. 626. Chapter 37: Thyroid and Parathyroid Agents - Page 626 Add a Note Question 7 See full question2m 8s Report this Question A client, diagnosed with hypothyroidism, is currently taking an opioid for knee pain. This client is at increased risk for developing which adverse reaction? You Selected: myxedema coma Correct response: myxedema coma Explanation: People with hypothyroidism are especially likely to experience respiratory depression and myxedema coma with opioid analgesics and other sedating drugs. Pulmonary congestion, tachycardia, and hyperventilation are not adverse effects related to hypothyroidism or the administration of opioids. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Therapeutic Actions and Indications, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 8 See full question31s Report this Question Prior to administering propylthiouracil, the nurse has reviewed the relevant black box warning and should teach the client about the need for what form of follow-up? You Selected: routine liver function testing Correct response: routine liver function testing Explanation: The FDA has issued a black box warning for propylthiouracil stating that severe liver injury resulting in death or acute liver failure may occur within 6 months of treatment. All clients should receive instructions about the signs and symptoms of acute liver failure. Routine liver function testing to assess for liver failure is important. There is no specific need for chest radiographs, CBCs, or glucose monitoring. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Implementation with Rationale, p. 620. Chapter 37: Thyroid and Parathyroid Agents - Page 620 Add a Note Question 9 See full question26s Report this Question What assessment should the nurse perform prior to administration of a scheduled dose of levothyroxine? You Selected: heart rate Correct response: heart rate Explanation: Regular monitoring of blood pressure and pulse is essential in older adults receiving levothyroxine. As a general rule, levothyroxine should not be given if the resting heart rate is more than 100 beats per minute. This medication does not impact any of the other functions and so assessment is not necessary. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Levothyroxine, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 10 See full question23s Report this Question A hospital client’s current medication administration record specifies oral administration of propylthiouracil (PTU) every 8 hours. What sign or symptom may have originally prompted the care provider to prescribe this drug? You Selected: persistent tachycardia Correct response: persistent tachycardia Explanation: Propylthiouracil (PTU) is used for the treatment of hyperthyroidism; one of the characteristic symptoms of this disease is tachycardia. Tinnitus, visual disturbances, and hypotension are not associated with hyperthyroidism. Question 1 See full question1m 28s Report this Question What statement should be the basis for a nurse’s description of the role of the parathyroid on the development of osteoporosis? You Selected: When there is too much parathyroid hormone, the bones release their calcium into the blood at a rate that is too high, resulting in bones which have too little calcium. Correct response: When there is too much parathyroid hormone, the bones release their calcium into the blood at a rate that is too high, resulting in bones which have too little calcium. Explanation: Osteoporosis associated with hyperparathyroidism is caused by the high parathyroid hormone that is secreted by the overactive parathyroid gland(s). This excess parathyroid hormone acts directly on the bones to remove calcium from the bones. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, OSTEOPOROSIS, p. 623. Chapter 37: Thyroid and Parathyroid Agents - Page 623 Add a Note Question 2 See full question2m 51s Report this Question The nurse is providing client education regarding the administration of levothyroxine (Synthroid). Which information should the nurse include? You Selected: Take with a full glass of water. Correct response: Take with a full glass of water. Explanation: The client should be instructed to take the medication with a full glass of water to help prevent difficulty swallowing. The medication should not be taken on an empty stomach and the client does not have to remain in the upright position after taking the medication. The medication should be taken as a single daily dose before breakfast each day to ensure consistent therapeutic levels. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, THYROID AND PARATHYROID AGENTS, p. 612. Chapter 37: Thyroid and Parathyroid Agents - Page 612 Add a Note Question 3 See full question55s Report this Question Knowing that thyroid hormones are principally concerned with the increase in metabolic rate of tissues, which symptoms would a nurse observe in a client with uncontrolled hypothyroidism? (Select all that apply.) You Selected: Bradycardia Weight gain Correct response: Weight gain Bradycardia Sleepiness Explanation: The signs and symptoms of hypothyroidism include: decreased metabolism, cold intolerance, low body temperature, weight gain, bradycardia, hypotension, lethargy, sleepiness, pale, cool, dry skin, face appears puffy, coarse hair, thick, hard nails, heavy menses, fertility problems, and low sperm count. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Signs and Symptoms of Thyroid Dysfunction, p. 613. Chapter 37: Thyroid and Parathyroid Agents - Page 613 Add a Note Question 4 See full question42s Report this Question A nurse is caring for a patient with thyrotoxicosis. The physician prescribes liotrix to the patient. Which adverse reaction to the drug should the nurse monitor for in the patient? You Selected: Tachycardia Correct response: Tachycardia Explanation: The nurse should monitor for tachycardia, palpitations, headache, nervousness, insomnia, diarrhea, vomiting, weight loss, fatigue, sweating, and flushing as adverse reactions after administering liotrix to the patient with thyrotoxicosis. Agranulocytosis, loss of hair, and skin rash are not the adverse reactions to liotrix. Agranulocytosis, loss of hair, and skin rash are adverse reactions found in a patient receiving a methimazole drug. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Levothyroxine, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 5 See full question35s Report this Question A nurse is caring for a client with chronic lymphocytic thyroiditis. The health care provider has prescribed liothyronine. For which condition of the client should the nurse be cautious before administering the drug? You Selected: cardiac disease Correct response: cardiac disease Explanation: The nurse should be cautious about existing conditions such as cardiac disease and also cautious about lactating clients before administering liothyronine to clients with chronic lymphocytic thyroiditis. The nurse need not be cautious about administering liothyronine to those with upper respiratory tract infection, diabetes, or elevated body temperature. The nurse should observe for elevated body temperature while managing the needs of a client administered thyroid hormones. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Thyroid Agents, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 6 See full question1m 11s Report this Question A health care provider has prescribed thyroid drugs to a client with euthyroid goiter. Which should the nurse include in the nursing diagnosis checklist? You Selected: Anxiety related to symptoms, adverse reactions, and treatment regimen Correct response: Anxiety related to symptoms, adverse reactions, and treatment regimen Explanation: The nurse should include anxiety related to symptoms, adverse reactions, and treatment regimen in the nursing diagnosis checklist on administering thyroid drugs to the client with euthyroid goiter. In the nursing diagnosis checklist for this client, the nurse need not include disturbed thought processes related to adverse drug reactions, risk for infection, or risk for impaired skin integrity related to adverse drug reactions. Risk for infection related to adverse drug reactions and risk for impaired skin integrity related to adverse reactions must be included in the nursing diagnosis checklist of a patient who is administered antithyroid drugs. The nursing diagnosis checklist of a client receiving ACTH must include disturbed thought processes related to adverse drug reactions. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Therapeutic Actions and Indications, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 7 See full question31s Report this Question A client is brought to the emergency department after taking an overdose of levothyroxine. When assessing this client, what adverse effects would the nurse expect to find? You Selected: Nervousness and tachycardia Correct response: Nervousness and tachycardia Explanation: Excessive doses of levothyroxine, a thyroid drug, can cause the same signs and symptoms that occur with hyperthyroidism. These include nervousness and tachycardia. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Levothyroxine, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 8 See full question27s Report this Question The nurse knows that which assessment finding suggests hyperthyroidism? You Selected: Blood pressure 145/87 Correct response: Blood pressure 145/87 Explanation: Moderate hypertension is a sign of hyperthyroidism. Bradycardia, cool and dry skin, and hard, thick nails are suggestive of hypothyroidism. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hyperthyroidism, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 9 See full question1m Report this Question A client is diagnosed with both hypothyroidism and adrenal insufficiency. If the adrenal insufficiency is not treated first, what may occur with the administration of thyroid hormone? You Selected: Acute adrenocortical insufficiency Correct response: Acute adrenocortical insufficiency Explanation: When hypothyroidism and adrenal insufficiency coexist, the adrenal insufficiency should be treated with a corticosteroid drug before starting thyroid replacement. Thyroid hormones increase tissue metabolism and tissue demands for adrenocortical hormones. If adrenal insufficiency is not treated first, administration of thyroid hormone may cause acute adrenocortical insufficiency, a life-threatening condition. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hyperthyroidism, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 10 See full question11m 39s Report this Question The nurse educates a client recently diagnosed with hypothyroidism about using the prescribed levothyroxine. The client has a history of diabetes. Which client statement establishes the need for further clarification? You Selected: “Thyroid replacement is lifelong; dosage changes must come from my provider.” Correct response: “It does not matter which brand of the drug I take, they are all the same.” Explanation: The nurse needs to clarify with further teaching the client’s statement that it does not matter what brand of levothyroxine is taken. The client needs to keep taking the same brand because switching brands can lead to changes in the hormone level and affect the treatment. The other statements made by the client support an adequate understanding of various teaching points. Taking the drug before breakfast allows the medication to dissolve and be absorbed on an empty stomach. Taking the medication at the same time of day helps to maintain a steady state of the drug. Thyroid replacement may cause symptoms of diabetes to increase, so monitoring for hyperglycemia is warranted since the client has a history of diabetes. Thyroid replacement in this case is lifelong, and the client should not intentionally change a dose by increasing, decreasing, or skipping a dose. Question 1 See full question3m 49s Report this Question The nurse is caring for a 42-year-old client who recently had a total hysterectomy that involved removal of her ovaries. What statement by the client suggests that she understands her risk of developing osteoporosis? You Selected: "The surgery increased my risk of developing the disease." Correct response: "The surgery increased my risk of developing the disease." Explanation: A loss of estrogen, which helps maintain calcium levels in bone, can lead to the development of osteoporosis. The removal of the patient's ovaries prevent her from producing estrogen. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hypoparathyroidism, p. 622. Chapter 37: Thyroid and Parathyroid Agents - Page 622 Add a Note Question 2 See full question12s Report this Question A client taking levothyroxine (Synthroid) is starting a new job and will be using a new health insurance and pharmacy formulary. What teaching should the nurse provide to this client regarding Synthroid? You Selected: Notify the primary care provider if Synthroid is not covered by insurance. Correct response: Notify the primary care provider if Synthroid is not covered by insurance. Explanation: Thyroid hormone replacement drugs are not equivalent to each other. Client should not change brands without first checking with the primary care provider. The provider needs to determine the equivalent dosages when changing medication brands. Thyroid hormones are usually taken once per day. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hyperthyroidism, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 3 See full question49s Report this Question An older adult has been prescribed a thyroid hormone replacement medication. The nurse should first clarify which prescription? You Selected: Levothyroxine (Synthroid) 150 mcg orally once per day Correct response: Levothyroxine (Synthroid) 150 mcg orally once per day Explanation: Synthroid is prescribed 100-125 mcg/day orally. A dose of 150 mcg orally once per day is outside of the normally prescribed range. The other medication doses are within recommended parameters. In addition, older adults are at higher risk of adverse reactions; therefore, a smaller dose is started initially and increased in small increments over a period of weeks. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Thyroid Agents, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 4 See full question24s Report this Question A client taking methimazole develops a rash. What is the nurse’s best recommendation to treat the rash? You Selected: Apply a soothing cream until the rash subsides. Correct response: Apply a soothing cream until the rash subsides. Explanation: If a client experiences a rash while taking methimazole, either soothing creams or lubricants may be applied; soap is used sparingly, if at all, until the rash subsides. Drug dosing may need to be changed, so the next step is to notify the health care provider. Wearing gloves does not address how to care for the rash. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Methimazole, p. 620. Chapter 37: Thyroid and Parathyroid Agents - Page 620 Add a Note Question 5 See full question43s Report this Question A client has been diagnosed with hypothyroidism and admits to the nurse that she has heard of her thyroid gland but does not know the function of thyroid hormone. The nurse should explain the fact that thyroid hormone is responsible for which action? You Selected: controlling the rate of cell metabolism throughout the body Correct response: controlling the rate of cell metabolism throughout the body Explanation: Thyroid hormones control the rate of cellular metabolism and thus influence the functioning of virtually every cell in the body. The heart, skeletal muscle, liver, and kidneys are especially responsive to the stimulating effects of thyroid hormones. The brain, spleen, and gonads are less responsive. Thyroid hormone does not primarily influence glucose levels or the function of the endocrine system. Question 1 See full question44s Report this Question Thyroid hormones are principally concerned with the increase in metabolic rate of tissues that can result in certain effects? What are some of these effects? (Select all that apply.) You Selected: Increased cardiac output Increased heart rate Increased body temperature Correct response: Increased heart rate Increased body temperature Increased cardiac output Explanation: Thyroid hormones are principally concerned with the increase in metabolic rate of tissues, which results in increases in the heart and respiratory rate, body temperature, cardiac output, oxygen consumption, and the metabolism of fats, proteins, and carbohydrates. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Therapeutic Actions and Indications, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 2 See full question1m 27s Report this Question A nurse is caring for a patient with hypothyroidism. The nurse would know that the effects of hypothyroidism include: You Selected: Decreased cardiac output Correct response: Decreased cardiac output Explanation: Decreased cardiac output is an effect of hypothyroidism. Low-grade fever, nervousness and restlessness, and increased systolic blood pressure are among the effects of hyperthyroidism. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hypothyroidism, p. 612. Chapter 37: Thyroid and Parathyroid Agents - Page 612 Add a Note Question 3 See full question34s Report this Question The nurse should expect which assessment findings in a client diagnosed with Hashimoto’s thyroiditis? You Selected: Blood pressure 110/70 Correct response: Blood pressure 110/70 Explanation: Hashimoto’s thyroiditis causes hypothyroidism. Some common signs include bradycardia, pale and cool skin, coarse hair, and moderate hypotension. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hypothyroidism, p. 613. Chapter 37: Thyroid and Parathyroid Agents - Page 613 Add a Note Question 4 See full question27s Report this Question A female client with hyperthyroidism reports nervousness and “racing” heart one week after starting antithyroid medication. How should the nurse respond to the client’s report? You Selected: “It may take three to four weeks for the effects of this medication to be seen.” Correct response: “It may take three to four weeks for the effects of this medication to be seen.” Explanation: Therapeutic effects of the antithyroid drugs may not be observed for three to four weeks. Counting the resting heart rate doesn’t address the client’s reports. Increasing the dosage is not initially recommended until the client has been taking the medication at least three to four weeks. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, PATIENT TEACHING FOR H.R., p. 618. Chapter 37: Thyroid and Parathyroid Agents - Page 618 Add a Note Question 5 See full question49s Report this Question Prior to administering propylthiouracil, the nurse has reviewed the relevant black box warning and should teach the client about the need for what form of follow-up? You Selected: routine liver function testing Correct response: routine liver function testing Explanation: The FDA has issued a black box warning for propylthiouracil stating that severe liver injury resulting in death or acute liver failure may occur within 6 months of treatment. All clients should receive instructions about the signs and symptoms of acute liver failure. Routine liver function testing to assess for liver failure is important. There is no specific need for chest radiographs, CBCs, or glucose monitoring. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Implementation with Rationale, p. 620. Chapter 37: Thyroid and Parathyroid Agents - Page 620 Add a Note Question 6 See full question37s Report this Question What assessment should the nurse perform prior to administration of a scheduled dose of levothyroxine? You Selected: heart rate Correct response: heart rate Explanation: Regular monitoring of blood pressure and pulse is essential in older adults receiving levothyroxine. As a general rule, levothyroxine should not be given if the resting heart rate is more than 100 beats per minute. This medication does not impact any of the other functions and so assessment is not necessary. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Levothyroxine, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 7 See full question45s Report this Question An older adult client has been using levothyroxine for several years on an outclient basis. Which client statement should the nurse attribute to the decreased effect of levothyroxine? You Selected: “I've been using a lot of antacids lately because of my indigestion.” Correct response: “I've been using a lot of antacids lately because of my indigestion.” Explanation: Antacids may decrease the effect of levothyroxine. Acetaminophen, stress, and high protein intake do not have this effect. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Clinically Important Drug–Drug Interactions, p. 615. Chapter 37: Thyroid and Parathyroid Agents - Page 615 Add a Note Question 8 See full question54s Report this Question An older adult resident of a long-term care facility has been prescribed calcium citrate to address decreasing bone density. The nurse should review the resident's medication administration record knowing that what medication may decrease the effects of calcium? You Selected: prednisone Correct response: prednisone Explanation: Corticosteroids reduce the effects of calcium by various mechanisms. Thiazide diuretics have the opposite effect. NSAIDs, calcium channel blockers, and beta-blockers do not appreciably affect the pharmacokinetics of calcium supplements. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents. Add a Note Question 9 See full question35s Report this Question A hospital client’s current medication administration record specifies oral administration of propylthiouracil (PTU) every 8 hours. What sign or symptom may have originally prompted the care provider to prescribe this drug? You Selected: persistent tachycardia Correct response: persistent tachycardia Explanation: Propylthiouracil (PTU) is used for the treatment of hyperthyroidism; one of the characteristic symptoms of this disease is tachycardia. Tinnitus, visual disturbances, and hypotension are not associated with hyperthyroidism. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Implementation with Rationale, p. 620. Chapter 37: Thyroid and Parathyroid Agents - Page 620 Add a Note Question 10 See full question18s Report this Question What is the rationale for a nurse to suggest avoiding whole grains to a client being treated for osteopenia? You Selected: Whole grains are known to interfere with calcium absorption. Correct response: Whole grains are known to interfere with calcium absorption. Explanation: Clients should be taught to avoid whole grain cereals especially in meals eaten before taking calcium because they interfere with calcium absorption. Question 1 See full question 16s Report this Question A client is receiving a thyroid hormone to treat hypothyroidism. Which would indicate to the nurse that the client needs a reduced dosage of the drug? You Selected: • Tachycardia Correct response: • Tachycardia Explanation: Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Evaluation, p. 618. Chapter 37: Thyroid and Parathyroid Agents - Page 618 Add a Note Question 2 See full question 1m 11s Report this Question Which would the nurse expect to assess in a patient who is to start therapy with biphosphonates? You Selected: • Tetany Correct response: • Muscle weakness Explanation: Muscle weakness is a sign of hypercalcemia for which biphosphonate, an antihypercalcemic agent, would be used. Hyperactive reflexes suggest hypocalcemia for which an antihypocalcemic agent would be used. Tetany suggests hypocalcemia for which an antihypocalcemic agent would be used. Paresthesias suggest hypocalcemia for which an antihypocalcemic agent would be used. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Signs and Symptoms of Calcium Imbalance, p. 622. Chapter 37: Thyroid and Parathyroid Agents - Page 622 Add a Note Question 3 See full question 15s Report this Question A patient taking thyroid drugs is found to be hyperthyroid. What should be done about the dosage of other drugs the patient is taking? You Selected: • Reduced Correct response: • Nothing Explanation: Excessive doses of thyroid drugs may produce hyperthyroidism and a greatly increased rate of metabolism. In this situation, larger doses of most other drugs are necessary to produce the same effects. However, rather than increasing dosage of other drugs, dosage of thyroid drugs should be reduced so the patient is euthyroid again. You would not stop the other drugs the patient is taking. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hyperthyroidism, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 4 See full question 13s Report this Question A nurse is caring for a client who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for: You Selected: • history of taking anticoagulant drugs. Correct response: • history of taking anticoagulant drugs. Explanation: If the client is taking anticoagulant drugs, there is a risk of a drug–drug interaction with levothyroxine that can result in an increased risk of bleeding. Therefore, the nurse should assess the client's medical record and drug history. Bleeding times such as INR, PR, and PTT should be closely monitored if it is necessary for the two drugs to be given together. There is no evidence that an allergy to seafood, the client's age, or hirsutism, which is excessive hair growth, would need to be assessed in this case. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Assessment: History and Examination, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 5 See full question 40s Report this Question The anatomy and physiology instructor is discussing bone development in the human body. According to the instructor, what hormone inhibits bone resorption? You Selected: • Calcitonin Correct response: • Calcitonin Explanation: Calcitonin inhibits bone resorption, whereas parathyroid hormone (PTH) increases resorption. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Structure and Function, p. 610. Chapter 37: Thyroid and Parathyroid Agents - Page 610 Add a Note Question 6 See full question 35s Report this Question Levothyroxine (Synthroid) 88 mcg is prescribed for a client. How many mg of Synthroid will the nurse administer? Do NOT round the answer. Your Response: • 0.088 Correct response: • 0.088 Explanation: 1 mg = 1000 mcg. 88 mcg = 0.088 mg Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Levothyroxine, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 7 See full question 11s Report this Question The nurse is caring for a client who is seeking care for a chronic condition. The nurse is aware that the FDA has issued a black box warning regarding the use of thyroid hormones for the treatment of what condition? You Selected: • Obesity Correct response: • Obesity Explanation: The FDA has issued a black box warning regarding the use of thyroid hormones for the treatment of obesity or for weight loss, either alone or with other therapeutic agents. Significant and serious complications may develop in euthyroid people taking thyroid hormones. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, THYROID HORMONES FOR OBESITY, p. 613. Chapter 37: Thyroid and Parathyroid Agents - Page 613 Add a Note Question 8 See full question 28s Report this Question When describing the parafollicular cells to a group of students, which hormone would the instructor identify as being produced by these cells? You Selected: • Parathormone Correct response: • Calcitonin Explanation: The parafollicular cells of the thyroid produce calcitonin. Parathormone is produced by the parathyroid glands. Levothyroxine and liothyronine are produced by the thyroid gland and stored in the follicular cells. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Structure and Function, p. 610. Chapter 37: Thyroid and Parathyroid Agents - Page 610 Add a Note Question 9 See full question 1m 19s Report this Question What assessment findings would suggest to the nurse that a client may be experiencing an adverse effect to levothyroxine? You Selected: • hyperactivity and insomnia Correct response: • hyperactivity and insomnia Explanation: Adverse effects of levothyroxine include signs and symptoms of hyperthyroidism. Other more serious adverse effects are tachycardia, cardiac dysrhythmias, angina pectoris, myocardial infarction, and heart failure. Nervousness, hyperactivity, insomnia, diarrhea, abdominal cramps, nausea, vomiting, weight loss, fever, and an intolerance to heat have also been reported. Bradycardia and constipation are associated with hypothyroidism. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Levothyroxine, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 10 See full question 11s Report this Question The nurse should recommend what daily dose of vitamin D for a 61-year-old client? You Selected: • 1500 international units Correct response: • 600 international units Explanation: The recommended dietary allowance, or RDA, for vitamin D is 600 international units for people 1 to 70 years of age and 800 international units daily for adults 71 years and older to prevent and treat osteoporosis. Reference: Question 1 See full question 1m 1s Report this Question What is the body’s physiological response when blood levels of calcium are excessive? You Selected: • The parathyroid glands stop making parathyroid hormone. Correct response: • The parathyroid glands stop making parathyroid hormone. Explanation: When blood calcium levels increase above a certain point, calcium-sensing receptors in the parathyroid gland are activated to decrease hormone production. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Antihypocalcemic Agents, p. 624. Chapter 37: Thyroid and Parathyroid Agents - Page 624 Add a Note Question 2 See full question 29s Report this Question When is calcitonin released by the body? You Selected: • When serum calcium levels rise Correct response: • When serum calcium levels rise Explanation: The release of calcitonin is not controlled by the hypothalamic–pituitary axis, but is regulated locally at the cellular level. Calcitonin is released when serum calcium levels rise. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Structure and Function, p. 621. Chapter 37: Thyroid and Parathyroid Agents - Page 621 Add a Note Question 3 See full question 23s Report this Question Knowing that thyroid hormones are principally concerned with the increase in metabolic rate of tissues, which symptoms would a nurse observe in a client with uncontrolled hypothyroidism? (Select all that apply.) You Selected: • Weight gain • Bradycardia • Sleepiness Correct response: • Weight gain • Bradycardia • Sleepiness Explanation: The signs and symptoms of hypothyroidism include: decreased metabolism, cold intolerance, low body temperature, weight gain, bradycardia, hypotension, lethargy, sleepiness, pale, cool, dry skin, face appears puffy, coarse hair, thick, hard nails, heavy menses, fertility problems, and low sperm count. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Signs and Symptoms of Thyroid Dysfunction, p. 613. Chapter 37: Thyroid and Parathyroid Agents - Page 613 Add a Note Question 4 See full question 21s Report this Question A nurse is caring for a patient with thyrotoxicosis. The physician prescribes liotrix to the patient. Which adverse reaction to the drug should the nurse monitor for in the patient? You Selected: • Loss of hair Correct response: • Tachycardia Explanation: The nurse should monitor for tachycardia, palpitations, headache, nervousness, insomnia, diarrhea, vomiting, weight loss, fatigue, sweating, and flushing as adverse reactions after administering liotrix to the patient with thyrotoxicosis. Agranulocytosis, loss of hair, and skin rash are not the adverse reactions to liotrix. Agranulocytosis, loss of hair, and skin rash are adverse reactions found in a patient receiving a methimazole drug. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Levothyroxine, p. 616. Chapter 37: Thyroid and Parathyroid Agents - Page 616 Add a Note Question 5 See full question 10s Report this Question A client presents at the clinic reporting weight loss despite an increased appetite. For which condition should this client be assessed? You Selected: • Hyperthyroidism Correct response: • Hyperthyroidism Explanation: Hyperthyroidism is manifested by increased appetite and metabolism. Without treatment, it may be difficult for hyperthyroid individuals to consume enough calories to prevent weight loss. Hypothyroidism, which may be caused by thyroiditis, causes decreased appetite and metabolism, and hypothyroid patients frequently experience weight gain. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hyperthyroidism, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 6 See full question 14s Report this Question The nurse knows that which assessment finding suggests hyperthyroidism? You Selected: • Blood pressure 145/87 Correct response: • Blood pressure 145/87 Explanation: Moderate hypertension is a sign of hyperthyroidism. Bradycardia, cool and dry skin, and hard, thick nails are suggestive of hypothyroidism. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Hyperthyroidism, p. 614. Chapter 37: Thyroid and Parathyroid Agents - Page 614 Add a Note Question 7 See full question 12s Report this Question The nurse should teach clients who are taking thyroid hormones to take the medication: You Selected: • on an empty stomach. Correct response: • on an empty stomach. Explanation: Thyroid hormones are administered once per day, early in the morning and preferably before breakfast. An empty stomach increases the absorption of the drug. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Bisphosphonates, p. 627. Chapter 37: Thyroid and Parathyroid Agents - Page 627 Add a Note Question 8 See full question 15s Report this Question A client who is receiving a strong iodide solution, potassium iodide, develops iodism. What would the nurse expect to find? You Selected: • Sore teeth Correct response: • Sore teeth Explanation: Signs and symptoms of iodism include sore teeth and gums, metallic taste and burning in the mouth, diarrhea, cold symptoms, and stomach upset. Rash is an adverse effect that is not indicative of iodism. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Prototype Summary: Strong Iodine Products, p. 620. Chapter 37: Thyroid and Parathyroid Agents - Page 620 Add a Note Question 9 See full question 1m 11s Report this Question The nurse administers teriparatide (Forteo) and evaluates the drug as effective in achieving desired effects when what is assessed? You Selected: • Increase in serum calcium and phosphorous Correct response: • Increase in serum calcium and decrease in serum phosphorous Explanation: With once-daily administration, teriparatide stimulates new bone formation, leading to an increase in skeletal mass. It increases serum calcium and decreases serum phosphorous. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 37: Thyroid and Parathyroid Agents, Adverse Effects, p. 625. Chapter 37: Thyroid and Parathyroid Agents - Page 625 Add a Note Question 10 See full question 54s Report this Question A nurse is reviewing the laboratory values of a client being treated for a diagnosis of hypocalcemia. The current serum calcium level is 8.1 mg/dL. What intervention does the nurse expect the prescriber to order? You Selected: • Order an additional calcium supplement. Correct response: • Order an additional calcium supplement. Explanation: Normal serum calcium levels are in the range of 8.5 to 10.5 mg/dL. The nurse would anticipate that the level is below the therapeutic range and the prescriber should order another calcium supplement. Once the hypocalcemia is stabilized, finding the underlying cause of recurrence is priority. Measurement of serum magnesium levels should also be completed to correct the hypocalcemia. The potassium chloride infusion is not associated with calcium. [Show More]

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