Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is collecting data from a client who has hypothyroidism.
When reviewing the findings and the client’s medical record, which of the following interventions should the nurse suggest to the provider?
A. Consider thyroid ablation therapy.
Choice A is wrong because thyroid ablation therapy is a treatment for hyperthyroidism, not hypothyroidism. Thyroid ablation therapy involves destroying part or all of the thyroid gland with radioactive iodine or surgery, which reduces the production of thyroid hormone. This would worsen the client’s condition and symptoms.
B. Increase the dosage of levothyroxine.
This is because the client has hypothyroidism, which means their thyroid gland does not produce enough thyroid hormone. Levothyroxine is a synthetic form of thyroid hormone that can replace the missing hormone and normalize the TSH level. The client’s TSH level is 8.9 mIU/L, which is above the normal range of 0.4 to 4.0 mIU/L. This indicates that the client’s current dosage of levothyroxine is insufficient and needs to be increased.
C. Replace lovastatin with cholestyramine.
Choice C is wrong because lovastatin is a statin drug that lowers cholesterol levels. Hypothyroidism can cause high cholesterol levels, but this is usually corrected by levothyroxine therapy. Replacing lovastatin with cholestyramine, a bile acid sequestrant that also lowers cholesterol levels, would not address the underlying cause of hypothyroidism and would not improve the client’s TSH level.
D. Restrict the client’s intake of iodized salt.
Choice D is wrong because restricting the intake of iodized salt would not help the client with hypothyroidism. Iodine is an essential element for the synthesis of thyroid hormone, but most people in developed countries get enough iodine from their diet. Hypothyroidism is usually caused by autoimmune disease, not iodine deficiency.
This question is an excerpt from Nurse Dive's nursing test bank - ATI PN Capstone Proctored Comprehensive Assessment 2020 B. Take the full exam now
Full Explanation
This is because the client has hypothyroidism, which means their thyroid gland does not produce enough thyroid hormone. Levothyroxine is a synthetic form of thyroid hormone that can replace the missing hormone and normalize the TSH level. The client’s TSH level is 8.9 mIU/L, which is above the normal range of 0.4 to 4.0 mIU/L. This indicates that the client’s current dosage of levothyroxine is insufficient and needs to be increased.
Choice A is wrong because thyroid ablation therapy is a treatment for hyperthyroidism, not hypothyroidism.
Thyroid ablation therapy involves destroying part or all of the thyroid gland with radioactive iodine or surgery, which reduces the production of thyroid hormone.
This would worsen the client’s condition and symptoms.
Choice C is wrong because lovastatin is a statin drug that lowers cholesterol levels. Hypothyroidism can cause high cholesterol levels, but this is usually corrected by levothyroxine therapy. Replacing lovastatin with cholestyramine, a bile acid sequestrant that also lowers cholesterol levels, would not address the underlying cause of hypothyroidism and would not improve the client’s TSH level.
Choice D is wrong because restricting the intake of iodized salt would not help the client with hypothyroidism. Iodine is an essential element for the synthesis of thyroid hormone, but most people in developed countries get enough iodine from their diet.
Hypothyroidism is usually caused by autoimmune disease, not iodine deficiency.
Similar Questions
A nurse is collecting data from a client who has recently stopped smoking.
Which of the following findings should the nurse recognize as a manifestation of acute nicotine withdrawal?
A. Tachycardia.
Choice A is wrong because tachycardia, or rapid heart rate, is not a symptom of nicotine withdrawal. In fact, smoking can increase blood pressure and heart rate, so quitting smoking may lower them.
B. Nervousness.
It occurs because nicotine stimulates the release of dopamine, a neurotransmitter that regulates mood and pleasure. When nicotine intake is stopped, dopamine levels drop and cause anxiety and irritability.
C. Weight loss.
Choice C is wrong because weight loss is not a symptom of nicotine withdrawal. On the contrary, weight gain is more likely to occur after quitting smoking, because nicotine suppresses appetite and increases metabolism.
D. Vomiting.
Choice D is wrong because vomiting is not a symptom of nicotine withdrawal. Vomiting may be a side effect of some nicotine replacement therapies, such as patches or gum, but it is not caused by the lack of nicotine itself.
Full Explanation
It occurs because nicotine stimulates the release of dopamine, a neurotransmitter that regulates mood and pleasure. When nicotine intake is stopped, dopamine levels drop and cause anxiety and irritability.
Choice A is wrong because tachycardia, or rapid heart rate, is not a symptom of nicotine withdrawal. In fact, smoking can increase blood pressure and heart rate, so quitting smoking may lower them.
Choice C is wrong because weight loss is not a symptom of nicotine withdrawal. On the contrary, weight gain is more likely to occur after quitting smoking, because nicotine suppresses appetite and increases metabolism.
Choice D is wrong because vomiting is not a symptom of nicotine withdrawal. Vomiting may be a side effect of some nicotine replacement therapies, such as patches or gum, but it is not caused by the lack of nicotine itself.
A nurse is caring for a preschooler immediately following a tonsillectomy and notices the child swallowing frequently.
Which of the following actions should the nurse take?
A. Check the back of the throat with a pen light.
Frequent swallowing after a tonsillectomy may indicate postoperative bleeding. The nurse should check the back of the throat with a pen light to assess for signs of hemorrhage.
B. Obtain the child’s vital signs in 15 min.
While obtaining vital signs is important, it does not directly address the concern of potential bleeding.
C. Administer analgesia.
Administering analgesia is appropriate for pain management but does not address the priority concern of bleeding.
D. Offer the child a drink of water.
Offering water could potentially worsen bleeding if it is occurring and should not be the first action.
Full Explanation
A. Frequent swallowing after a tonsillectomy may indicate postoperative bleeding. The nurse should check the back of the throat with a pen light to assess for signs of hemorrhage.
B. While obtaining vital signs is important, it does not directly address the concern of potential bleeding.
C. Administering analgesia is appropriate for pain management but does not address the priority concern of bleeding.
D. Offering water could potentially worsen bleeding if it is occurring and should not be the first action.
A nurse is reinforcing teaching about HbA1c with a client who has type 1 diabetes mellitus.
Which of the following information should the nurse include?
A. An HbA1c value greater than 8% indicates diabetic control of blood sugar.
Choice A is wrong because an HbA1c value greater than 8% indicates poor diabetic control of blood sugar. The HbA1c target for most people with type 1 diabetes is 48 mmol/mol (or 6.5%) or lower.
B. The HbA1c value is altered by eating habits the day before the test.
Choice B is wrong because the HbA1c value is not altered by eating habits the day before the test. The test does not require fasting and can be done at any time of the day.
C. The HbA1c value determines long-term blood glucose control for the past 120 days.
The HbA1c value determines long-term blood glucose control for the past 120 days. This is because the HbA1c test measures what percentage of hemoglobin proteins in your blood are coated with sugar (glycated). Hemoglobin proteins in red blood cells live for around 120 days, so the test reflects your average blood sugar level for the past two to three months.
D. An HbA1c test is performed once per year.
Choice D is wrong because an HbA1c test should be performed more than once per year. The frequency of the test depends on the type of diabetes, your treatment plan and your blood sugar level. For example, you may need the test twice a year if you have good blood sugar control, or four times a year if you take insulin or have trouble keeping your blood sugar level within your target range.
Full Explanation
The HbA1c value determines long-term blood glucose control for the past 120 days. This is because the HbA1c test measures what percentage of hemoglobin proteins in your blood are coated with sugar (glycated). Hemoglobin proteins in red blood cells live for around 120 days, so the test reflects your average blood sugar level for the past two to three months.
Choice A is wrong because an HbA1c value greater than 8% indicates poor diabetic control of blood sugar. The HbA1c target for most people with type 1 diabetes is 48 mmol/mol (or 6.5%) or lower.
Choice B is wrong because the HbA1c value is not altered by eating habits the day before the test. The test does not require fasting and can be done at any time of the day.
Choice D is wrong because an HbA1c test should be performed more than once per year.
The frequency of the test depends on the type of diabetes, your treatment plan and your blood sugar level. For example, you may need the test twice a year if you have good blood sugar control, or four times a year if you take insulin or have trouble keeping your blood sugar level within your target range.