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NurseDive Free Nursing Practice Question
Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse should teach the client to immediately report which of the following?
A. Sore throat
Correct. Propylthiouracil (PTU) is an antithyroid medication used to treat hyperthyroidism, including Graves' disease. It can sometimes cause agranulocytosis, a condition characterized by a severe reduction in white blood cells, which can lead to symptoms like a sore throat and fever. These symptoms should be reported immediately.
B. Constipation
Constipation is not a common side effect of propylthiouracil. If it occurs, it is usually not an urgent concern, and can often be managed with dietary and lifestyle changes.
C. Increased urine output
Increased urine output is not typically associated with propylthiouracil. It is more likely to be seen with diuretic medications or conditions like diabetes.
D. Painful, excessive menstruation
Painful, excessive menstruation is not a direct side effect of propylthiouracil. However, hormonal changes related to hyperthyroidism can affect menstrual patterns. If the client is experiencing significant changes in menstrual bleeding, it should be reported to the healthcare provider, but it may not be considered an immediate emergency.
This question is an excerpt from Nurse Dive's nursing test bank - RN ATI Medsurg Proctored Exam. Take the full exam now
Full Explanation
A. Correct. Propylthiouracil (PTU) is an antithyroid medication used to treat hyperthyroidism, including Graves' disease. It can sometimes cause agranulocytosis, a condition characterized by a severe reduction in white blood cells, which can lead to symptoms like a sore throat and fever. These symptoms should be reported immediately.
B. Constipation is not a common side effect of propylthiouracil. If it occurs, it is usually not an urgent concern, and can often be managed with dietary and lifestyle changes.
C. Increased urine output is not typically associated with propylthiouracil. It is more likely to be seen with diuretic medications or conditions like diabetes.
D. Painful, excessive menstruation is not a direct side effect of propylthiouracil. However, hormonal changes related to hyperthyroidism can affect menstrual patterns. If the client is experiencing significant changes in menstrual bleeding, it should be reported to the healthcare provider, but it may not be considered an immediate emergency.
Similar Questions
A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?
A. Glucocorticoid medications
Glucocorticoid medications are not the primary treatment for diabetic ketoacidosis (DKA). They may be used in specific situations, but they are not the first-line treatment.
B. Oral hypoglycemic medications
Oral hypoglycemic medications are not appropriate for a client with DKA. DKA is a serious condition that requires prompt treatment with insulin and intravenous fluids.
C. Dextrose 5% in 0.45% sodium chloride
Dextrose 5% in 0.45% sodium chloride is not the initial treatment for DKA. This solution contains dextrose, which would raise the blood glucose levels, but it does not provide the necessary insulin to address the underlying issue of insulin deficiency.
D. 0.9% sodium chloride
Correct. The initial treatment for DKA involves administering intravenous fluids, typically with 0.9% sodium chloride (normal saline). This helps to restore blood volume, correct electrolyte imbalances, and gradually lower the high blood glucose levels. Insulin is also administered concurrently to address the underlying insulin deficiency.
Full Explanation
A. Glucocorticoid medications are not the primary treatment for diabetic ketoacidosis (DKA). They may be used in specific situations, but they are not the first-line treatment.
B. Oral hypoglycemic medications are not appropriate for a client with DKA. DKA is a serious condition that requires prompt treatment with insulin and intravenous fluids.
C. Dextrose 5% in 0.45% sodium chloride is not the initial treatment for DKA. This solution contains dextrose, which would raise the blood glucose levels, but it does not provide the necessary insulin to address the underlying issue of insulin deficiency.
D. Correct. The initial treatment for DKA involves administering intravenous fluids, typically with 0.9% sodium chloride (normal saline). This helps to restore blood volume, correct electrolyte imbalances, and gradually lower the high blood glucose levels. Insulin is also administered concurrently to address the underlying insulin deficiency.
The nurse is reviewing a teaching tool created for insulin therapy Which statement on the tool should be corrected? Select all that apply.
A. NPH insulin may be mixed with pens
NPH insulin may be mixed with pens. This statement is correct. NPH insulin can be mixed with other insulins, and it is available in pens for ease of administration.
B. insulin detemir is administered to taking meals
Insulin detemir is administered once or twice daily, not necessarily with meals. Detemir is a long-acting insulin and can be taken once or twice daily, depending on the individual's specific treatment plan. It does not need to be strictly timed with meals.
C. insulin glargine may be used to treat gestational diabetes
Insulin glargine is a long-acting insulin and is generally not used as a first-line treatment for gestational diabetes. Short-acting insulins are typically recommended. Gestational diabetes is usually managed with short-acting insulins (like regular insulin) due to their faster onset and shorter duration of action. Long-acting insulins like glargine are not typically used in this context.
D. Regular insulin can be administered intravenously
Regular insulin can be administered intravenously. This is a correct statement. Regular insulin can indeed be given intravenously in a hospital setting for precise control of blood glucose levels.
E. Lispro is a rapid acting insulin
Lispro is a rapid acting insulin. This statement is accurate. Lispro is a rapid-acting insulin analog used to control high blood sugar levels during and after meals. It has a fast onset of action.
Full Explanation
A. NPH insulin may be mixed with pens. This statement is correct. NPH insulin can be mixed with other insulins, and it is available in pens for ease of administration.
B. Insulin detemir is administered once or twice daily, not necessarily with meals. Detemir is a long-acting insulin and can be taken once or twice daily, depending on the individual's specific treatment plan. It does not need to be strictly timed with meals.
C. Insulin glargine is a long-acting insulin and is generally not used as a first-line treatment for gestational diabetes. Short-acting insulins are typically recommended. Gestational diabetes is usually managed with short-acting insulins (like regular insulin) due to their faster onset and shorter duration of action. Long-acting insulins like glargine are not typically used in this context.
D. Regular insulin can be administered intravenously. This is a correct statement. Regular insulin can indeed be given intravenously in a hospital setting for precise control of blood glucose levels.
E. Lispro is a rapid-acting insulin. This statement is accurate. Lispro is a rapid-acting insulin analog used to control high blood sugar levels during and after meals. It has a fast onset of action.
The client with type 1 diabetes mellitus is prescribed to take NPH (Humulin N) insulin at 5 PM each day. The client should be instructed that the greatest risk of hypoglycemia will occur about what time?
A. 1AM while sleeping
1 AM while sleeping: NPH insulin, like Humulin N, typically reaches its peak effectiveness about 4-12 hours after administration. Since the client takes it at 5 PM, the time of greatest risk for hypoglycemia is around 1 AM when the insulin's effects are at their peak. This is a critical period for monitoring blood glucose levels.
B. PM shortly after lunch
8 PM shortly after dinner: By 8 PM, the NPH insulin's effectiveness is not at its peak. It's been about 3 hours since administration, and the insulin is still working to lower blood glucose levels. This time frame is not associated with the highest risk of hypoglycemia.
C. 6 PM shortly after dinner
6 PM shortly after dinner: At 6 PM, it's been only about an hour since the client took the NPH insulin. The insulin is just beginning to take effect, and the risk of hypoglycemia is not as high as it would be later in the night.
D. 11:00 AM, shortly before lunch
11:00 AM, shortly before lunch: By 11:00 AM, the effects of the NPH insulin from the previous evening have largely worn off. This time frame is not associated with a high risk of hypoglycemia related to the evening dose of NPH insulin.
Full Explanation
1 AM while sleeping: NPH insulin, like Humulin N, typically reaches its peak effectiveness about 4-12 hours after administration. Since the client takes it at 5 PM, the time of greatest risk for hypoglycemia is around 1 AM when the insulin's effects are at their peak. This is a critical period for monitoring blood glucose levels.
B. 8 PM shortly after dinner: By 8 PM, the NPH insulin's effectiveness is not at its peak. It's been about 3 hours since administration, and the insulin is still working to lower blood glucose levels. This time frame is not associated with the highest risk of hypoglycemia.
C. 6 PM shortly after dinner: At 6 PM, it's been only about an hour since the client took the NPH insulin. The insulin is just beginning to take effect, and the risk of hypoglycemia is not as high as it would be later in the night.
D. 11:00 AM, shortly before lunch: By 11:00 AM, the effects of the NPH insulin from the previous evening have largely worn off. This time frame is not associated with a high risk of hypoglycemia related to the evening dose of NPH insulin.