Nursing Elites

1. A client is diagnosed with hyperthyroidism. The nurse anticipates which of the following medications to be ordered?

• A. Levothyroxine
• B. Propylthiouracil
• C. Lithium
• D. Metoprolol

Correct answer: B

Rationale: The correct answer is B: Propylthiouracil. Propylthiouracil is an antithyroid medication used to manage hyperthyroidism by inhibiting the synthesis of thyroid hormones. Levothyroxine (Choice A) is typically used to treat hypothyroidism, the opposite of hyperthyroidism. Lithium (Choice C) is not used to treat hyperthyroidism but is commonly used to manage bipolar disorder. Metoprolol (Choice D) is a beta-blocker that may be used to manage symptoms like tachycardia associated with hyperthyroidism, but it is not the primary treatment for the condition.

2. In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would expect a decline in:

• A. Serum glucose level.
• B. Hair loss.
• C. Bone mineralization.
• D. Menstrual flow.

Correct answer: A

Rationale: The correct answer is A: Serum glucose level. In Cushing's syndrome, there is excess cortisol production which can lead to hyperglycemia. Successful treatment of Cushing's syndrome aims to normalize cortisol levels, resulting in a decline in serum glucose levels. Choice B, hair loss, is not specifically associated with Cushing's syndrome or its treatment. Choice C, bone mineralization, is often compromised in Cushing's syndrome due to the effects of excess cortisol on bones; however, successful treatment would aim to improve bone health rather than decline it. Choice D, menstrual flow, is not directly linked to Cushing's syndrome or its treatment, so a decline in menstrual flow would not be an expected outcome of successful treatment.

3. A healthcare professional reviews a client's electrolyte laboratory report and notes that the potassium level is 3.2 mEq/L. Which of the following would the healthcare professional note on the electrocardiogram as a result of the laboratory value?

• A. U waves
• B. Absent P waves
• C. Elevated T waves
• D. Elevated ST segment

Correct answer: A

Rationale: The correct answer is A: U waves. A low potassium level (hypokalemia) can manifest as U waves on an ECG. U waves are small, extra deflections seen after the T wave and may indicate cardiac irritability. Absent P waves (Choice B) are associated with conditions like atrial fibrillation. Elevated T waves (Choice C) can be seen in hyperkalemia, not hypokalemia. Elevated ST segment (Choice D) is not typically associated with low potassium levels but can be seen in conditions like myocardial infarction.

4. A client with hypothyroidism is being treated with levothyroxine. Which of the following symptoms would indicate that the client may be receiving too much medication?

• A. Bradycardia
• B. Weight gain
• C. Tachycardia
• D. Cold intolerance

Correct answer: C

Rationale: Tachycardia is a sign of excessive thyroid hormone replacement. Levothyroxine is used to treat hypothyroidism by supplementing thyroid hormone levels. If a client with hypothyroidism experiences symptoms of tachycardia, it suggests that they may be receiving an excessive amount of levothyroxine, causing hyperthyroidism. Bradycardia (Choice A) is more commonly associated with hypothyroidism, not excessive levothyroxine. Weight gain (Choice B) and cold intolerance (Choice D) are also typical symptoms of hypothyroidism and would not typically indicate overmedication.

5. A client is receiving levothyroxine for hypothyroidism. Which of the following findings would indicate that the medication is effective?

• A. Decreased heart rate
• B. Increased weight
• C. Increased energy levels
• D. Decreased appetite

Correct answer: C

Rationale: The correct answer is C: Increased energy levels. When a client with hypothyroidism is receiving levothyroxine, increased energy levels indicate that thyroid hormone levels are being normalized, which is a positive response to treatment. This improvement reflects the effectiveness of the medication in addressing the underlying hypothyroidism. Choices A, B, and D are incorrect. Decreased heart rate and decreased appetite may be symptoms of hypothyroidism and would not necessarily indicate the effectiveness of levothyroxine. Increased weight could also be a symptom of hypothyroidism and does not directly reflect the medication's effectiveness.

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