Chapter 42, Thyroid and Antithyroid Drugs TEST BANK INTRODUCTORY CLINICAL PHARMACOLOGY 12TH EDITION By Susan M Ford

1. A client with thyrotoxicosis is prescribed levothyroxine. The nurse would prioritize which finding on assessment? A) Tachycardia B) Agranulocytosis C) Loss of hair D) Skin rash Answer: A Rationale: The nurse should monitor for tachycardia, palpitations, headache, nervousness, insomnia, diarrhea, vomiting, weight loss, fatigue, sweating, and flushing as adverse reactions after administering levothyroxine to a client with thyrotoxicosis. Agranulocytosis, loss of hair, and skin rash are not the adverse reactions to levothyroxine; they are adverse reactions found in a client receiving methimazole. Question format: Multiple Choice Chapter: 42 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 574, Summary Drug Table 2. A nurse is preparing to administer levothyroxine to a client who is also prescribed citalopram. The nurse predicts which assessment finding may occur in this client? A) Prolonged bleeding B) Decreased effectiveness of the thyroid drug C) Increased risk of paresthesias D) Increased risk of hypoglycemia Answer: B Rationale: The nurse should monitor for a decreased effectiveness of thethyroid drug as the result of the interaction with selective serotonin reuptake inhibitors (SSRIs) such as citalopram. When the client is receiving oral anticoagulants with thyroid hormones, the client is at risk of prolonged bleeding. Increased risk of hypoglycemia occurs when oral hypoglycemics and insulin are administeredwith thyroid hormones to the client. The nurse should observe for paresthesias as one of the adverse reactions in a client receiving antithyroid drugs. Question format: Multiple Choice Chapter: 42 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies