Page 1472 - Saunders Comprehensive Review For NCLEX-RN

Priority Concepts: Clinical Judgment; Thermoregulation
Reference: Lewis et al. (2017), p. 1169.

522. Answer: 3

Rationale: Oral doses of levothyroxine should be taken on an empty stomach to
enhance absorption. Dosing should be done in the morning before breakfast.
Test-Taking Strategy: Note that options 1, 2, and 4 are comparable or alike in that
these options address administering the medication with food.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Endocrine Medications: Thyroid Hormones
Health Problem: Adult Health: Endocrine: Thyroid Disorders
Priority Concepts: Client Education; Thermoregulation
Reference: Hodgson, Kizior (2018), p. 675.

523. Answer: 2

Rationale: Excessive doses of levothyroxine can produce signs and symptoms of
hyperthyroidism. These include tachycardia, chest pain, tremors, nervousness,
insomnia, hyperthermia, extreme heat intolerance, and sweating. The client should
be instructed to notify the PHCP if these occur. Options 1, 3, and 4 are signs of
hypothyroidism.
Test-Taking Strategy: Focus on the subject, the need to notify the PHCP. Recall
the symptoms associated with hypothyroidism, the purpose of administering
levothyroxine, and the effects of the medication. Options 1, 3, and 4 are symptoms
related to hypothyroidism.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Endocrine Medications: Thyroid Hormones
Health Problem: Adult Health: Endocrine: Thyroid Disorders
Priority Concepts: Client Education; Safety
Reference: Lewis et al. (2017), p. 1169.

524. Answer: 2

Rationale: Pramlintide is used for clients with types 1 and 2 diabetes mellitus who
use insulin. It is administered subcutaneously before meals to lower blood glucose
level after meals, leading to less fluctuation during the day and better long-term
glucose control. Because pramlintide delays gastric emptying, any prescribed oral
medications should be taken 1 hour before or 2 hours after an injection of
pramlintide; therefore, instructing the client to take his or her pills 1 hour before or 2
hours after the injection is correct. Pramlintide should not be taken at the same time
as other medications. Pramlintide is given immediately before the meal in order to
control postprandial rise in blood glucose, not necessarily to prevent stomach upset.

1472