Correct Answer: C

Rationale: A murmur heard on auscultation is an abnormal finding that may indicate a congenital heart defect or other cardiac issue, requiring immediate reporting to the provider for further evaluation, such as an echocardiogram.
Choice A is wrong because a weight loss of 8% since birth is within the normal range for newborns (up to 10% in the first few days) and does not require immediate reporting unless accompanied by other concerns like poor feeding.
Choice B is wrong because acrocyanosis of the hands and feet is a common, benign finding in newborns due to immature circulation and does not typically require reporting.
Choice D is wrong because jaundice of the face and chest within 24 hours is often physiological and expected, but it should be monitored; it does not require immediate reporting unless severe or accompanied by other symptoms.

Correct Answer: C

Rationale: Taking levothyroxine in the morning on an empty stomach (30-60 minutes before food or other medications) ensures optimal absorption and efficacy for treating hypothyroidism.
Choice A is wrong because taking levothyroxine with a meal can reduce absorption, decreasing its effectiveness; it should be taken on an empty stomach.
Choice B is wrong because it typically takes 4-6 weeks for levothyroxine to stabilize thyroid hormone levels and for symptoms to improve, not 1 week.
Choice D is wrong because thyroid function tests are typically checked every 6-8 weeks initially to adjust the dose, then every 6-12 months once stable, not automatically every 12 months.

Correct Answer: C

Rationale: Calf pain and swelling are concerning findings that may indicate deep vein thrombosis (DVT), a known risk of tamoxifen due to its estrogen-like effects on clotting factors, requiring immediate reporting to the provider for evaluation, such as an ultrasound.
Choice A is wrong because hot flashes are a common side effect of tamoxifen due to its anti-estrogenic effects and do not typically require reporting unless severe.
Choice B is wrong because vaginal dryness is an expected side effect of tamoxifen and can be managed with non-hormonal lubricants, not requiring immediate reporting.
Choice D is wrong because a weight gain of 2 kg in 1 month is not significant and may be related to other factors; it should be monitored but does not require immediate reporting.

Correct Answer: A

Rationale: An elevated antinuclear antibody (AN
A) titer is a hallmark finding in systemic lupus erythematosus, present in over 95% of clients, indicating autoimmune activity.
Choice B is incorrect because the erythrocyte sedimentation rate (ESR) is typically elevated in SLE due to inflammation, not decreased.
Choice C is incorrect because complement levels (C3, C4) are often decreased in SLE due to immune complex formation, not normal.
Choice D is incorrect because rheumatoid factor may be positive in some SLE clients, but it is not specific to SLE and is more associated with rheumatoid arthritis.

Correct Answer: A

Rationale: A WBC count of 2,500/mm3 is below the normal range (5,000-10,000/mm3) and indicates leukopenia, a common side effect of chemotherapy that increases infection risk, requiring immediate reporting to the provider for potential interventions like growth factors or antibiotics.
Choice B is wrong because a hemoglobin of 12 g/dL is within the normal range for females (12-16 g/dL) and does not require reporting.
Choice C is wrong because a platelet count of 150,000/mm3 is within the normal range (150,000-400,000/mm3) and does not indicate thrombocytopenia.
Choice D is wrong because a potassium level of 4.0 mEq/L is within the normal range (3.5-5.0 mEq/L) and does not require reporting.