Nursing Elites

1. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

• A. The client will start at a high dose, and the dose will be tapered as needed.
• B. The client will remain on the initial dosage during the course of treatment.
• C. The client's dosage will be adjusted daily based on blood levels.
• D. The client will start on a low dose, which will be gradually increased.

Correct answer: D

Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes. Choice A is incorrect because starting at a high dose can increase the risk of adverse effects and is not the recommended approach. Choice B is incorrect because maintaining the initial dosage throughout the treatment may not achieve optimal therapeutic levels. Choice C is incorrect because adjusting the dosage daily based on blood levels is not the standard practice for initiating Levothyroxine treatment.

2. A healthcare professional is preparing to administer a dose of Hydromorphone IV to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication over 5 minutes.
• B. Administer a dose of Naloxone prior to giving the Hydromorphone.
• C. Assess the client's blood pressure prior to administration.
• D. Inject the medication into the client's subcutaneous tissue.

Correct answer: A

Rationale: The correct action for the healthcare professional preparing to administer IV Hydromorphone to a client is to administer the medication over 5 minutes. This slow administration is crucial to reduce the risk of hypotension and respiratory depression. Administering the medication rapidly can lead to adverse effects. Option B, administering Naloxone prior to Hydromorphone, is incorrect because Naloxone is used as an antidote for opioid overdose, not as a routine pre-medication. Option C, assessing the client's blood pressure before administration, is important but not the immediate action to take to reduce adverse effects of Hydromorphone. Option D, injecting the medication into the client's subcutaneous tissue, is incorrect as Hydromorphone is meant for intravenous administration for rapid onset of action.

3. Which of the following drugs is associated with the reaction of tendon dysfunction?

• A. Digitalis
• B. Niacin
• C. Tetracycline
• D. Fluoroquinolones

Correct answer: D

Rationale: Fluoroquinolones are known to be associated with tendon dysfunction or rupture. These drugs can weaken the tendons, leading to potential issues such as tendonitis or even tendon rupture. It is essential for healthcare providers to be cautious when prescribing fluoroquinolones, especially in patients who may be at higher risk for tendon-related complications.

4. A healthcare professional is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The healthcare professional should set the IV pump to deliver how many mL/hr?

• A. 200 mL/hr
• B. 150 mL/hr
• C. 100 mL/hr
• D. 250 mL/hr

Correct answer: A

Rationale: To calculate the flow rate in mL/hr: (Volume in mL / Time in hours) = Flow rate in mL/hr. In this case, (100 mL / 0.5 hr) = 200 mL/hr. The correct calculation is: 100 mL (volume) / 0.5 hr (time) = 200 mL/hr. Therefore, the correct answer is 200 mL/hr. Choice B (150 mL/hr), C (100 mL/hr), and D (250 mL/hr) are incorrect as they do not match the calculated flow rate needed for the administration of clindamycin.

5. A client is prescribed Ranitidine. Which of the following laboratory results should be monitored by the nurse?

• A. Complete blood count (CBC).
• B. Serum creatinine.
• C. Serum potassium.
• D. Serum glucose.

Correct answer: A

Rationale: Ranitidine can potentially lead to blood dyscrasias, necessitating the monitoring of the client's CBC. Checking the CBC can help detect any abnormalities in blood cell counts and assess the client's overall hematologic status during Ranitidine therapy.

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