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. What is the antidote for Heparin?

• A. Protamine sulfate
• B. Narcan
• C. Romazicon
• D. Naloxone

Correct answer: A

Rationale: The correct answer is A: Protamine sulfate. Heparin is an anticoagulant medication used to prevent blood clots. In cases of overdose or excessive bleeding due to Heparin, protamine sulfate is administered as the specific antidote. Protamine sulfate works by neutralizing Heparin's anticoagulant activity. Choices B, C, and D are incorrect. Narcan (Naloxone) is used to reverse opioid overdose, Romazicon (Flumazenil) is used to reverse benzodiazepine overdose, and Naloxone is also used to reverse opioid overdose but is not the antidote for Heparin.

3. A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The provider should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?

• A. 1-year-old who has no health problems
• B. 17-year-old who has a hypersensitivity to Penicillin
• C. 25-year-old who is pregnant
• D. 52-year-old who takes a multivitamin supplement

Correct answer: B

Rationale: The correct answer is B. A 17-year-old can receive the influenza vaccine via nasal spray even if they have a hypersensitivity to penicillin, as this is not a contraindication for the influenza immunization. The nasal spray vaccine (LAIV) is a live attenuated vaccine that is suitable for healthy individuals aged 2-49 years. Pregnancy (choice C) is a contraindication for the nasal spray influenza vaccine. Children under 2 years of age (choice A) are also not candidates for the nasal spray. Taking a multivitamin supplement (choice D) is not a determining factor for the type of influenza vaccine a person should receive.

4. A client who takes Chlorpromazine for the treatment of Schizophrenia is due for a follow-up assessment. The nurse should expect the greatest improvement in which of the following manifestations? (Select all that apply.)

• A. Disorganized speech.
• B. Bizarre behavior.
• C. Impaired social interactions.
• D. Hallucinations.

Correct answer: A

Rationale: When a client takes a conventional antipsychotic medication like chlorpromazine, the greatest improvement is typically seen in positive symptoms such as disorganized speech. These medications are more effective in managing positive symptoms like disorganized speech rather than negative symptoms like impaired social interactions or hallucinations. Therefore, the nurse should anticipate improvement in disorganized speech as a positive response to chlorpromazine treatment.

5. A client with tobacco use disorder is being educated about Nicotine replacement therapy. Which statement by the client indicates an understanding of the teaching?

• A. I should avoid eating right before chewing a piece of nicotine gum.
• B. I will need to stop using the nicotine gum after 1 year.
• C. I know that nicotine gum is a safe alternative to smoking during pregnancy.
• D. I must chew the nicotine gum quickly for about 15 minutes.

Correct answer: A

Rationale: The correct answer is A. To maximize the effectiveness of nicotine gum, the client should avoid eating or drinking 15 minutes before and while using it. This helps ensure proper absorption of nicotine through the oral mucosa. Choice B is incorrect because the duration of nicotine gum use can vary depending on the individual's needs and progress. Choice C is incorrect as nicotine gum should be used during pregnancy only under healthcare provider guidance. Choice D is incorrect because nicotine gum should be chewed slowly until a tingling sensation is felt, then parked between the cheek and gum until the tingling stops.

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