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 patient is receiving education about a new prescription for Omeprazole to manage heartburn. What information should the nurse include in the teaching?

• A. Take this medication at bedtime.
• B. This medication decreases the production of gastric acid.
• C. Take this medication 2 hours after eating.
• D. This medication can cause hyperkalemia.

Correct answer: B

Rationale: The correct information to include when teaching a patient about Omeprazole is that it decreases the production of gastric acid. Omeprazole works by inhibiting the proton pump in the stomach lining, thereby reducing acid secretion. This mechanism helps in managing heartburn symptoms effectively. Choice A is incorrect because Omeprazole is usually taken before a meal. Choice C is incorrect as Omeprazole is typically taken before meals, not after. Choice D is incorrect because hyperkalemia is not a common side effect of Omeprazole.

3. A client has a prescription for Furosemide. Which of the following instructions should the nurse include?

• A. Take the medication in the morning.
• B. Increase your intake of potassium-rich foods.
• C. Expect your urine to turn orange.
• D. Avoid prolonged sunlight exposure.

Correct answer: B

Rationale: The correct answer is B: 'Increase your intake of potassium-rich foods.' Furosemide is a loop diuretic that can lead to hypokalemia (low potassium levels) due to increased excretion of potassium in the urine. To counteract this effect and maintain electrolyte balance, the client should be advised to increase their intake of potassium-rich foods. This instruction helps prevent potential complications associated with low potassium levels. Choices A, C, and D are incorrect. Taking Furosemide in the morning does not affect its effectiveness; urine turning orange is not an expected side effect of Furosemide; and avoiding prolonged sunlight exposure is not directly related to Furosemide use.

4. A client has a new prescription for Atorvastatin. Which of the following instructions should the nurse include?

• A. Avoid drinking grapefruit juice.
• B. Take the medication with your evening meal.
• C. Increase your intake of leafy green vegetables.
• D. Stop taking the medication if you experience muscle pain.

Correct answer: A

Rationale: The correct answer is A: 'Avoid drinking grapefruit juice.' Grapefruit juice should be avoided when taking Atorvastatin because it can increase the blood levels of the medication, potentially leading to a higher risk of adverse effects like muscle pain and liver damage. It is important to follow this instruction to ensure the safe and effective use of Atorvastatin. Choices B, C, and D are incorrect. Taking Atorvastatin with food, specifically a low-fat meal, is recommended, but it is not necessary to specify the evening meal. While increasing intake of leafy green vegetables is generally beneficial for health, it is not a specific instruction for Atorvastatin. Lastly, stopping the medication if one experiences muscle pain is not advisable without consulting a healthcare provider, as muscle pain can be a symptom of a serious side effect of Atorvastatin that requires medical attention.

5. What is one therapeutic use for nitroglycerin?

• A. Relief or prevention of anginal attacks
• B. Diuresis and mobilization of excess fluid
• C. Decreasing nausea and vomiting
• D. Relief of anxiety

Correct answer: A

Rationale: Nitroglycerin is primarily used for the relief or prevention of anginal attacks. It works by dilating blood vessels, increasing blood flow and oxygen to the heart muscle, thereby relieving chest pain caused by angina. The medication is not indicated for diuresis, antiemetic effects, or anxiety relief. Therefore, choices B, C, and D are incorrect as they do not reflect the therapeutic use of nitroglycerin.

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