a nurse is caring for an older adult client in a long term care facility who has hypothyroidism and a new prescription for levothyroxine which of the
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Nursing Elites

ATI RN

ATI Pharmacology

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?

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 provider is providing discharge instructions to a client who is prescribed Enalapril. Which of the following adverse effects should the healthcare provider instruct the client to monitor?

Correct answer: A

Rationale: The correct answer is A: Dry cough. A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. Enalapril can cause a non-productive cough due to its effect on bradykinin levels. The client should be advised to report this symptom to their healthcare provider to consider alternative treatments. Choices B, C, and D are incorrect because weight gain, diarrhea, and nausea are not typically associated with Enalapril use.

3. A client has a new prescription for Diltiazem. Which of the following statements should the nurse include in the teaching?

Correct answer: B

Rationale: The correct statement to include when teaching a client about Diltiazem is to avoid drinking grapefruit juice. Grapefruit juice can increase the levels of diltiazem in the blood, leading to potential toxicity and increased side effects. It is important for the client to be aware of this interaction to ensure the safe and effective use of the medication. Option A is incorrect because dry mouth is not a common side effect of Diltiazem. Option C is incorrect because Diltiazem is actually used to treat rapid heart rates. Option D is unrelated to the medication and not relevant to the teaching.

4. A client is prescribed Diltiazem. Which of the following findings should the nurse monitor?

Correct answer: B

Rationale: Diltiazem is a calcium channel blocker that can lead to bradycardia as an adverse effect due to its negative chronotropic and dromotropic effects on the heart. The nurse should monitor the client's heart rate regularly to detect any signs of bradycardia and take appropriate actions if necessary. Tachycardia (Choice A) is not an expected finding with Diltiazem use. Hypertension (Choice C) is actually a condition that Diltiazem is used to treat. Hyperkalemia (Choice D) is not a common adverse effect of Diltiazem.

5. In which of the following cases is Lansoprazole not used?

Correct answer: D

Rationale: Lansoprazole is a proton pump inhibitor mainly used to treat conditions related to the stomach, such as gastritis, peptic ulcers, and Zollinger-Ellison syndrome. Thalamus hypertrophy is not a condition that Lansoprazole is indicated for; it is used for gastrointestinal issues and not neurological conditions.

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