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 client has a new prescription for Nitroglycerin to treat angina. Which of the following instructions should be included?

Correct answer: C

Rationale: When using Nitroglycerin patches to treat angina, it is crucial to apply the patch to a different site each time. This practice helps prevent skin irritation and ensures proper absorption of the medication, optimizing its effectiveness in managing angina symptoms.

3. A client is receiving heparin therapy. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?

Correct answer: B

Rationale: The corrected answer is B: aPTT. The activated partial thromboplastin time (aPTT) is the laboratory value used to monitor the effectiveness of heparin therapy. The aPTT should be maintained at 1.5 to 2 times the normal level to ensure therapeutic anticoagulation. Monitoring aPTT helps healthcare providers adjust heparin doses to achieve the desired anticoagulant effects and prevent complications such as bleeding or clotting. Choice A, PT (prothrombin time), is used to monitor warfarin therapy, not heparin. Choice C, INR (international normalized ratio), is also used to monitor warfarin therapy. Choice D, platelet count, is important for assessing the risk of bleeding, but it does not directly monitor the effectiveness of heparin therapy.

4. Which of the following is the antidote for lead poisoning?

Correct answer: C

Rationale: Calcium disodium ethylenediaminetetraacetic acid (CaEDTA) is the antidote for lead poisoning. CaEDTA works by chelating lead, forming a complex that is then excreted in the urine. It is used in chelation therapy to treat lead poisoning by reducing lead levels in the body.

5. A healthcare professional is caring for a client who has a new prescription for Morphine to manage post-operative pain. Which of the following assessments should the healthcare professional perform first?

Correct answer: D

Rationale: The healthcare professional should prioritize assessing the client's respiratory rate because respiratory depression is a life-threatening adverse effect of Morphine. Monitoring the respiratory rate allows for early detection of potential complications and timely intervention to prevent harm. Assessing urine output, bowel sounds, and pain level are important but should come after ensuring the client's respiratory status is stable as it is the most critical assessment to prevent serious complications associated with opioid use.

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