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. ACE Inhibitors are used in the treatment of all EXCEPT:

• A. Hypertension
• B. Heart Failure
• C. Hypotension
• D. Diabetic nephropathy

Correct answer: C

Rationale: ACE inhibitors are commonly used in the treatment of hypertension, heart failure, and diabetic nephropathy due to their ability to reduce blood pressure, improve heart function, and protect the kidneys. However, they are not indicated for hypotension as they can further lower blood pressure, worsening the condition. Therefore, the correct answer is C. Choice A, hypertension, is correct as ACE inhibitors are a first-line treatment for this condition. Choice B, heart failure, is also correct as ACE inhibitors help improve heart function in patients with heart failure. Choice D, diabetic nephropathy, is correct as ACE inhibitors can slow the progression of kidney damage in diabetic patients.

3. A client is receiving treatment with carboplatin. Which of the following findings should the nurse monitor?

• A. Hyperglycemia
• B. Ototoxicity
• C. Hypertension
• D. Bradycardia

Correct answer: B

Rationale: Corrected Rationale: Carboplatin is known to cause ototoxicity as a serious adverse effect. It is essential for the nurse to monitor the client for any signs or symptoms of hearing loss or other auditory issues to address them promptly. Incorrect Choices Rationale: A) Hyperglycemia is not a common side effect associated with carboplatin. C) Hypertension is not a typical finding to monitor for specifically related to carboplatin treatment. D) Bradycardia is not a primary concern when monitoring a client on carboplatin.

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

• A. Take this medication at bedtime.
• B. Remain upright for 30 minutes after taking the medication.
• C. Take this medication with food.
• D. Increase your intake of calcium-rich foods.

Correct answer: B

Rationale: The correct answer is to instruct the client to remain upright for 30 minutes after taking Alendronate. Alendronate can cause esophageal irritation and even ulceration if it remains in contact with the esophagus. By staying upright, the medication is more likely to pass through the esophagus and into the stomach, reducing the risk of irritation and complications. Choice A is incorrect because Alendronate should be taken in the morning, not at bedtime, and the client should remain upright after taking it. Choice C is incorrect because Alendronate should be taken on an empty stomach, usually in the morning, to enhance absorption. Choice D is incorrect because while calcium intake is important, it is not directly related to the administration of Alendronate.

5. A healthcare provider is reviewing a client's medical history and notes that the client has a prescription for Digoxin. Which of the following findings is a manifestation of Digoxin toxicity?

• A. Elevated blood pressure
• B. Bradycardia
• C. Yellow-tinged vision
• D. Ringing in the ears

Correct answer: C

Rationale: Yellow-tinged vision, along with nausea, vomiting, and confusion, are common manifestations of Digoxin toxicity. Visual disturbances are important to recognize as they can indicate the need for immediate medical attention and potential adjustment of Digoxin therapy to prevent serious complications. Elevated blood pressure is not typically associated with Digoxin toxicity; instead, hypotension may occur. Bradycardia is a common therapeutic effect of Digoxin rather than a sign of toxicity. Ringing in the ears, or tinnitus, is also a potential side effect of Digoxin but is less specific to toxicity compared to yellow-tinged vision.

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