Nursing Elites

1. When educating a client who has a prescription for Levothyroxine, which instruction should the nurse include?

• A. Take this medication on an empty stomach.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct instruction for taking Levothyroxine is on an empty stomach. This helps to enhance the absorption and effectiveness of the medication. Consuming it with food or antacids can impede its absorption, leading to decreased efficacy.

2. A client is prescribed Atorvastatin. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. Blood glucose
• B. Creatine kinase
• C. Hemoglobin
• D. Sodium

Correct answer: B

Rationale: Creatine kinase should be monitored in clients taking Atorvastatin as it can indicate muscle damage, a serious adverse effect of statins. Elevated creatine kinase levels can suggest myopathy or rhabdomyolysis, which are potential complications associated with statin therapy. Monitoring creatine kinase levels helps in early detection of muscle damage and guides appropriate management to prevent severe complications.

3. A client has anemia and a new prescription for ferrous sulfate liquid. Which of the following instructions should the nurse provide?

• A. Take the medication on an empty stomach to decrease gastrointestinal irritation.
• B. Take the medication with orange juice to enhance absorption.
• C. Take the medication with milk.
• D. Rinse the mouth before taking the iron.

Correct answer: B

Rationale: Taking ferrous sulfate with orange juice can help increase the absorption of iron. Orange juice contains vitamin C, which aids in the absorption of iron from the medication. This combination can enhance the effectiveness of the iron supplement for a client with anemia. Option A is incorrect because taking iron on an empty stomach can cause gastrointestinal upset. Option C is incorrect because calcium in milk can inhibit iron absorption. Option D is irrelevant to enhancing iron absorption.

4. 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: The nurse should expect that levothyroxine will be started at a low dose and gradually increased over several weeks. This cautious approach is crucial, especially in older adult clients, to prevent toxicity and ensure optimal therapeutic outcomes for managing hypothyroidism. Choice A is incorrect because starting at a high dose and tapering as needed is not the standard approach for levothyroxine. Choice B is incorrect because the initial dosage is typically adjusted to reach the optimal therapeutic dose. Choice C is incorrect as adjusting the dosage daily based on blood levels is not necessary for levothyroxine, as it has a long half-life and requires time to reach a steady state.

5. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?

• A. Restrict fluid intake to 1,000 mL per day.
• B. Maintain a consistent sodium intake.
• C. Take the medication at bedtime.
• D. Expect to have frequent headaches.

Correct answer: B

Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.

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