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. Which of the following diuretics inhibits sodium reabsorption in the kidneys while sparing K+ and hydrogen ions?

• A. Spironolactone
• B. Furosemide
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: A

Rationale: Spironolactone is the correct answer as it is classified as a potassium-sparing diuretic. It works by inhibiting sodium reabsorption in the kidneys while promoting the retention of potassium and hydrogen ions. This mechanism of action helps in reducing fluid retention without causing excessive loss of potassium, which is a common side effect of other diuretics. Furosemide (choice B), Hydrochlorothiazide (choice C), and Bumetanide (choice D) are not correct as they are not potassium-sparing diuretics. Furosemide and Bumetanide are loop diuretics that inhibit sodium, potassium, and chloride reabsorption in the loop of Henle. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, leading to potassium loss.

3. A client is to receive Pamidronate for bone pain related to cancer. What precaution should the nurse take during the administration of Pamidronate?

• A. Inspect the skin for redness and irritation around the injection site.
• B. Assess the IV site for thrombophlebitis frequently during administration.
• C. Instruct the client to lie down for 30 minutes after oral administration.
• D. Monitor for signs of anaphylaxis for 20 minutes after intramuscular injection.

Correct answer: B

Rationale: Pamidronate is typically administered through IV infusion, which can cause irritation to veins. The nurse should frequently assess the IV site for thrombophlebitis during the administration to promptly detect any potential complications related to the infusion. Inspecting the skin for redness and irritation around the injection site (Choice A) is not directly related to IV infusion. Instructing the client to lie down after oral administration (Choice C) is not necessary for IV administration. Monitoring for signs of anaphylaxis after an intramuscular injection (Choice D) is not relevant for an IV infusion of Pamidronate.

4. A client is starting therapy with filgrastim, and a nurse is providing teaching on monitoring adverse effects. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Bone pain
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Bone pain. The nurse should instruct the client to monitor for bone pain since it is a common adverse effect of filgrastim. This occurs due to increased bone marrow activity stimulated by the medication.

5. A client is prescribed Digoxin. Which of the following findings should the nurse monitor as a sign of potential toxicity?

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

Correct answer: A

Rationale: Bradycardia is a common sign of Digoxin toxicity. Digoxin can lead to toxicity, which can manifest as various signs and symptoms, including bradycardia. Monitoring the client's heart rate closely is crucial to detect and manage potential toxicity early. Hypertension, hyperglycemia, and hypocalcemia are not typically associated with Digoxin toxicity; therefore, they are incorrect choices.

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