Nursing Elites

1. A client is receiving levothyroxine for hypothyroidism. The nurse should monitor the client for which potential side effect?

• A. Weight gain
• B. Dry skin
• C. Hair loss
• D. Hyperthermia

Correct answer: A

Rationale: Levothyroxine is a medication used to treat hypothyroidism by supplementing the body with thyroid hormone. If the dosage of levothyroxine is too high, it can cause symptoms of hyperthyroidism, including weight loss. Therefore, weight gain can be a potential side effect of levothyroxine if the dosage is excessive.

2. Which assessment finding requires nursing intervention prior to the administration of medication?

• A. Apical pulse heard best at the pulmonic site
• B. Irregular apical pulse rhythm
• C. Presence of a systolic heart murmur
• D. Apical pulse rate of 50 beats/minute

Correct answer: D

Rationale: An apical pulse rate of 50 beats/minute indicates bradycardia, a heart rate below the normal range, which requires immediate nursing intervention before administering medication to address the potential impact of the bradycardia on the patient's overall condition.

3. When should a client receiving insulin lispro administer this medication?

• A. Before meals
• B. After meals
• C. At bedtime
• D. Before sleep

Correct answer: A

Rationale: Insulin lispro is a rapid-acting insulin that should be administered shortly before meals. This timing helps to synchronize the peak action of insulin with the rise in blood glucose levels after eating, effectively managing blood glucose levels in the body.

4. A patient with irritable bowel syndrome starts a new prescription for dicyclomine, an anticholinergic medication. The client reports the onset of sensitivity to light and a dry mouth. How should the nurse respond?

• A. Determine if the medication is being taken correctly
• B. Provide instructions on managing these side effects
• C. Schedule an appointment for evaluation by the healthcare provider
• D. Advise stopping the medication until the unpleasant side effects wear off

Correct answer: B

Rationale: The correct response is to provide instructions on managing these side effects. Sensitivity to light and dry mouth are common side effects of anticholinergic medications like dicyclomine. It is essential for the nurse to educate the patient on strategies to cope with these side effects, such as staying hydrated to address dry mouth and wearing sunglasses to reduce sensitivity to light. Option A is not the priority as the side effects are expected with this medication and do not necessarily indicate incorrect use. Option C is not immediately necessary as the side effects are common and can be managed without a healthcare provider evaluation. Option D is not recommended unless advised by the healthcare provider as abruptly stopping the medication can lead to worsening symptoms or withdrawal effects.

5. A client with severe rheumatoid arthritis is prescribed adalimumab. The nurse should monitor for which potential adverse effect?

• A. Increased risk of infection
• B. Bone marrow suppression
• C. Hair loss
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Increased risk of infection. Adalimumab is known to increase the risk of infection due to its immunosuppressive effects. Patients on adalimumab should be closely monitored for signs and symptoms of infection, such as fever, chills, and malaise, and should promptly report any such symptoms to their healthcare provider for further evaluation and management. Monitoring for infection is crucial to prevent serious complications in patients receiving adalimumab therapy.

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