Nursing Elites

1. A healthcare professional is assessing a client who has a new prescription for levothyroxine. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Increased heart rate
• C. Heat intolerance
• D. Elevated blood pressure

Correct answer: C

Rationale: The correct answer is C: Heat intolerance. Heat intolerance is a concerning sign of levothyroxine toxicity and should be reported to the provider promptly. Levothyroxine is a medication used to treat hypothyroidism by supplementing the body's thyroid hormones. When a client experiences heat intolerance, it can indicate that the dose of levothyroxine is too high, leading to hyperthyroidism symptoms. Weight gain, increased heart rate, and elevated blood pressure are not typically associated with levothyroxine toxicity; instead, they are more commonly seen in conditions like hypothyroidism.

2. A client with a diagnosis of acute myocardial infarction (MI) is receiving thrombolytic therapy. The nurse monitors the client for which potential complication associated with this therapy?

• A. Hypertension
• B. Bleeding
• C. Hyperkalemia
• D. Hypoglycemia

Correct answer: B

Rationale: Thrombolytic therapy is associated with an increased risk of bleeding due to its mechanism of action in dissolving blood clots. Therefore, the nurse should closely monitor the client for any signs of hemorrhage, such as unexplained bruising, bleeding gums, or blood in the urine or stools. Hypertension is not a common complication of thrombolytic therapy. Hyperkalemia and hypoglycemia are also not typically associated with this therapy.

3. Prior to a cardiac catheterization, what instruction should the client be reminded of?

• A. You will need to be NPO for 6 to 8 hours before the procedure.
• B. You will not be able to move around during the procedure.
• C. You will be required to lie still for several hours after the test.
• D. You will not have to drink any fluids immediately before the test.

Correct answer: A

Rationale: Being NPO (nothing by mouth) for 6 to 8 hours before a cardiac catheterization is crucial to prevent complications such as aspiration during the procedure. This helps ensure the safety and accuracy of the test results by minimizing the risk of food or liquid in the stomach interfering with the procedure. Choice B is incorrect because the client will need to lie still during the procedure to ensure its accuracy. Choice C is incorrect as the client is typically required to lie flat for a few hours after the test, not several hours. Choice D is incorrect as the client is usually not allowed to drink fluids immediately before the test to prevent complications.

4. Prior to a dipyridamole thallium scan, what substance should the LPN/LVN ensure the client has not consumed?

• A. Caffeine
• B. Fatty meal
• C. Excess sugar
• D. Milk products

Correct answer: A

Rationale: Caffeine should be avoided before a dipyridamole thallium scan as it can interfere with the test results. Caffeine is a stimulant that can affect the heart rate and may lead to inaccurate findings during the scan. Fatty meals, excess sugar, and milk products do not specifically interfere with the dipyridamole thallium scan procedure. Therefore, it is essential for the LPN/LVN to check and ensure that the client has not consumed caffeine prior to the procedure to obtain accurate diagnostic results.

5. During an assessment, a client taking valproic acid exhibits elevated liver enzymes. What finding should the nurse report to the provider?

• A. Elevated liver enzymes
• B. Weight loss
• C. Dry mouth
• D. Increased appetite

Correct answer: A

Rationale: Elevated liver enzymes are a critical finding that the nurse should report to the provider when assessing a client taking valproic acid. It can be indicative of hepatotoxicity, a severe side effect associated with valproic acid use. Timely reporting and intervention are essential to prevent further complications and ensure the client's safety and well-being. Choices B, C, and D are not directly related to valproic acid use or the manifestation of hepatotoxicity. Weight loss, dry mouth, and increased appetite are not typically associated with elevated liver enzymes in the context of valproic acid administration.

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