Nursing Elites

1. A client has been on levothyroxine therapy for several months. Which of the following findings indicates a therapeutic response to the medication?

• A. Decrease in level of thyroxine (T4)
• B. Increase in weight
• C. Increase in hours of sleep per night
• D. Decrease in level of thyroid stimulating hormone (TSH)

Correct answer: D

Rationale: A therapeutic response to levothyroxine is indicated by a decrease in the level of TSH. This decrease signifies that the body requires less stimulation to produce thyroid hormone, reflecting a normalization of thyroid function due to the medication's effectiveness. Choices A, B, and C are incorrect as an increase in T4 levels, weight gain, and increased sleep hours are not indicative of a therapeutic response to levothyroxine therapy.

2. A client has been prescribed Alendronate for osteoporosis. Which of the following instructions should the nurse provide?

• A. Take the medication with a full glass of water after getting up in the morning.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Chew the tablet and mix it with applesauce if swallowing is difficult.
• D. Take the medication at bedtime to minimize the chance of esophageal irritation.

Correct answer: A

Rationale: The correct instruction for a client prescribed Alendronate for osteoporosis is to take the medication with a full glass of water after getting up in the morning. This is important to reduce the risk of esophageal irritation. Choice B is also correct as remaining upright for at least 30 minutes after taking the medication helps prevent esophageal irritation and ensures proper absorption. Choice C is incorrect because Alendronate tablets should not be chewed or mixed with any other substance. Choice D is incorrect as taking the medication at bedtime increases the risk of esophageal irritation due to lying down after ingestion.

3. When educating a client with a new prescription for Atorvastatin to treat Hyperlipidemia, which instruction should the nurse include?

• A. Take this medication in the morning.
• B. Avoid drinking grapefruit juice.
• C. Increase your intake of green, leafy vegetables.
• D. Expect your stools to turn clay-colored.

Correct answer: B

Rationale: The correct instruction for the nurse to include when educating a client with a new prescription for Atorvastatin to treat Hyperlipidemia is to avoid drinking grapefruit juice. Grapefruit juice can increase the blood levels of atorvastatin, leading to an elevated risk of serious side effects such as liver damage and muscle problems. It is essential for the client to be aware of this potential interaction and to follow the nurse's advice to avoid grapefruit juice while taking Atorvastatin. Choices A, C, and D are incorrect. Taking Atorvastatin in the morning is a common recommendation but not the priority over avoiding grapefruit juice. Increasing intake of green, leafy vegetables is generally a healthy dietary choice but is not specific to the medication. Expecting stools to turn clay-colored is not a common side effect of Atorvastatin.

4. A client has been prescribed diltiazem (Cardizem) and asks the nurse what type of drug this is. Which response by the nurse is most appropriate?

• A. “A beta blocker.”
• B. “A sodium channel blocker.”
• C. “An alpha blocker.”
• D. “A calcium channel blocker.”

Correct answer: D

Rationale: Diltiazem (Cardizem) belongs to the class of drugs known as calcium channel blockers. These medications work by blocking calcium from entering the muscle cells of the heart and blood vessels, leading to relaxation of the blood vessels and reduced workload on the heart. This helps in lowering blood pressure and improving blood flow. It is crucial for the nurse to provide accurate information to the client about the type of drug prescribed to ensure understanding and compliance with the treatment plan.

5. A healthcare provider is teaching the parents of a school-age child about transdermal Methylphenidate. Which of the following instructions should the healthcare provider include?

• A. Apply one patch twice a day.
• B. Leave the patch on for 9 hours.
• C. Apply the patch to the child's waist.
• D. Use the opened tray within 6 months.

Correct answer: B

Rationale: When administering transdermal Methylphenidate, it is important to leave the patch on for 9 hours each day to ensure the medication is effective. This duration allows for proper absorption of the medication through the skin. It is crucial for parents to follow this instruction to achieve the desired therapeutic effect for their child.

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