Nursing Elites

1. A patient is prescribed levothyroxine (Synthroid) for hypothyroidism. What is a key point the nurse should include in the patient education?

• A. Take the medication on an empty stomach with a full glass of water to ensure proper absorption.
• B. Do not take this medication with calcium supplements.
• C. Avoid taking this medication with grapefruit juice.
• D. Take the medication with food to enhance absorption.

Correct answer: A

Rationale: The correct answer is A. Levothyroxine should be taken on an empty stomach with a full glass of water, typically 30 minutes to an hour before breakfast, to ensure proper absorption. Taking it with food, calcium supplements, or grapefruit juice can interfere with its absorption. Choice B is incorrect because taking levothyroxine with calcium supplements can reduce its effectiveness. Choice C is incorrect because grapefruit juice can also interfere with levothyroxine absorption. Choice D is incorrect because taking levothyroxine with food can decrease its absorption.

2. Which of the following correctly identifies the plasma protein inflammatory mediator systems?

• A. Phagocytic, interferon, and complement systems.
• B. Complement, fibrinolytic, and clotting systems.
• C. Complement, clotting, and kinin systems.
• D. Complement, clotting, and acute phase reactant systems.

Correct answer: C

Rationale: The correct answer is C: Complement, clotting, and kinin systems. These are the three main plasma protein inflammatory mediator systems. The complement system helps in inflammation and immune responses, the clotting system is involved in blood coagulation, and the kinin system regulates inflammation and blood pressure. Choice A is incorrect because interferon is not part of the plasma protein inflammatory mediator systems. Choice B is incorrect because the fibrinolytic system is not a primary inflammatory mediator system. Choice D is incorrect because acute phase reactants are not part of the plasma protein inflammatory mediator systems.

3. A patient is prescribed estradiol (Estrace) for hormone replacement therapy (HRT). What should the nurse monitor during this therapy?

• A. Blood glucose levels
• B. Liver function tests
• C. Kidney function tests
• D. Blood pressure

Correct answer: B

Rationale: During estradiol therapy, monitoring liver function tests is essential due to the potential for liver dysfunction. Estradiol can affect liver function, making it crucial to monitor enzyme levels. Choice A, blood glucose levels, is not directly impacted by estradiol therapy, making it an incorrect choice. Choice C, kidney function tests, is not typically affected by estradiol therapy, so it is not the priority for monitoring. Choice D, blood pressure, is also not the primary parameter to monitor during estradiol therapy unless there are pre-existing conditions that warrant such monitoring.

4. A nurse on a postsurgical unit is providing care for a 76-year-old female client who is two days post-hemiarthroplasty (hip replacement) and who states that her pain has been out of control for the last several hours, though she is not exhibiting signs of pain. Which guideline should the nurse use for short-term and long-term treatment of the client's pain?

• A. Pain is what the client says it is, even if she is not exhibiting outward signs.
• B. Pain should be treated only when it is associated with observable symptoms.
• C. Long-term opioid use is generally safe for elderly clients in a hospital setting.
• D. The client's pain should be reassessed after every dose of pain medication.

Correct answer: A

Rationale: Pain is a subjective experience, and the client's report of pain should be taken seriously even if there are no outward signs. Choice B is incorrect because pain can be present without observable symptoms, and waiting for observable signs may delay appropriate pain management. Choice C is incorrect because the safety of long-term opioid use in elderly clients is a complex issue and should be carefully evaluated due to the risk of adverse effects. Choice D is incorrect because while pain reassessment is important, it should not be limited to just after medication administration but should occur regularly to ensure adequate pain control.

5. A 55-year-old male patient is taking finasteride (Proscar) for benign prostatic hyperplasia (BPH). What patient teaching should the nurse provide regarding the use of this medication?

• A. Avoid taking over-the-counter antacids while on this medication.
• B. This medication may decrease libido.
• C. This medication may take several months to improve symptoms.
• D. This medication may cause increased hair growth.

Correct answer: C

Rationale: Correct Answer: The nurse should inform the patient that finasteride may take several months to improve symptoms of BPH. It is essential for patients to understand the delayed onset of action to manage their expectations and compliance. Choice A is incorrect because there is no significant interaction between finasteride and over-the-counter antacids. Choice B is incorrect as finasteride is more commonly associated with decreased libido rather than increased libido. Choice D is incorrect as finasteride is known to reduce hair growth rather than increase it.

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