Nursing Elites

1. The healthcare provider is assessing the effectiveness of the drug amiodarone. Which client statement best indicates that the drug has been effective?

• A. I have not had as many spells of angina.
• B. I have not had as much swelling in my ankles lately.
• C. My doctor told me my cholesterol levels were improving with each visit.
• D. I do not notice as many irregular heartbeats as before I started taking this medication.

Correct answer: D

Rationale: The correct answer is option D. The effectiveness of amiodarone is best assessed by a reduction in irregular heartbeats since it is primarily used to treat ventricular dysrhythmias. This drug's main purpose is to control irregular heart rhythms, so a decrease in irregular heartbeats indicates its effectiveness. Options A, B, and C are incorrect because amiodarone is not primarily used to address angina, ankle swelling, or cholesterol levels, so improvements in these areas do not directly reflect the drug's effectiveness.

2. How should the healthcare provider schedule the administering of propylthiouracil (PTU)?

• A. Offer both drugs together with a meal
• B. Give parental dose once every 24 hours
• C. Schedule both medications at bedtime
• D. Administer iodine one hour before PTU

Correct answer: D

Rationale: Administering iodine one hour before PTU is crucial to ensure proper absorption and effectiveness of PTU. This timing helps optimize the therapeutic benefits of PTU by allowing it to be absorbed efficiently without interference from iodine, ultimately leading to better treatment outcomes for the patient. Choices A, B, and C are incorrect because offering both drugs together with a meal, giving parental dose once every 24 hours, and scheduling both medications at bedtime do not address the specific timing requirement of administering iodine before PTU for optimal absorption.

3. A client with diabetes mellitus type 2 is prescribed liraglutide. The nurse should include which instruction in the client's teaching plan?

• A. Administer this medication once a week.
• B. Administer this medication once a month.
• C. Administer this medication twice a day.
• D. Administer this medication once a day.

Correct answer: D

Rationale: The correct answer is to administer liraglutide once a day. Liraglutide is typically prescribed to be taken once daily, as directed by the healthcare provider. This dosing schedule helps maintain consistent levels of the medication in the body to effectively manage blood sugar levels in clients with diabetes mellitus type 2. Option A, administering once a week, is incorrect as it would not provide consistent control of blood sugar levels. Option B, administering once a month, is also incorrect as it is not the recommended dosing frequency for liraglutide. Option C, administering twice a day, is inaccurate as liraglutide is not typically dosed in this manner. It is important for the nurse to emphasize the importance of adherence to the prescribed dosing regimen to achieve optimal therapeutic outcomes.

4. A client taking long-term steroids also has ranitidine prescribed. The nurse provides which explanation as to why these drugs are given together?

• A. Ranitidine reduces the risk of ulcers associated with steroids.
• B. Ranitidine decreases the risk of infection associated with steroids.
• C. Ranitidine decreases blood sugar elevations associated with steroids.
• D. Ranitidine reduces sodium retention associated with steroid usage.

Correct answer: A

Rationale: The correct answer is A. Ranitidine is prescribed with long-term steroids to reduce the risk of ulcers associated with steroid therapy. Although steroids can increase the risk of ulcers due to their effect on the gastrointestinal system, ranitidine works by reducing stomach acid production, thus helping to prevent ulcer formation. Choices B, C, and D are incorrect as ranitidine is not given to decrease the risk of infection, reduce blood sugar elevations, or reduce sodium retention associated with steroid usage.

5. A client with a history of heart failure is prescribed carvedilol. The nurse should monitor the client for which adverse effect?

• A. Dizziness upon standing
• B. Weight loss
• C. Bradycardia
• D. Hypotension

Correct answer: D

Rationale: The correct answer is D: Hypotension. Carvedilol, a beta-blocker, can lead to hypotension by blocking the effects of adrenaline, which can cause blood vessels to dilate and reduce blood pressure. While dizziness upon standing is a potential adverse effect of carvedilol, it is more specifically related to orthostatic hypotension, which is a form of hypotension that occurs when a person stands up from a sitting or lying position. Weight loss and bradycardia are not typically associated with carvedilol use. Therefore, the nurse should primarily monitor for hypotension in a client taking carvedilol.

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