Nursing Elites

1. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

• A. The client will start at a high dose, and the dose will be tapered as needed.
• B. The client will remain on the initial dosage during the course of treatment.
• C. The client's dosage will be adjusted daily based on blood levels.
• D. The client will start on a low dose, which will be gradually increased.

Correct answer: D

Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes. Choice A is incorrect because starting at a high dose can increase the risk of adverse effects and is not the recommended approach. Choice B is incorrect because maintaining the initial dosage throughout the treatment may not achieve optimal therapeutic levels. Choice C is incorrect because adjusting the dosage daily based on blood levels is not the standard practice for initiating Levothyroxine treatment.

2. Which of the following is NOT an opioid or NSAID?

• A. Morphine
• B. Ibuprofen
• C. Hydromorphone
• D. Acetaminophen

Correct answer: D

Rationale: Acetaminophen is the correct answer as it is not classified as an opioid or NSAID. Acetaminophen is considered a non-opioid analgesic, which means it works by a different mechanism than opioids and NSAIDs to relieve pain and reduce fever. Morphine, hydromorphone, and ibuprofen, on the other hand, are classified as opioids or NSAIDs. Morphine and hydromorphone are opioids, while ibuprofen is an NSAID (Nonsteroidal Anti-Inflammatory Drug), all of which work through different mechanisms compared to acetaminophen.

3. A client with Bipolar disorder has a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

• A. This medication can safely be taken during pregnancy.
• B. Eliminate grapefruit juice from your diet.
• C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
• D. Notify your provider if you develop a rash.

Correct answer: B

Rationale: The correct answer is B: "Eliminate grapefruit juice from your diet." Grapefruit juice affects carbamazepine metabolism and should be avoided. It can lead to increased levels of the medication, potentially causing toxicity. Monitoring carbamazepine blood levels and the complete blood count (CBC) is essential to ensure the medication's efficacy and safety. Although choice A is incorrect (This medication can safely be taken during pregnancy), carbamazepine is classified as a Pregnancy Category D drug, which means there is positive evidence of human fetal risk. Choice D (Notify your provider if you develop a rash) is also important because carbamazepine can cause serious adverse effects like Stevens-Johnson syndrome, which can be life-threatening. Regular monitoring and prompt reporting of any rash are crucial. Therefore, choices C and D are also relevant instructions for the client.

4. A client has a new prescription for Clonidine. Which of the following adverse effects should the nurse monitor?

• A. Drowsiness
• B. Dry mouth
• C. Weight gain
• D. Insomnia

Correct answer: B

Rationale: Dry mouth is a common adverse effect of Clonidine. Clonidine can reduce saliva production, leading to dry mouth. To alleviate this symptom, the client should be advised to increase fluid intake or use sugar-free gum or candy. Monitoring for dry mouth is important to prevent complications such as oral health issues. Drowsiness, weight gain, and insomnia are potential side effects of Clonidine but are less common compared to dry mouth. Therefore, the nurse should prioritize monitoring for dry mouth as it's a more prevalent adverse effect associated with this medication.

5. A healthcare professional is preparing to administer a dose of Hydromorphone IV to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication over 5 minutes.
• B. Administer a dose of Naloxone prior to giving the Hydromorphone.
• C. Assess the client's blood pressure prior to administration.
• D. Inject the medication into the client's subcutaneous tissue.

Correct answer: A

Rationale: The correct action for the healthcare professional preparing to administer IV Hydromorphone to a client is to administer the medication over 5 minutes. This slow administration is crucial to reduce the risk of hypotension and respiratory depression. Administering the medication rapidly can lead to adverse effects. Option B, administering Naloxone prior to Hydromorphone, is incorrect because Naloxone is used as an antidote for opioid overdose, not as a routine pre-medication. Option C, assessing the client's blood pressure before administration, is important but not the immediate action to take to reduce adverse effects of Hydromorphone. Option D, injecting the medication into the client's subcutaneous tissue, is incorrect as Hydromorphone is meant for intravenous administration for rapid onset of action.

Similar Questions