Nursing Elites

1. A client is being taught about a new prescription for Celecoxib. Which of the following information should be included in the teaching?

• A. Increases the risk for a myocardial infarction
• B. Decreases the risk of stroke
• C. Inhibits COX-1
• D. Increases platelet aggregation

Correct answer: A

Rationale: The correct answer is A: 'Increases the risk for a myocardial infarction.' Celecoxib, a COX-2 inhibitor, increases the risk for a myocardial infarction due to its effect on suppressing vasodilation, which can lead to this adverse cardiovascular event. Choices B, C, and D are incorrect. Celecoxib does not decrease the risk of stroke, inhibit COX-1, or increase platelet aggregation. It's crucial for the nurse to educate the client about the increased risk for a myocardial infarction when taking Celecoxib and emphasize monitoring for signs of heart issues and the importance of seeking prompt medical attention if symptoms occur.

2. 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: The nurse should expect that levothyroxine will be started at a low dose and gradually increased over several weeks. This cautious approach is crucial, especially in older adult clients, to prevent toxicity and ensure optimal therapeutic outcomes for managing hypothyroidism. Choice A is incorrect because starting at a high dose and tapering as needed is not the standard approach for levothyroxine. Choice B is incorrect because the initial dosage is typically adjusted to reach the optimal therapeutic dose. Choice C is incorrect as adjusting the dosage daily based on blood levels is not necessary for levothyroxine, as it has a long half-life and requires time to reach a steady state.

3. A healthcare provider is providing teaching to a client who is starting therapy with paclitaxel. Which of the following adverse effects should the healthcare provider instruct the client to monitor?

• A. Bradycardia
• B. Diarrhea
• C. Neutropenia
• D. Urinary retention

Correct answer: C

Rationale: The correct answer is C: Neutropenia. Paclitaxel commonly causes neutropenia due to bone marrow suppression. It is essential for clients receiving this medication to monitor for signs of neutropenia, such as fever, chills, and increased susceptibility to infections, as it can increase the risk of serious complications.

4. What is the therapeutic use of Alprazolam?

• A. Preventing thrombus formation
• B. Relief of anxiety
• C. Decreasing the risk of stroke
• D. Increasing urinary output

Correct answer: B

Rationale: The therapeutic use of Alprazolam is for the relief of anxiety. Alprazolam belongs to a class of medications known as benzodiazepines, which are commonly prescribed to manage anxiety disorders and panic attacks. It works by enhancing the effects of a natural chemical in the body (GABA) to produce a calming effect on the brain and nerves, thereby alleviating symptoms of anxiety.

5. A healthcare provider is reviewing a client's health record and notes that the client is experiencing episodes of hypokalemia. Which of the following medications should the healthcare provider identify as a cause of the client's hypokalemia?

• A. Captopril
• B. Lisinopril
• C. Furosemide
• D. Spironolactone

Correct answer: C

Rationale: Furosemide is a loop diuretic that acts on the kidneys to increase urine production. This increased urine output can lead to the excessive excretion of potassium, resulting in hypokalemia. Monitoring potassium levels and considering supplementation may be necessary when a patient is on furosemide to prevent or manage hypokalemia.

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