Nursing Elites

1. A client has been taking levothyroxine for 6 months. Which of the following findings indicates that the medication is effective?

• A. Weight gain
• B. Increased heart rate
• C. Decreased TSH levels
• D. Elevated blood pressure

Correct answer: C

Rationale: In a client taking levothyroxine for thyroid hormone replacement, decreased TSH levels indicate that the medication is effective. TSH levels decrease as the thyroid hormone levels are adequately replaced by levothyroxine, signaling a positive response to treatment. Choices A, B, and D are incorrect because weight gain, increased heart rate, and elevated blood pressure are not expected findings indicating the effectiveness of levothyroxine therapy. Weight gain may suggest inadequate dosing, while increased heart rate and elevated blood pressure could indicate over-replacement or side effects of the medication.

2. A healthcare professional is reviewing laboratory results for a client who has been taking carbamazepine. Which of the following findings should the healthcare professional report to the provider?

• A. WBC count 3,000/mm3
• B. Platelet count 150,000/mm3
• C. Hemoglobin 14 g/dL
• D. Serum potassium 4.5 mEq/L

Correct answer: A

Rationale: A WBC count of 3,000/mm3 indicates leukopenia, a serious side effect of carbamazepine. Leukopenia can increase the risk of infections due to decreased white blood cell count, which is important to report to the provider for further evaluation and management. Platelet count within normal range (choice B), hemoglobin level within normal range (choice C), and serum potassium level within normal range (choice D) are not directly associated with carbamazepine use and do not require immediate reporting as they do not indicate a serious adverse effect.

3. The healthcare provider is reinforcing instructions to a client with heart failure who is prescribed a low-sodium diet. The provider should advise the client to choose which food item?

• A. Canned soup
• B. Fresh vegetables
• C. Processed cheese
• D. Pickled vegetables

Correct answer: B

Rationale: Fresh vegetables are a suitable choice for clients on a low-sodium diet as they are naturally low in sodium and provide essential nutrients. In contrast, canned soup, processed cheese, and pickled vegetables tend to be high in sodium, which is not recommended for individuals with heart failure and on a low-sodium diet. Fresh vegetables are also rich in fiber, vitamins, and minerals, making them a healthier option compared to the other choices provided.

4. A client has a new prescription for atenolol. Which of the following instructions should be included in the discharge teaching?

• A. Take the medication at bedtime.
• B. Monitor your heart rate daily.
• C. Increase your intake of potassium-rich foods.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct answer is to instruct the client to monitor their heart rate daily when taking atenolol. Atenolol can lead to bradycardia, a slow heart rate. By monitoring heart rate daily, the client can promptly identify any significant changes and seek medical attention if necessary. This proactive approach enables early detection of potential adverse effects of atenolol, contributing to the client's safety and well-being. Choices A, C, and D are incorrect because taking atenolol at bedtime, increasing potassium-rich foods intake, or avoiding dairy products are not specific instructions related to the potential side effects of atenolol.

5. While assessing a client taking propranolol, which finding should the nurse report to the provider?

• A. Bradycardia
• B. Dry mouth
• C. Constipation
• D. Increased appetite

Correct answer: A

Rationale: Bradycardia is a significant side effect of propranolol, a beta-blocker that slows the heart rate. It indicates potential cardiovascular complications and should be reported promptly to the healthcare provider for further evaluation and management. Dry mouth, constipation, and increased appetite are common side effects of various medications but are not directly associated with propranolol's mechanism of action.

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