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. When educating a client about the use of risedronate to treat osteoporosis, which instruction should be included?

• A. Drink a full glass of water with each dose.
• B. Take the medication on an empty stomach.
• C. Remain upright for 30 minutes after taking the medication.
• D. Avoid lying down for at least 1 hour after taking the medication.

Correct answer: C

Rationale: The correct instruction for a client taking risedronate to treat osteoporosis is to remain upright for 30 minutes after taking the medication. This is important to prevent esophageal irritation, as risedronate can cause irritation if it remains in contact with the esophagus. By staying upright, the medication is more likely to reach the stomach quickly and reduce the risk of irritation to the esophagus. Choices A, B, and D are incorrect. Drinking a full glass of water is recommended, not milk, to help with swallowing the medication. Risedronate should be taken on an empty stomach, not with meals, to ensure proper absorption. Additionally, avoiding lying down for at least 1 hour after taking the medication helps prevent esophageal irritation.

3. A healthcare professional is assessing a client who has been taking digoxin. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Dry cough
• C. Hypokalemia
• D. Bradycardia

Correct answer: D

Rationale: The correct answer is D: Bradycardia. Bradycardia is a significant finding associated with digoxin toxicity. Digoxin, a medication commonly used to treat heart conditions, can lead to bradycardia as a sign of toxicity. Bradycardia requires immediate attention and reporting to the healthcare provider for further evaluation and management to prevent serious complications. Choices A, B, and C are incorrect because weight gain, dry cough, and hypokalemia are not specific signs of digoxin toxicity. While weight gain can be a side effect of digoxin, it is not a classic sign of toxicity. Dry cough is more commonly associated with medications like ACE inhibitors, and hypokalemia can be a complication of digoxin therapy but is not a direct sign of toxicity.

4. A healthcare professional is assessing a client who has a new prescription for enalapril. Which of the following findings should the professional report to the provider?

• A. Frequent urination
• B. Dry cough
• C. Tremors
• D. Dizziness

Correct answer: B

Rationale: The correct answer is B: Dry cough. A dry cough is a common side effect of enalapril that can indicate the development of angioedema or potentially life-threatening angioedema. An onset of dry cough should be reported to the provider promptly as it may require discontinuation of the medication to prevent further complications. Frequent urination, tremors, and dizziness are not typically associated with enalapril use and are less likely to be of immediate concern compared to a dry cough in this context.

5. A client with a history of heart failure is admitted with a diagnosis of pulmonary edema. Which intervention should the LPN/LVN expect to assist with first?

• A. Administer a diuretic as prescribed.
• B. Place the client in a high Fowler's position.
• C. Prepare the client for intubation.
• D. Insert an indwelling urinary catheter.

Correct answer: B

Rationale: In a client with pulmonary edema, placing them in a high Fowler's position is the priority intervention. This position helps to improve ventilation and oxygenation by decreasing venous return, reducing the workload on the heart, and facilitating fluid redistribution from the lungs. It is crucial to optimize respiratory function and oxygenation before considering other interventions like administering medications, preparing for intubation, or inserting a urinary catheter. Administering a diuretic, preparing for intubation, or inserting a urinary catheter may be necessary but should follow the priority of improving oxygenation through positioning.

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