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: 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.

2. A client has a new prescription for Metoprolol. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Monitor for signs of hyperglycemia.
• C. Avoid sudden discontinuation of the medication.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct answer is to instruct the client to avoid sudden discontinuation of Metoprolol. Metoprolol is a beta-blocker that should be tapered off gradually to prevent rebound hypertension and other cardiac issues. Abruptly stopping Metoprolol can lead to serious complications, so it is essential for the client to follow the healthcare provider's guidance on discontinuation. Choice A is incorrect because Metoprolol can be taken with or without food. Choice B is incorrect as Metoprolol is not typically associated with causing hyperglycemia. Choice D is also incorrect as there is no need to increase potassium-rich foods specifically due to taking Metoprolol.

3. A client has a new prescription for Digoxin for heart failure. Which of the following adverse effects should the client monitor for and report to the provider?

• A. Dry cough
• B. Pedal edema
• C. Bruising
• D. Yellow-tinged vision

Correct answer: D

Rationale: The correct answer is D: Yellow-tinged vision. Yellow-tinged vision is a potential adverse effect of Digoxin and may indicate toxicity. Clients should be instructed to report this symptom promptly to the healthcare provider to prevent complications. Dry cough (choice A) is not typically associated with Digoxin. Pedal edema (choice B) is more commonly seen with heart failure but is not a direct adverse effect of Digoxin. Bruising (choice C) is not a common adverse effect of Digoxin.

4. A client has a new prescription for Ondansetron. Which of the following statements should the nurse include?

• A. Take the medication 30 minutes before chemotherapy.
• B. Expect your urine to turn orange.
• C. Increase your intake of high-fiber foods.
• D. Avoid drinking grapefruit juice.

Correct answer: A

Rationale: The correct answer is A: 'Take the medication 30 minutes before chemotherapy.' Ondansetron, an antiemetic, should be taken before chemotherapy to prevent nausea and vomiting. Taking it 30 minutes before chemotherapy ensures the medication is most effective in controlling chemotherapy-induced nausea and vomiting. Choices B, C, and D are incorrect. Option B is unrelated to Ondansetron, option C is not necessary for this medication, and option D does not interact with Ondansetron but is relevant for other medications.

5. A client has been prescribed Aspirin for prevention of cardiovascular disease. Which of the following findings indicates the medication is effective?

• A. The client has a decrease in troponin levels.
• B. The client has a regular heart rhythm.
• C. The client experiences a decrease in episodes of angina.
• D. The client's blood pressure remains stable.

Correct answer: C

Rationale: The correct answer is C. A decrease in episodes of angina is an indicator of Aspirin's effectiveness in preventing cardiovascular events. Aspirin works by inhibiting platelet aggregation, thereby reducing the formation of blood clots that could lead to angina episodes or more severe cardiovascular complications. Choices A, B, and D are incorrect because troponin levels, heart rhythm, and blood pressure are not direct indicators of Aspirin's effectiveness in preventing cardiovascular events.

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