Nursing Elites

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

• A. Take this medication with food.
• B. Take this medication at bedtime.
• C. Take this medication on an empty stomach.
• D. Take this medication with antacids.

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach to increase absorption and efficacy. Taking it with food or antacids can interfere with its absorption. By taking Levothyroxine on an empty stomach, the client ensures optimal absorption and effectiveness of the medication.

2. A client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

• A. Perform immediate gastric lavage.
• B. Prepare the client for hemodialysis.
• C. Administer an additional oral dose of lithium.
• D. Request a stat repeat of the laboratory test.

Correct answer: A

Rationale: In a client with a plasma lithium level of 2.1 mEq/L, immediate gastric lavage is appropriate for severe toxicity. Gastric lavage can help lower the client's lithium level by removing the unabsorbed lithium from the stomach.

3. A healthcare provider plans to administer Morphine IV to a postoperative client. Which of the following actions should the provider take?

• A. Monitor for seizures and confusion with repeated doses.
• B. Protect the client's skin from severe diarrhea associated with morphine.
• C. Withhold this medication if the respiratory rate is less than 12/min.
• D. Administer Morphine intermittently via IV bolus over 30 seconds or less.

Correct answer: C

Rationale: The correct action for the provider is to withhold morphine if the client's respiratory rate is 12/min or less. Respiratory depression is a serious side effect of morphine and other opioids. Withholding the medication and informing the healthcare provider is essential to prevent further respiratory compromise in the client. Choices A, B, and D are incorrect because monitoring for seizures and confusion, protecting the client's skin from severe diarrhea, and administering morphine via IV bolus over 30 seconds or less are not the primary actions to ensure client safety when administering morphine IV. Respiratory status is crucial due to the risk of respiratory depression associated with opioid administration.

4. When completing a nursing history for a client taking Simvastatin, which of the following disorders should the nurse identify as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in clients with active moderate-to-severe liver disorders, particularly if they are already on a statin like simvastatin. Hepatitis C is a liver condition that can be exacerbated by Ezetimibe, leading to potential complications. Therefore, the nurse should identify active hepatitis C as a contraindication to adding Ezetimibe to the client's medications. Choices A, B, and D are incorrect because they are not directly related to the contraindication of Ezetimibe in clients taking Simvastatin.

5. A client has a prescription for Erythromycin. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Expect your urine to turn dark yellow.
• C. Take the medication with a full glass of milk.
• D. Report persistent diarrhea to your provider.

Correct answer: D

Rationale: The correct answer is D: 'Report persistent diarrhea to your provider.' Erythromycin is known to cause Clostridium difficile-associated diarrhea, which can be severe. Instructing the client to report any persistent diarrhea to their healthcare provider promptly is crucial to prevent complications. Choices A, B, and C are incorrect. Taking Erythromycin with food is generally recommended to reduce stomach upset, but it is not the most critical instruction. Expecting urine to turn dark yellow is not a common side effect of Erythromycin. Taking Erythromycin with a full glass of milk is not necessary and may not be appropriate for all clients, especially those with lactose intolerance or dairy allergies.

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