Nursing Elites

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

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

Correct answer: A

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, leading to reduced effectiveness of the medication.

2. What instruction should the healthcare provider include to minimize an adverse effect of Clomipramine for OCD in an adolescent client?

• A. Wear sunglasses when outdoors.
• B. Check your temperature daily.
• C. Take this medication in the morning.
• D. Add extra calories to your diet.

Correct answer: A

Rationale: The correct answer is A: 'Wear sunglasses when outdoors.' To minimize the anticholinergic effect of Clomipramine, the client should wear sunglasses when outdoors to reduce photophobia. This adverse effect is common with tricyclic antidepressant (TCA) use. Choices B, C, and D are incorrect. Checking temperature daily, timing of medication intake, or adding extra calories to the diet are not directly related to minimizing adverse effects of Clomipramine.

3. A client with increased intracranial pressure is receiving Mannitol. Which finding should the nurse report to the provider?

• A. Blood glucose 150 mg/dL
• B. Urine output 40 mL/hr
• C. Dyspnea
• D. Bilateral equal pupil size

Correct answer: C

Rationale: Dyspnea is a concerning finding in a client receiving Mannitol as it can be a manifestation of heart failure, an adverse effect of the medication. It suggests potential fluid overload or exacerbation of heart conditions, both of which require immediate attention. Reporting dyspnea promptly allows for timely evaluation and management. Blood glucose levels and urine output are important parameters to monitor but are not directly related to the administration of Mannitol for increased intracranial pressure. Bilateral equal pupil size is a normal and expected finding.

4. When administering the drug lithium, what is one important side effect to watch for?

• A. Anaphylaxis
• B. Seizures
• C. Angioedema
• D. Pulmonary Edema

Correct answer: C

Rationale: When administering lithium, it is crucial to watch for the side effect of angioedema. Angioedema is a potential adverse reaction associated with lithium therapy, characterized by rapid swelling beneath the skin, often around the eyes and lips. Monitoring for this side effect is essential to promptly address and manage any signs of angioedema that may occur during lithium treatment. Choices A, B, and D are incorrect because anaphylaxis, seizures, and pulmonary edema are not typically associated side effects of lithium administration.

5. A client has a new prescription for a combination of oral NRTIs (abacavir, lamivudine, and zidovudine) for the treatment of HIV. Which of the following statements should the nurse include in teaching the client?

• A. These medications work by blocking HIV entry into cells.
• B. These medications work by weakening the cell wall of the HIV virus.
• C. These medications work by inhibiting enzymes to prevent HIV replication.
• D. These medications work by preventing protein synthesis within the HIV cell.

Correct answer: C

Rationale: The NRTI antiretroviral medications this client is prescribed work by inhibiting the enzyme reverse transcriptase, thus preventing HIV replication. By inhibiting this crucial enzyme, the drug interferes with the virus's ability to replicate and spread in the body. Choice A is incorrect because NRTIs do not block HIV entry into cells. Choice B is incorrect as NRTIs do not weaken the cell wall of the virus. Choice D is incorrect as NRTIs do not prevent protein synthesis within the HIV cell.

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