Nursing Elites

1. A client is being taught about a new prescription for Escitalopram to treat generalized anxiety disorder. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication with food.
• B. I will monitor my blood sugar levels while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I can crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing Escitalopram, the client should taper the medication slowly according to a prescribed dosing schedule to reduce the risk of withdrawal syndrome. Abruptly stopping the medication can lead to withdrawal symptoms, so it is important to follow the healthcare provider's instructions for gradual discontinuation. Choices A, B, and D are incorrect because Escitalopram should not necessarily be taken with food, there is no direct correlation with blood sugar levels, and the medication should not be crushed before swallowing.

2. A client is prescribed levothyroxine for hypothyroidism. Which of the following findings should indicate to the nurse that the medication is effective?

• A. Decreased heart rate
• B. Increased energy levels
• C. Weight loss
• D. Improved mental clarity

Correct answer: B

Rationale: Increased energy levels are a key indicator of the effectiveness of levothyroxine in treating hypothyroidism. Levothyroxine works to regulate thyroid hormone levels, which can lead to improved energy levels as the body's metabolism is restored. While the other options may also improve with treatment, increased energy levels directly reflect the correction of the thyroid hormone imbalance. Decreased heart rate can be an indicator of overmedication, weight loss can be attributed to increased metabolism but may not directly reflect the effectiveness of levothyroxine, and improved mental clarity is a more general cognitive improvement that may not directly relate to thyroid function.

3. A healthcare provider is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare provider should recognize that the medication affected which of the following systems in the client?

• A. Cardiovascular
• B. Immune
• C. Central nervous
• D. Gastrointestinal

Correct answer: C

Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders that can be caused by certain medications affecting the central nervous system, such as typical antipsychotic medications. These effects can lead to symptoms like tremors, muscle rigidity, and involuntary movements, which are all related to disruptions in the central nervous system. Choices A, B, and D are incorrect because extrapyramidal effects are specifically associated with the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.

4. 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 indicates that Aspirin is effectively preventing the formation of clots that could lead to cardiovascular events. Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle, usually due to coronary artery disease. Aspirin works by inhibiting platelet aggregation, thereby reducing the risk of clot formation in the arteries. Improvement in angina symptoms suggests that the medication is successfully preventing clot-related complications in the cardiovascular system. Monitoring and recognizing a decrease in angina episodes can be a valuable indicator of the medication's efficacy in preventing cardiovascular events. Choices A, B, and D are incorrect because a decrease in troponin levels, a regular heart rhythm, or stable blood pressure, while important parameters, do not directly reflect the effectiveness of Aspirin in preventing cardiovascular events through antiplatelet action.

5. What is the pharmacological class of Lithium?

• A. Antidiabetics, biguanides
• B. Mood stabilizers
• C. Antiarrhythmics, anticonvulsants
• D. Vascular headache suppressants

Correct answer: B

Rationale: Lithium is classified as a mood stabilizer due to its primary use in managing bipolar disorder, where it helps stabilize mood swings and prevent episodes of mania and depression. While it can have other effects on the body, its main therapeutic role lies in its mood-stabilizing properties. Choices A, C, and D are incorrect as lithium is not classified as antidiabetics, biguanides, antiarrhythmics, anticonvulsants, or vascular headache suppressants. Its main pharmacological class is mood stabilizers.

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