Nursing Elites

1. A client is instructed to take levothyroxine (Synthroid). The medication should be taken:

• A. With food
• B. At lunchtime
• C. On an empty stomach
• D. At bedtime with a snack

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach to enhance absorption. Taking it with food or at bedtime can interfere with its absorption, reducing its effectiveness. Therefore, it is essential for the client to take levothyroxine on an empty stomach to ensure optimal therapeutic outcomes.

2. A client with chronic renal failure is receiving ferrous sulfate (Feosol). The nurse monitors the client for which common side effect associated with this medication?

• A. Diarrhea
• B. Weakness
• C. Headache
• D. Constipation

Correct answer: D

Rationale: Constipation is a common side effect of iron supplements such as ferrous sulfate. Iron can cause constipation by slowing down the movement of the digestive system and hardening the stool. Patients should be advised to increase their fluid intake, dietary fiber, and physical activity to help alleviate this side effect. Diarrhea (Choice A) is not a common side effect associated with ferrous sulfate. Weakness (Choice B) and headache (Choice C) are not typically linked to this medication.

3. During an admission assessment, a client informs the nurse that they take propylthiouracil (PTU) daily. Based on this information, the nurse suspects that the client has a history of:

• A. Myxedema
• B. Graves' disease
• C. Addison's disease
• D. Cushing's syndrome

Correct answer: B

Rationale: Propylthiouracil (PTU) is a medication commonly used to treat hyperthyroidism, including Graves' disease, which is characterized by an overactive thyroid gland. The client mentioning the daily use of PTU indicates that they likely have a history of Graves' disease, as this medication helps manage the condition by reducing the production of thyroid hormones. Therefore, the correct answer is B: Graves' disease. Choice A, Myxedema, is incorrect as it refers to a condition of severe hypothyroidism, the opposite of hyperthyroidism. Choices C and D, Addison's disease and Cushing's syndrome, respectively, are unrelated to the use of PTU or hyperthyroidism, making them incorrect choices.

4. A client is prescribed calcium gluconate after thyroidectomy. The medication is most likely prescribed to:

• A. Treat thyroid storm.
• B. Prevent cardiac irritability.
• C. Treat hypocalcemic tetany.
• D. Stimulate the release of parathyroid hormone.

Correct answer: C

Rationale: After a thyroidectomy, the parathyroid glands can be inadvertently removed or damaged, leading to a decrease in calcium levels and potentially causing hypocalcemic tetany. Calcium gluconate is given to supplement calcium levels and prevent or treat hypocalcemia-related symptoms, such as muscle spasms and tetany.

5. Meperidine hydrochloride (Demerol) is prescribed for a client with pain. Which of the following would the nurse monitor for as a side effect of this medication?

• A. Diarrhea
• B. Bradycardia
• C. Hypertension
• D. Urinary retention

Correct answer: D

Rationale: Meperidine hydrochloride (Demerol) is an opioid analgesic that can cause various side effects. Common side effects include respiratory depression, orthostatic hypotension, tachycardia, drowsiness, constipation, and urinary retention. Diarrhea is not a common side effect of Meperidine hydrochloride. Bradycardia and hypertension are not typically associated with this medication. Therefore, the nurse should monitor for urinary retention as a potential side effect of Meperidine hydrochloride.

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