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. Before administering furosemide (Lasix) to a client with heart failure, what is the most important laboratory test result for the nurse to check?

• A. Potassium level
• B. Creatinine level
• C. Cholesterol level
• D. Blood urea nitrogen

Correct answer: A

Rationale: The correct answer is to check the potassium level before administering furosemide (Lasix) to a client with heart failure. Furosemide is a loop diuretic that can cause hypokalemia, so it is crucial to assess the potassium level to prevent complications like cardiac arrhythmias associated with low potassium levels.

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 being taught about the use of enoxaparin (Lovenox) for the prevention of deep vein thrombosis. Which instruction should the nurse include in the teaching plan?

• A. Inject the medication subcutaneously.
• B. Avoid massaging the injection site after administration.
• C. Administer the medication at the same time each day.
• D. Do not expel the air bubble from the syringe before injection.

Correct answer: C

Rationale: Enoxaparin (Lovenox) is administered subcutaneously at the same time each day to maintain consistent blood levels. Injecting the medication into the muscle is incorrect, as it should be given subcutaneously. Massaging the injection site should be avoided to prevent bruising. The air bubble in the prefilled syringe should not be expelled, as it ensures the full dose is administered.

5. Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?

• A. Tinnitus
• B. Diarrhea
• C. Constipation
• D. Decreased respirations

Correct answer: A

Rationale: The correct answer is A: Tinnitus. Salicylic acid can lead to systemic toxicity, known as salicylism, which may manifest with symptoms like tinnitus, dizziness, hyperventilation, and mental disturbances. Tinnitus is a common early sign of salicylism and should be monitored closely by the nurse to prevent further complications.

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