Nursing Elites

1. A patient with hyperthyroidism is prescribed propylthiouracil (PTU). What is the primary purpose of this medication?

• A. Increase thyroid hormone production
• B. Suppress thyroid hormone production
• C. Enhance iodine absorption
• D. Stimulate the thyroid gland

Correct answer: B

Rationale: Propylthiouracil (PTU) is a medication used to treat hyperthyroidism by suppressing the production of thyroid hormones. It works by inhibiting the enzyme responsible for the synthesis of thyroid hormones, thereby reducing their levels in the body. This helps to alleviate the symptoms of hyperthyroidism and restore thyroid hormone levels to normal range.

2. A patient with a diagnosis of deep vein thrombosis (DVT) is receiving heparin therapy. Which laboratory test should the nurse monitor to evaluate the effectiveness of the heparin therapy?

• A. Prothrombin time (PT)
• B. Partial thromboplastin time (PTT)
• C. Bleeding time
• D. Platelet count

Correct answer: B

Rationale: The correct answer is B: Partial thromboplastin time (PTT). Heparin affects the intrinsic pathway of the coagulation cascade, which is reflected by changes in the PTT. Monitoring the PTT helps ensure that the patient's blood is within the desired therapeutic range and prevents complications related to clotting or bleeding. Prothrombin time (PT) primarily assesses the extrinsic pathway and is not as sensitive to heparin therapy. Bleeding time and platelet count are not specific tests for monitoring the effectiveness of heparin therapy in DVT.

3. A patient with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. What is the primary purpose of this medication?

• A. Reduce mucus production
• B. Relieve bronchospasm
• C. Suppress cough
• D. Thin respiratory secretions

Correct answer: B

Rationale: Tiotropium is a long-acting bronchodilator used to relieve bronchospasm and improve airflow in patients with chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles around the airways, leading to bronchodilation and improved breathing, making it an essential treatment in managing COPD symptoms.

4. Your patient has an order to receive Levothyroxine Sodium 75 mcg daily IV. You have a vial containing 100 mcg available from the pharmacy. According to the package insert, 5 mL of 0.9% sodium chloride is needed to reconstitute. You add the appropriate amount of sodium chloride to the vial. How many mcg of medication are in 1 mL of the vial?

• A. 20 mcg
• B. 15 mcg
• C. 25 mcg
• D. 30 mcg

Correct answer: A

Rationale: After reconstitution, the concentration of Levothyroxine Sodium in the vial is 100 mcg in 5 mL, which equals 20 mcg/mL. Therefore, in 1 mL of the vial, there are 20 mcg of medication.

5. A client with chronic pain is prescribed a fentanyl (Duragesic) patch. Which instruction should the nurse provide to the client?

• A. Apply the patch to a clean, dry, and hairless area of the skin.
• B. Use a heating pad over the patch to enhance absorption.
• C. Change the patch daily to maintain effectiveness.
• D. Place the patch on the same site with each application.

Correct answer: A

Rationale: The correct instruction for applying a fentanyl (Duragesic) patch is to place it on a clean, dry, and hairless area of the skin. This ensures proper adhesion of the patch and optimal absorption of the medication. Using a heating pad over the patch is contraindicated as it can increase drug absorption and lead to overdose. Changing the patch daily is necessary for some medications, but fentanyl patches are usually changed every 72 hours to maintain a steady blood level of the medication. Placing the patch on the same site with each application can lead to skin irritation, uneven drug absorption, and should be avoided to allow the skin to recover between applications.

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