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1. Which of the following is a key symptom of hyperthyroidism?
- A. Weight loss.
- B. Weight gain.
- C. Tachycardia.
- D. Dry skin.
Correct answer: A
Rationale: The correct answer is weight loss. In hyperthyroidism, there is an excess production of thyroid hormones leading to an increased metabolic rate. This increased metabolism can result in weight loss despite normal or increased appetite. Choice B (Weight gain) is more commonly associated with hypothyroidism where the metabolic rate is decreased. Choice C (Tachycardia) is another common symptom of hyperthyroidism due to the effects of thyroid hormones on the heart, causing an increased heart rate. Choice D (Dry skin) is not a typical symptom of hyperthyroidism; instead, it is more commonly associated with hypothyroidism.
2. A middle-aged adult with a family history of CAD has the following: total cholesterol 198 (11 mmol/L); LDL cholesterol 120 (6.7 mmol/L); HDL cholesterol 58 (3.2 mmol/L); triglycerides 148 (8.2 mmol/L); blood sugar 102 (5.7 mmol/L); and C-reactive protein (CRP) 4.2. The health care provider prescribes a statin medication and aspirin. The client asks the nurse why these medications are needed. Which is the best response by the nurse?
- A. The labs indicate severe hyperlipidemia and the medications will lower your LDL, along with a low-fat diet.
- B. The triglycerides are elevated and will not return to normal without these medications.
- C. The CRP is elevated indicating inflammation seen in cardiovascular disease, which can be lowered by the medications prescribed.
- D. These medications will reduce the risk of type 2 diabetes.
Correct answer: C
Rationale: CRP is a marker of inflammation, which is elevated in cardiovascular disease. Statins and aspirin help lower CRP and reduce the risk of heart attacks and strokes.
3. The nurse is teaching a nursing student about the minimal effective concentration (MEC) of antibiotics. Which statement by the nursing student indicates understanding of this concept?
- A. A serum drug level greater than the MEC ensures that the drug is bacteriostatic.
- B. A serum drug level greater than the MEC broadens the spectrum of the drug.
- C. A serum drug level greater than the MEC helps eradicate bacterial infections.
- D. A serum drug level greater than the MEC increases the therapeutic index.
Correct answer: C
Rationale: The MEC is the minimum amount of drug needed to halt the growth of a microorganism. A level greater than the MEC helps eradicate infections. Drugs at or above the MEC are usually bactericidal, not bacteriostatic. Therefore, choice A is incorrect. Broadening the spectrum of a drug refers to its range of activity against different microorganisms, which is not directly related to MEC. Thus, choice B is incorrect. Increasing the therapeutic index involves maximizing the effectiveness of a drug while minimizing its toxicity, which is not specifically related to MEC. Therefore, choice D is also incorrect.
4. A healthcare professional is reviewing laboratory results for a client who is at risk for nephrotoxicity due to medications. Which of the following serum creatinine results does the healthcare professional document as normal?
- A. 0.2 mg/dL
- B. 1.0 mg/dL
- C. 2.8 mg/dL
- D. 3.9 mg/dL
Correct answer: B
Rationale: The normal serum creatinine level typically ranges from 0.6 to 1.3 mg/dL. A result of 1.0 mg/dL falls within this normal range. A serum creatinine level of 0.2 mg/dL is abnormally low and may indicate decreased muscle mass or malnutrition. On the other hand, results of 2.8 mg/dL and 3.9 mg/dL are elevated, signifying impaired kidney function and potential nephrotoxicity from medications.
5. A client with chronic kidney disease (CKD) is experiencing nausea, vomiting, visual changes, and anorexia. Which action by the nurse is best?
- A. Check the client’s digoxin (Lanoxin) level.
- B. Administer an anti-nausea medication.
- C. Ask if the client can eat crackers.
- D. Refer the client to a gastrointestinal specialist.
Correct answer: A
Rationale: In a client with chronic kidney disease experiencing symptoms like nausea, vomiting, visual changes, and anorexia, it is crucial for the nurse to suspect digoxin (Lanoxin) toxicity. These symptoms are indicative of digoxin toxicity. Therefore, the best action for the nurse to take is to check the client's digoxin level. Administering anti-nausea medication, asking about eating crackers, and referring to a gastrointestinal specialist may help with symptom management but do not address the underlying cause of the symptoms, which is digoxin toxicity in this case.
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