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A 43-year-old female client who has had a thyroidectomy due to Grave's disease is prescribed a thyroid replacement hormone. Which signs and symptoms are associated with thyroid hormone toxicity and should be reported promptly to the health care provider?
- A. Tinnitus and dizziness
- B. Tachycardia and chest pain
- C. Dry skin and intolerance to cold
- D. Weight gain and increased appetite
Correct Answer: B
Rationale: The signs and symptoms of thyroid hormone toxicity, especially when the dosage is excessive, include tachycardia (rapid heart rate) and chest pain. These symptoms are indicative of hyperthyroidism, where the body receives an excessive amount of thyroid hormone. It is crucial to report these symptoms promptly to the healthcare provider to adjust the medication dosage and prevent potential complications.
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A client with chronic kidney disease is prescribed darbepoetin alfa. The nurse should monitor for which potential side effect?
- A. Hypertension
- B. Hypotension
- C. Hyperkalemia
- D. Hyperglycemia
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The practical nurse administered 15 units of NPH insulin subcutaneously to a client before they consumed their breakfast at 7:30 AM. At what time is the client at an increased risk for a hypoglycemic reaction?
- A. 8:30 to 11:30 AM
- B. 3:30 to 7:30 PM
- C. 9:30 PM to midnight
- D. 1:00 to 5:00 AM
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
After receiving the third dose of a new oral anticoagulant prescription, which action should the nurse implement? Select all that apply.
- A. Notify the healthcare provider of the finding
- B. Provide a PRN NSAID for gum discomfort
- C. Review the most recent coagulation lab values
- D. Complete a medication variance report
Correct Answer: C
Rationale: Reviewing the most recent coagulation lab values is crucial after receiving multiple doses of a new oral anticoagulant to ensure the patient is within the desired therapeutic range and to prevent adverse events related to over or under-anticoagulation. Notifying the healthcare provider of any concerning findings is important, but it may not be the immediate priority after receiving the third dose. Providing a PRN NSAID for gum discomfort is not typically indicated with oral anticoagulant therapy, as it may increase the risk of bleeding. Completing a medication variance report is more relevant in cases of medication errors or discrepancies, which may not apply in this scenario.
A client with asthma is prescribed fluticasone. The nurse should instruct the client to use this medication at which time?
- A. During an asthma attack
- B. Twice a day
- C. Once a day
- D. At night before bed
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client who is newly diagnosed with erosive esophagitis secondary to GERD experiences symptoms after taking lansoprazole PO for one full week. Which actions should the nurse take?
- A. Confirm that the client is taking the medication correctly
- B. Auscultate the client's bowel sounds and assess the apical pulse
- C. Advise the client that healing typically takes several weeks
- D. Notify the healthcare provider to consider a higher dose
Correct Answer: C
Rationale: It is essential for the nurse to educate the client that healing from erosive esophagitis typically takes several weeks to manage expectations. This information helps the client understand the timeline for improvement and reduces anxiety about the effectiveness of the treatment. It is not necessary to confirm the timing of medication intake, assess bowel sounds, or measure the apical pulse in this scenario. Since symptoms have persisted after one week of lansoprazole, it may not be appropriate to immediately escalate to a higher dose without further assessment or guidance from the healthcare provider.