Nokea
A client has a new prescription for levothyroxine. Which of the following instructions should the nurse include?
- A. Take the medication on an empty stomach.
- B. Take the medication with food.
- C. Take the medication at bedtime.
- D. Take the medication with an antacid.
Correct Answer: A
Rationale: The correct answer is A: 'Take the medication on an empty stomach.' Levothyroxine should be taken on an empty stomach to ensure optimal absorption. Food, especially high-fiber foods, can interfere with the absorption of levothyroxine. Taking it with an antacid or at bedtime may also affect its absorption. Instructing the client to take the medication on an empty stomach will help maintain consistent blood levels of levothyroxine. Choice B is incorrect as taking levothyroxine with food can reduce its absorption. Choice C is incorrect because taking levothyroxine at bedtime may lead to inconsistent blood levels due to food intake during the day. Choice D is incorrect as antacids can interfere with the absorption of levothyroxine.
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A client with peptic ulcer disease is being taught about managing the disorder. Which of the following statements by the client indicates an understanding of the teaching?
- A. 'I should take NSAIDs for pain relief.'
- B. 'I should avoid drinking alcohol.'
- C. 'I should eat small, frequent meals.'
- D. 'I should drink milk to coat my stomach.'
Correct Answer: B
Rationale: The correct answer is B. Avoiding alcohol is crucial in managing peptic ulcer disease as it helps prevent irritation and further damage to the stomach lining. Alcohol can worsen symptoms and hinder the healing process in individuals with this condition. Choice A is incorrect because NSAIDs can worsen peptic ulcers by irritating the stomach lining. Choice C is a correct dietary recommendation for managing peptic ulcer disease as it helps reduce stomach acid secretion and promotes healing. Choice D is incorrect as milk may temporarily soothe ulcer pain, but it can stimulate acid production and worsen symptoms in the long run.
A healthcare professional is assessing a client who has been taking lithium carbonate for bipolar disorder. Which of the following findings should the professional report to the provider?
- A. Increased urination
- B. Tremors
- C. Weight gain
- D. Blurred vision
Correct Answer: B
Rationale: Tremors are a concerning sign of lithium toxicity that indicate a potential overdose. Tremors can progress to more severe symptoms if not addressed promptly. Reporting tremors promptly allows the provider to assess the client's lithium levels, adjust the dosage, or provide appropriate interventions to prevent further complications. Increased urination, weight gain, and blurred vision are potential side effects of lithium but are not indicative of toxicity or overdose. While they should still be monitored, they are not as urgent as tremors in the context of lithium therapy.
A client with heart failure is receiving digoxin. Which finding should indicate to the nurse that the client is experiencing digoxin toxicity?
- A. Constipation
- B. Blurred vision
- C. Bradycardia
- D. Dry cough
Correct Answer: C
Rationale: Bradycardia is a hallmark sign of digoxin toxicity. Digoxin, a medication used to treat heart conditions, can lead to toxicity manifesting as bradycardia. Bradycardia occurs due to the drug's effect on slowing down the heart rate excessively. Constipation (Choice A) is not typically associated with digoxin toxicity. Blurred vision (Choice B) is more commonly linked to visual disturbances caused by digoxin, but it is not a defining sign of toxicity. Dry cough (Choice D) is not a recognized symptom of digoxin toxicity. It is crucial for the nurse to recognize the early signs of digoxin toxicity to prevent serious complications and provide appropriate interventions promptly.
A client is receiving heparin therapy. Which of the following laboratory tests should be monitored to evaluate the effectiveness of the therapy?
- A. Prothrombin time (PT)
- B. International normalized ratio (INR)
- C. Activated partial thromboplastin time (aPTT)
- D. Complete blood count (CBC)
Correct Answer: C
Rationale: Activated partial thromboplastin time (aPTT) is the most appropriate laboratory test to monitor the effectiveness of heparin therapy. Heparin works on the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps assess its anticoagulant effect. Therapeutic levels of aPTT for clients on heparin therapy are typically 1.5 to 2.5 times the control value. Prothrombin time (PT) and International normalized ratio (INR) are used to monitor warfarin therapy, which acts on the extrinsic pathway of the coagulation cascade. Complete blood count (CBC) is not specific for monitoring the effectiveness of heparin therapy.
During an assessment, a client taking valproic acid exhibits elevated liver enzymes. What finding should the nurse report to the provider?
- A. Elevated liver enzymes
- B. Weight loss
- C. Dry mouth
- D. Increased appetite
Correct Answer: A
Rationale: Elevated liver enzymes are a critical finding that the nurse should report to the provider when assessing a client taking valproic acid. It can be indicative of hepatotoxicity, a severe side effect associated with valproic acid use. Timely reporting and intervention are essential to prevent further complications and ensure the client's safety and well-being. Choices B, C, and D are not directly related to valproic acid use or the manifestation of hepatotoxicity. Weight loss, dry mouth, and increased appetite are not typically associated with elevated liver enzymes in the context of valproic acid administration.