A client has been taking levothyroxine for 6 months. Which of the following findings indicates that the medication is effective?
- A. Weight gain
- B. Increased heart rate
- C. Decreased TSH levels
- D. Elevated blood pressure
Correct Answer: C
Rationale: In a client taking levothyroxine for thyroid hormone replacement, decreased TSH levels indicate that the medication is effective. TSH levels decrease as the thyroid hormone levels are adequately replaced by levothyroxine, signaling a positive response to treatment. Choices A, B, and D are incorrect because weight gain, increased heart rate, and elevated blood pressure are not expected findings indicating the effectiveness of levothyroxine therapy. Weight gain may suggest inadequate dosing, while increased heart rate and elevated blood pressure could indicate over-replacement or side effects of the medication.
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A client has a new prescription for allopurinol. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Increase your fluid intake.
- C. Avoid consuming dairy products.
- D. Take the medication in the morning.
Correct Answer: B
Rationale: Increasing fluid intake is essential when taking allopurinol to prevent the formation of kidney stones. Allopurinol can increase the levels of uric acid in the body, which can lead to kidney stone formation. By increasing fluid intake, the client can help flush out excess uric acid and prevent the development of kidney stones. It is important to drink plenty of water throughout the day to maintain adequate hydration and reduce the risk of kidney stone formation. Choices A, C, and D are incorrect. Taking allopurinol with food or in the morning does not specifically relate to preventing kidney stone formation. Avoiding dairy products is not a standard recommendation when taking allopurinol.
When educating a client about the use of risedronate to treat osteoporosis, which instruction should be included?
- A. Drink a full glass of water with each dose.
- B. Take the medication on an empty stomach.
- C. Remain upright for 30 minutes after taking the medication.
- D. Avoid lying down for at least 1 hour after taking the medication.
Correct Answer: C
Rationale: The correct instruction for a client taking risedronate to treat osteoporosis is to remain upright for 30 minutes after taking the medication. This is important to prevent esophageal irritation, as risedronate can cause irritation if it remains in contact with the esophagus. By staying upright, the medication is more likely to reach the stomach quickly and reduce the risk of irritation to the esophagus. Choices A, B, and D are incorrect. Drinking a full glass of water is recommended, not milk, to help with swallowing the medication. Risedronate should be taken on an empty stomach, not with meals, to ensure proper absorption. Additionally, avoiding lying down for at least 1 hour after taking the medication helps prevent esophageal irritation.
A client has a new prescription for clozapine. Which of the following instructions should the nurse include?
- A. You should have your white blood cell count checked regularly.
- B. You should take this medication on an empty stomach.
- C. You should avoid eating foods high in tyramine.
- D. You should avoid taking this medication with milk.
Correct Answer: A
Rationale: The correct answer is A: 'You should have your white blood cell count checked regularly.' Clozapine can lead to agranulocytosis, a serious condition characterized by a low white blood cell count. Regular monitoring of the white blood cell count is crucial to detect this adverse effect early and prevent serious complications. Choices B, C, and D are incorrect because taking clozapine on an empty stomach, avoiding foods high in tyramine, or avoiding taking the medication with milk are not specific instructions related to the potential adverse effect of agranulocytosis associated with clozapine.
A client has a new prescription for methotrexate. Which of the following instructions should the nurse include?
- A. Avoid consuming dairy products.
- B. Take the medication on an empty stomach.
- C. Increase your intake of folic acid.
- D. Monitor for signs of hyperglycemia.
Correct Answer: C
Rationale: Increasing folic acid intake is crucial when taking methotrexate because the medication can lead to folic acid deficiency. Folic acid supplementation helps counteract this deficiency and reduces the risk of adverse effects associated with methotrexate therapy. Choices A, B, and D are incorrect. Avoiding dairy products is not specifically necessary for methotrexate therapy. Methotrexate is usually taken with food to reduce gastrointestinal side effects, so taking it on an empty stomach is not recommended. Monitoring for signs of hyperglycemia is not directly related to methotrexate use.
A healthcare provider is providing discharge instructions to a client who has a new prescription for warfarin. Which of the following statements should the healthcare provider include?
- A. Avoid using a soft toothbrush.
- B. Report any signs of bleeding.
- C. Increase your intake of leafy green vegetables.
- D. Take the medication with food.
Correct Answer: B
Rationale: The correct answer is to instruct the client to report any signs of bleeding when taking warfarin. Warfarin is an anticoagulant medication that increases the risk of bleeding, so it is essential to monitor for any signs of abnormal bleeding and report them promptly for appropriate management. Choices A, C, and D are incorrect. Instructing the client to avoid using a soft toothbrush is not directly related to warfarin therapy. Increasing the intake of leafy green vegetables is not recommended as they contain vitamin K, which can interfere with warfarin's anticoagulant effects. Taking warfarin with food can be inconsistent and may not result in optimal absorption.
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