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A client with hypothyroidism is prescribed levothyroxine (Synthroid). Which instruction should the nurse provide?
- A. Take the medication with a meal.
- B. Take the medication at bedtime.
- C. Take the medication on an empty stomach.
- D. Take the medication with an antacid.
Correct Answer: C
Rationale: The correct answer is C: Take the medication on an empty stomach. Levothyroxine should be taken on an empty stomach in the morning, at least 30 minutes before eating, to ensure optimal absorption. Food can interfere with the absorption of levothyroxine, reducing its effectiveness. Taking it with a meal (option A) or at bedtime (option B) may lead to decreased absorption. Taking it with an antacid (option D) can also interfere with absorption. Therefore, the best instruction is to take the medication on an empty stomach to maximize its therapeutic effects.
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A client with chronic kidney disease is prescribed a low-protein diet. Which laboratory result should the nurse monitor to evaluate the effectiveness of the diet?
- A. Blood urea nitrogen (BUN)
- B. Serum potassium
- C. Serum calcium
- D. Creatinine clearance
Correct Answer: A
Rationale: The correct answer is A: Blood urea nitrogen (BUN). BUN is a waste product that reflects protein intake and kidney function. In chronic kidney disease, high protein intake can increase BUN levels, so monitoring BUN helps assess the effectiveness of the low-protein diet.
Incorrect choices:
B: Serum potassium - This is more related to kidney function but not specifically affected by a low-protein diet.
C: Serum calcium - Calcium levels are not directly affected by protein intake or a low-protein diet in chronic kidney disease.
D: Creatinine clearance - This measures kidney function but is not directly influenced by protein intake.
A client is scheduled for a colonoscopy. Which instruction should the nurse provide?
- A. Eat a light breakfast on the day of the procedure.
- B. You will need to drink a bowel preparation solution before the procedure.
- C. Avoid all liquids for 24 hours before the procedure.
- D. You can continue taking your blood thinners until the day of the procedure.
Correct Answer: B
Rationale: The correct answer is B because drinking a bowel preparation solution helps clear the colon for better visualization during the colonoscopy. This step is crucial to ensure accuracy of the procedure. Choice A is incorrect as the client should have a clear liquid diet the day before the procedure. Choice C is incorrect as hydration is important, but clear liquids are allowed. Choice D is incorrect because blood thinners may need to be adjusted prior to the procedure to reduce bleeding risk.
A client with newly diagnosed diabetes mellitus is receiving teaching on foot care. Which instruction should the nurse include?
- A. Walk barefoot whenever possible to toughen your feet.
- B. Soak your feet in hot water daily to improve circulation.
- C. Trim your toenails straight across to prevent ingrown toenails.
- D. Use a heating pad to keep your feet warm.
Correct Answer: C
Rationale: Correct Answer: C - Trim your toenails straight across to prevent ingrown toenails.
Rationale:
1. Trimming toenails straight across helps prevent ingrown nails.
2. Ingrown nails can lead to infection, especially risky for diabetics due to poor wound healing.
3. Walking barefoot toughens feet, increasing risk of injury.
4. Soaking in hot water can cause burns or skin damage.
5. Using a heating pad can lead to burns or decreased sensation in feet, increasing injury risk.
Summary:
Option C is correct as it directly addresses a common issue in diabetic foot care - ingrown toenails. Options A, B, and D pose risks of injury or damage to the feet, which is detrimental for diabetic individuals.
The healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD). Which finding should the provider expect?
- A. Increased anteroposterior chest diameter.
- B. Decreased respiratory rate.
- C. Dull percussion sounds over the lungs.
- D. Hyperresonance on chest percussion.
Correct Answer: A
Rationale: The correct answer is A: Increased anteroposterior chest diameter. In COPD, the chronic airway obstruction leads to air trapping, causing the chest to become hyperinflated. This results in an increase in the anteroposterior chest diameter, often referred to as "barrel chest."
Explanation for why other choices are incorrect:
B: Decreased respiratory rate is not typically seen in COPD; patients often exhibit an increased respiratory rate due to difficulty breathing.
C: Dull percussion sounds over the lungs are associated with conditions like pneumonia or pleural effusion, not COPD.
D: Hyperresonance on chest percussion is typically found in conditions like emphysema, a type of COPD, but it is not specific to COPD as a whole.
A client with chronic kidney disease (CKD) is experiencing hyperkalemia. Which intervention should the nurse implement to address this condition?
- A. Administer calcium gluconate.
- B. Encourage a diet high in potassium.
- C. Provide potassium supplements.
- D. Restrict sodium intake.
Correct Answer: A
Rationale: The correct answer is A: Administer calcium gluconate. Calcium gluconate is used to stabilize the cardiac membrane in hyperkalemia, preventing dangerous cardiac arrhythmias. It does not lower potassium levels but helps protect the heart.
B: Encouraging a diet high in potassium would worsen hyperkalemia.
C: Providing potassium supplements would further elevate potassium levels.
D: Restricting sodium intake does not directly address hyperkalemia.