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A nurse is caring for a client who has Graves' disease and is to start therapy with propylthiouracil. The nurse should expect which of the following outcomes?
- A. Decreased heart rate
- B. Decreased WBC count
- C. Increased Hgb
- D. Increased blood pressure
Correct Answer: A
Rationale: The correct answer is A: Decreased heart rate. Propylthiouracil is an antithyroid medication used to treat hyperthyroidism in conditions like Graves' disease. It works by inhibiting the production of thyroid hormones. Since hyperthyroidism can cause an increased heart rate due to the excess thyroid hormones, the expected outcome of propylthiouracil therapy is a decreased heart rate as it helps normalize thyroid hormone levels. The other choices are incorrect because propylthiouracil does not directly affect WBC count (B), Hgb levels (C), or blood pressure (D) in the context of treating hyperthyroidism.
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A nurse is talking with a client who takes NSAIDs routinely to treat osteoarthritis and has a new prescription for misoprostol. The client asks the nurse why he needs the second medication. Which of the following is an appropriate response?
- A. Misoprostol will help prevent stomach ulcers, which can develop from taking NSAIDs for a long time.
- B. Misoprostol helps protect you against the effects long-term NSAID use can have on your kidney function.
- C. Misoprostol will boost the effectiveness of the NSAIDs, so you can get the same pain relief with lower dosages.
- D. Misoprostol is a very effective antacid that will help reduce the stomach irritation you can get from NSAIDs.
Correct Answer: A
Rationale: The correct answer is A because misoprostol is often prescribed along with NSAIDs to help prevent stomach ulcers that can develop from long-term NSAID use. NSAIDs can irritate the stomach lining and increase the risk of ulcers. Misoprostol works by reducing the production of stomach acid and protecting the stomach lining. Choices B, C, and D are incorrect because misoprostol is specifically used to protect the stomach from NSAID-related ulcers, not to protect kidney function, boost NSAID effectiveness, or act as an antacid.
A nurse is reinforcing discharge teaching with a client who has a new diagnosis of type 2 diabetes mellitus and a prescription for exenatide. Which of the following instructions should the nurse include in the teaching?
- A. Contact the provider if you experience unexplained muscle pain.
- B. Inject the medication into the subcutaneous tissue of your abdomen.
- C. Take the medication at bedtime.
- D. Discard excess medication after 60 days.
Correct Answer: B
Rationale: The correct answer is B: Inject the medication into the subcutaneous tissue of your abdomen. Exenatide is a medication used to treat type 2 diabetes and is administered by subcutaneous injection. Injecting it into the abdomen allows for better absorption. It is important for the nurse to instruct the client on the correct administration technique to ensure the medication is effective.
Incorrect choices:
A: Contact the provider if you experience unexplained muscle pain - Although monitoring for side effects is important, muscle pain is not a common side effect of exenatide.
C: Take the medication at bedtime - Exenatide is typically taken before meals, not at bedtime.
D: Discard excess medication after 60 days - Exenatide must be refrigerated and has a shorter shelf life once opened, typically 30 days, not 60.
A nurse working in an urgent care clinic is collecting data from a client who takes montelukast. Which of the following is an expected therapeutic effect of this medication?
- A. Improved peripheral vasodilation
- B. Neutralized gastric acid
- C. Increased WBC count
- D. Reduced bronchial inflammation
Correct Answer: D
Rationale: The correct answer is D: Reduced bronchial inflammation. Montelukast is a leukotriene receptor antagonist used to manage asthma and allergic rhinitis by reducing inflammation and bronchoconstriction in the airways. This improves breathing and reduces symptoms. Option A is incorrect as montelukast does not affect peripheral vasodilation. Option B is incorrect as it does not neutralize gastric acid. Option C is incorrect as montelukast does not affect white blood cell count. In summary, montelukast's main therapeutic effect is reducing bronchial inflammation, making option D the correct choice.
A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include?
- A. Hepatic enzymes process medications more rapidly.
- B. Gastric emptying rate increases.
- C. Brain receptors become less sensitive to medications.
- D. Renal excretion time slows for medication.
Correct Answer: D
Rationale: The correct answer is D: Renal excretion time slows for medication. As individuals age, there is a decline in renal function, leading to a decrease in glomerular filtration rate and renal blood flow. This results in a slower excretion of medications from the body, leading to potential accumulation and increased risk of toxicity. Choices A, B, and C are incorrect as hepatic enzymes may actually decrease in function with age, gastric emptying rate tends to slow down, and brain receptors can become more sensitive rather than less sensitive to medications in older adults.
A nurse is caring for a client who has prescriptions for spironolactone and lisinopril. The nurse should monitor for which of the following adverse effects?
- A. Hyperkalemia
- B. Hypoglycemia
- C. Hypokalemia
- D. Hyperglycemia
Correct Answer: A
Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic, which can lead to elevated potassium levels (hyperkalemia). Lisinopril is an ACE inhibitor that may also contribute to increased potassium levels. Monitoring for hyperkalemia is essential due to the risk of serious cardiac arrhythmias. Hypoglycemia (choice B) and hyperglycemia (choice D) are not typically associated with these medications. Hypokalemia (choice C) is the opposite of what is expected with spironolactone.