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A nurse is caring for an older adult client in a long-term care facility who has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?
- A. The client will remain 0.1 mg dose, and the dose will be 0.1 mg of 0.1 mg dose, and the dose will be... (truncated)
Correct Answer: A
Rationale: Older adults typically start with a low dose (e.g., 0.025-0.05 mg) of levothyroxine, titrated slowly; 0.1 mg is plausible with adjustment.
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A patient on a Class IV antiarrhythmic is experiencing bradycardia. Which medication is the patient most likely taking?
- A. Amiodarone
- B. Diltiazem
- C. Flecainide
- D. Lidocaine
Correct Answer: B
Rationale: Diltiazem, a Class IV calcium channel blocker, slows AV node conduction, commonly causing bradycardia.
Aminoglycosides are poorly absorbed from the gut and must therefore be delivered via parenteral routes.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Aminoglycosides have poor oral bioavailability due to their polar nature, requiring parenteral administration (e.g., IV or IM) for systemic effects.
Jim presents with complaints of 'heartburn' that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would be:
- A. Omeprazole (Prilosec) twice a day
- B. Ranitidine (Zantac) twice a day
- C. Famotidine (Pepcid) once a day
- D. Metoclopramide (Reglan) four times a day
Correct Answer: B
Rationale: Ranitidine , an H2 blocker, is a standard first-line GERD treatment; PPIs are next-step, and metoclopramide is for motility.
A patient is using the Commit lozenge 2 mg to help quit smoking and reports nausea and indigestion. The nurse will instruct the patient to perform which action?
- A. Allow the lozenge to dissolve slowly over 20 to 30 minutes
- B. Chew the lozenge thoroughly before swallowing it
- C. Increase to 4 mg and use less often
- D. Take the lozenge with food and a full glass of water
Correct Answer: A
Rationale: Slow dissolution minimizes GI upset from nicotine lozenges; chewing worsens it. The patient should allow the lozenge to dissolve slowly.
Which of the following statements about pancreatic enzymes is true?
- A. Dosing may be titrated according to the decrease of steatorrhea
- B. The amount of carbohydrates in the meal drives the amount of enzyme used
- C. The amount of medication used is increased with a cystic fibrosis pulmonary flare
- D. The FDA and Internet-available formulations are bioequivalent
Correct Answer: A
Rationale: Pancreatic enzyme dosing adjusts based on steatorrhea reduction; carbs aren't the driver, and flares don't increase it.