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A nurse is collecting data from a client who has been taking methimazole for 2 months for the treatment of a thyroid imbalance. Which of the following findings indicates that the medication is effective?
- A. Weight gain
- B. Decreased menstrual flow
- C. Clear breath sounds
- D. Increased libido
Correct Answer: A
Rationale: The correct answer is A: Weight gain. Methimazole is used to treat hyperthyroidism, which often causes weight loss due to increased metabolism. If the medication is effective, the client's thyroid hormone levels should normalize, leading to a potential reversal of weight loss and even weight gain. Decreased menstrual flow (B) and increased libido (D) are not direct indicators of methimazole effectiveness. Clear breath sounds (C) could indicate improved respiratory status but are not specific to thyroid function.
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A nurse is reinforcing teaching about the IPLEDGE program with a female client who has a new prescription for isotretinoin. The nurse should tell the client that which of the following is a requirement of the program?
- A. Clients must have a Papanicolaou test every 6 months during treatment.
- B. Sexually active female clients must use two forms of birth control during treatment.
- C. Clients must begin a daily supplement of vitamin A for 1 month prior to initiating therapy.
- D. Female clients must have a negative mammogram prior to beginning therapy.
Correct Answer: B
Rationale: The correct answer is B: Sexually active female clients must use two forms of birth control during treatment. This is a requirement of the IPLEDGE program for isotretinoin due to the teratogenic effects of the medication. Isotretinoin can cause severe birth defects if taken during pregnancy, so using two forms of birth control is crucial to prevent pregnancy while on the medication. This requirement aims to ensure the safety of the fetus.
Choices A, C, and D are incorrect because they are not specific requirements of the IPLEDGE program for isotretinoin. A Papanicolaou test every 6 months, a daily supplement of vitamin A, and a negative mammogram are not mandatory components of the program. It is essential to focus on the specific requirements outlined by the IPLEDGE program to ensure the safe use of isotretinoin.
A nurse is caring for a client who has a prescription for morphine 4 mg IM stat. The medication is dispensed in a 5 mg/mL prefilled syringe. Which of the following actions should the nurse take?
- A. Dispose of the excess medication in the sharps container.
- B. Give the full contents of the prefilled syringe.
- C. Discard the excess medication with a second nurse as a witness.
- D. Inject the prescribed dose and save the rest for a later use.
Correct Answer: C
Rationale: The correct answer is C: Discard the excess medication with a second nurse as a witness. The nurse should discard the excess medication in the presence of another nurse to ensure proper disposal and avoid any medication errors or potential harm to the patient. This action aligns with medication safety practices and helps prevent medication errors.
Choice A: Disposing of the excess medication in the sharps container is incorrect because it does not involve a witness for proper disposal and may not follow facility protocols.
Choice B: Giving the full contents of the prefilled syringe would result in administering more medication than prescribed, risking harm to the patient.
Choice D: Injecting the prescribed dose and saving the rest for later use is incorrect as it goes against safe medication practices and may lead to errors in dosing.
In summary, choice C is the correct action to ensure safe and appropriate disposal of excess medication, while the other choices may lead to potential errors and harm to the patient.
A nurse is evaluating the laboratory results of four clients. The nurse should report which of the following laboratory results to the provider?
- A. A client who has a prescription for heparin and an aPTT of 90 seconds (30-40 seconds).
- B. A client who has a prescription for warfarin and an INR of 2.0 (0.8 to 1.1).
- C. A client who has a prescription for heparin and an aPTT of 65 seconds (30-40 seconds).
- D. A client who has a prescription for warfarin and an INR of 3.0 (0.8 to 1.1).
Correct Answer: A
Rationale: The correct answer is A. A client who has a prescription for heparin and an aPTT of 90 seconds (30-40 seconds) should be reported to the provider because the aPTT result is significantly above the therapeutic range, indicating a potential risk of bleeding due to excessive anticoagulation. Heparin therapy requires close monitoring of aPTT levels to ensure the medication's efficacy and safety. Reporting this result promptly to the provider allows for timely adjustment of the heparin dosage to prevent complications.
Choices B, C, and D are incorrect because they fall within or close to the desired therapeutic ranges for the respective medications. Therefore, they do not require immediate reporting to the provider as they suggest appropriate anticoagulation levels.
A nurse is reviewing a list of current medications for a client who is starting therapy with furosemide. Which of the following medications should the nurse identify as being contraindicated?
- A. Levothyroxine
- B. Lithium carbonate
- C. Albuterol
- D. Cetirizine
Correct Answer: B
Rationale: The correct answer is B: Lithium carbonate. Furosemide can cause sodium depletion, leading to increased lithium levels and potential lithium toxicity. Levothyroxine (A) is not contraindicated with furosemide. Albuterol (C) may increase the risk of hypokalemia when used with furosemide but is not a contraindication. Cetirizine (D) does not have significant interactions with furosemide.
A nurse is collecting data from a client who is taking sumatriptan. Which of the following reports indicates a therapeutic response to the medication?
- A. Improved mood
- B. Absence of headache
- C. Increased bone mass
- D. Relief of chest pain
Correct Answer: B
Rationale: The correct answer is B: Absence of headache. Sumatriptan is commonly used to treat migraines. A therapeutic response would be the absence of headache, indicating that the medication is effectively managing the client's migraine symptoms. Improved mood (A) is not a direct indication of sumatriptan's effectiveness. Increased bone mass (C) is unrelated to sumatriptan's intended use for migraines. Relief of chest pain (D) is not a typical response to sumatriptan. Therefore, the absence of headache is the most relevant indicator of a therapeutic response to sumatriptan.