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A nurse is talking with a client who has been taking levothyroxine to treat hypothyroidism. The nurse should instruct the client to avoid taking which of the following over-the-counter medications within 4 hr of taking levothyroxine?
- A. Fish oil supplements
- B. Bulk-forming laxatives
- C. Oral antihistamines
- D. Calcium supplements
Correct Answer: D
Rationale: The correct answer is D: Calcium supplements. Calcium can interfere with the absorption of levothyroxine, reducing its effectiveness. It is recommended to avoid taking calcium supplements within 4 hours of levothyroxine to ensure proper absorption. Fish oil supplements (A), bulk-forming laxatives (B), and oral antihistamines (C) do not typically interfere with levothyroxine absorption, so they are safe to take without waiting 4 hours.
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A nurse is collecting data from a client who is experiencing oxycodone toxicity. Which of the following findings should the nurse expect?
- A. Tachypnea
- B. Sedation
- C. Dilated pupils
- D. Tachycardia
Correct Answer: B
Rationale: The correct answer is B: Sedation. Oxycodone is an opioid that depresses the central nervous system, leading to sedation as a common manifestation of toxicity. Tachypnea (A) is more commonly associated with opioid withdrawal rather than toxicity. Dilated pupils (C) are more indicative of stimulant toxicity, not opioids. Tachycardia (D) is unlikely with oxycodone toxicity due to its depressant effects on the cardiovascular system. Other choices are not relevant to oxycodone toxicity.
A nurse in a provider's office is reviewing the laboratory findings of client who has been taking gemfibrozil for 3 months. Which of the following findings should the nurse expect?
- A. Increased serum creatinine
- B. Reduced serum calcium
- C. Increased Hgb
- D. Reduced triglycerides
Correct Answer: D
Rationale: The correct answer is D: Reduced triglycerides. Gemfibrozil is a lipid-lowering medication that works by decreasing triglyceride levels. The nurse should expect a reduction in triglycerides as a therapeutic effect of the medication. Option A (Increased serum creatinine) is incorrect as gemfibrozil typically does not affect creatinine levels. Option B (Reduced serum calcium) is incorrect as gemfibrozil does not impact calcium levels. Option C (Increased Hgb) is incorrect as gemfibrozil does not directly affect hemoglobin levels. Therefore, the nurse should anticipate a decrease in triglyceride levels as the expected finding in a client taking gemfibrozil.
Nurses Notes 0830: Walk-in clinic visit for adolescent client who is accompanied by their guardian. The guardian states, 'My child has a partner, and I want to be sure that they have some birth control before becoming sexually active': The client states, 'I want to be sure I don't get pregnant or get an STI.' 0915: Witnessed consent signed by client and guardian. Assisted provider with placement of intrauterine device (IUD). Client tolerated procedure well. Provider Prescriptions 0930: Human Papillomavirus (HPV) vaccine, administer first dose today IM
Which of the following client statements indicate that the nurse's reinforced teaching about the immunization was effective? Select all that apply.
- A. I need to have a blood test when I'm an adult to see if I'm still immune.
- B. This shot will keep me from getting herpes.
- C. Now I won't need to worry about having pap smears.
- D. I need to come back in 2 months for another shot.
- E. I will need a booster shot every 10 years.
- F. This shot can prevent me from getting some kinds of cancer.
- G. My partner should get this shot too.
Correct Answer: D, F, G
Rationale: The correct answers are D, F, and G. This indicates effective teaching because client D shows understanding of the need for a follow-up shot. Client F understands the preventive benefits against cancer. Client G recognizes the importance of their partner also getting the shot. Other choices are incorrect because client A confuses immunity with immunization timing, B and C show misunderstandings about the shot's purpose, and E is inaccurate about the frequency of booster shots.
A nurse is reinforcing teaching with a client who has pancreatitis and a new prescription for pancrelipase. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will take this medication whole.
- B. I can expect this medication to cure the pancreatitis.
- C. I should discontinue the medication if I develop fatty stools.
- D. I will take this medication at bedtime.
Correct Answer: A
Rationale: The correct answer is A: "I will take this medication whole." This is correct because pancrelipase should be taken whole to ensure the proper release of enzymes in the small intestine for digestion. Option B is incorrect because pancrelipase does not cure pancreatitis but helps with digestion. Option C is incorrect because fatty stools are expected side effects of pancrelipase and not a reason to discontinue the medication. Option D is incorrect because pancrelipase should be taken with meals or snacks, not specifically at bedtime.
A nurse is reviewing the allergies of a client who has rheumatoid arthritis prior to administering celecoxib to the client. The nurse should identify that which of the following allergies is a contraindication for receiving this medication?
- A. Sulfonamides
- B. Shellfish
- C. Fluoroquinolones
- D. Peanuts
Correct Answer: A
Rationale: The correct answer is A: Sulfonamides. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) and belongs to the class of sulfonamides. Patients allergic to sulfonamides are at risk of cross-reactivity with celecoxib, leading to severe allergic reactions. Shellfish (B), fluoroquinolones (C), and peanuts (D) are not related to the mechanism of action or composition of celecoxib, so they are not contraindications. It is important for the nurse to identify sulfonamide allergies to prevent adverse reactions in patients receiving celecoxib.