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A patient has received a new prescription for levothyroxine. Which statement made by the patient indicates that the education was effective?
- A. Avoid the use of iron supplements.
- B. Consume foods that are high in iodine.
- C. Take medication on an empty stomach.
- D. Administer levothyroxine at bedtime.
Correct Answer: C
Rationale: Levothyroxine should be taken on an empty stomach (C), 30-60 minutes before breakfast, for optimal absorption. Iron supplements (A) should be timed separately, not avoided. High-iodine foods (B) don’t enhance efficacy. Bedtime dosing (D) is less effective than morning.
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A client taking atorvastatin has an increased serum creatine phosphokinase (CK) level. What should the nurse assess the client for?
- A. Excessive bruising.
- B. Peripheral edema.
- C. Muscle tenderness.
- D. Nausea and vomiting.
Correct Answer: C
Rationale: Elevated CK with atorvastatin indicates possible myopathy, causing muscle tenderness (C). Bruising (A) is unrelated to CK. Edema (B) suggests other causes. Nausea/vomiting (D) are gastrointestinal side effects, not linked to CK.
A client with type I diabetes mellitus has been prescribed a glucagon emergency kit for home use. When should the nurse instruct the client and family to administer glucagon?
- A. Prior to meals to prevent hyperglycemia.
- B. When symptoms of severe hypoglycemia are present.
- C. When the client is unable to eat during sick days.
- D. At the onset of symptoms of diabetic ketoacidosis.
Correct Answer: B
Rationale: This question is identical to Question 25. Glucagon is for severe hypoglycemia (B), not hyperglycemia (A), sick days (C), or ketoacidosis (D). Note: Duplicate question; consider removing.
A patient in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system to manage asthma. This system delivers an inhaled powdered form of these combined medications. What instruction should the nurse provide to this patient’s caregivers?
- A. Instruct the patient to exhale rapidly into the mouthpiece when using the discus.
- B. Explain that the patient should not use the discus more than twice daily.
- C. Inform that patients using the discus may experience a decrease in blood pressure.
- D. Suggest offering the discus to the patient for use during an acute asthma attack.
Correct Answer: B
Rationale: Fluticasone/salmeterol is a maintenance therapy, used twice daily (B). Exhaling into the mouthpiece (A) is incorrect; inhalation is required. Hypotension (C) isn’t a common side effect. It’s not for acute attacks (D), which require rescue inhalers.
A female patient who follows a vegetarian diet has recently been prescribed warfarin. She mentions that she consumes leafy green vegetables daily. What should be the nurse’s response?
- A. Praise the patient for her healthy lifestyle and encourage her to maintain her current dietary habits.
- B. Assure the patient that her dietary choices will enhance the effectiveness of the medication in preventing blood clots.
- C. Inform the patient that her healthcare provider needs to be informed about her current diet.
- D. Recommend that the patient substitutes the leafy vegetables with a protein source like nuts or beans.
Correct Answer: C
Rationale: Leafy greens, high in vitamin K, can reduce warfarin’s anticoagulant effect. Informing the provider (C) ensures dose adjustment. Praising (A) or assuring enhanced efficacy (B) ignores the interaction. Substituting vegetables (D) is unnecessary with proper monitoring.
The nurse is preparing a discharge teaching plan for a patient who is taking ciprofloxacin hydrochloride tablets due to suspected anthrax exposure. What instructions should be included in the teaching plan?
- A. Crush and mix the tablets with pudding if you have trouble swallowing the tablets.
- B. Increase fluid intake while taking the medication.
- C. Use nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve mild joint aches and pains caused by the medication.
- D. Report any tendon pain or swelling to the healthcare provider immediately.
- E. Limit exposure to sunlight and avoid tanning beds.
Correct Answer: B,D,E
Rationale: Ciprofloxacin requires high fluid intake (B) to prevent crystalluria, immediate reporting of tendon pain/swelling (D) due to rupture risk, and sun protection (E) due to photosensitivity. Crushing tablets (A) alters release, risking side effects. NSAIDs (C) increase seizure risk with ciprofloxacin.